**7. Conclusion and recommendations**

In this study, an exhaustive review of literature on the epidemiology and determinants of HIV/AIDS transmission has been organized into a repository from which relevant data for building the dynamic epidemiologic models was derived. The results of epidemiologic models can be used to provide important insights into HIV/AIDS transmission dynamics at the macro (human population) level and to evaluate alternative HIV/AIDS prevention and control strategies. Thus, dynamic epidemiologic modelling is an essential research tool that scientists can employ to make prediction estimates of current prevalence and future incidence of HIV/AIDS cases. Computational models can be used to examine alternative strategies for effective interventions that lead to better planning and policy-making for all disease control and prevention efforts.

Despite knowledge of their status, PLWHA are continuing to engage in HIV/AIDS-risky behaviors. Understanding the multiple variables that impact on HIV/AIDS-risky behaviors among PLWHA will be critical in the search for alternatives to the way in which these problems are addressed at the present time. Psychosocial factors and substance abuse variables, which play a significant role in HIV/AIDS-risky behaviors, may contribute to the high probability of HIV/AIDS transmission. Cross-disciplinary research – to include advanced knowledge of basic and applied psychological and social research and the manners in which they interact together – is needed to develop effective HIV/AIDS prevention and control strategies. Scientists interested in HIV/AIDS research can employ these correlation findings to identify factors that covary with behaviors that put people at risk for negative outcomes.

Recognizing that the impact of HIV/AIDS is not only biological but psychosocial in nature, intervention programs, including education and counseling, must be designed holistically to address the complex challenges faced by PLWHA. This population should be offered or provided a comprehensive set of psychosocial interventions at all levels of the health system. In particular, depression-related issues for PLWHA should be addressed and specific psychosocial and psychotherapeutic interventions should be provided to more effectively address associated alcohol and other substance abuse problems. Based on the findings of this study, our recommendations are as follows to identify and create effective strategies to reduce HIV/AIDS and ultimately eliminate this devastating pandemic: 1) Create dynamic epidemiologic models that integrate SES and psychosocial variables as they are required to explore the epidemiology of HIV/AIDS; 2) Use epidemiologic models to address the social determinants of health as these factors are critical to reduce and eliminate HIV/AIDS and other health disparities; 3) Advance research to examine the resistance to behavior change as well as the motivation for behavior change as these factors also are central to the design of effective HIV/AIDS prevention and intervention strategies; 4) Develop cross-disciplinary research that includes advanced knowledge of basic and applied psychological and social research and the ways in which they interact together; and 5) Encourage strong collaborations among researchers, policy-makers, and communities to identify and address biomedical, behavioral, and psychosocial factors that are responsible for the risky sexual behaviors that ultimately result in further transmission of HIV/AIDS.
