Leveraging HIV in Curricular Innovation at Spelman College

In this “flat” world, interdisciplinary practices, which often involve problem-solving, have become increasingly essential. The traditional disciplinary practices of many academic institutions are restrained by their approaches to problems, use of theory, and traditional questions. Problem-solving, by its complexity and natural demand for expansive thinking, invites interdisciplinary thought. Commonly, social issues have been theorized to “come in ‘layers’ that need to be separated and analyzed, but solutions usually need to be comprehensive, addressing the problem as a system, not as pieces” (Davis as cited in Latucca, 2004). Industrial and governmental institutions have long embraced and implemented interdisciplinarity into research given their emphasis on teams and problem-driven research. Institutions such as the National Science Foundation and the National Academy of Sciences have convened special initiatives and calls to document strategies and suggestions for producing interdisciplinary “friendly” environments at colleges and universities. Institutions are strongly encouraged to produce students who can readily engage in teams across sectors (Rhoten, Mansilla, Chun & Klein, 2007).

The increase in academic publications and conferences pertaining to interdisciplinarity throughout the college and university curriculums is a clear indicator of its continuing and growing prominence. Moreover, institutions of higher education have implemented numerous initiatives to facilitate seamless transitions of students from academe into interdisciplinary work settings.

Spelman College has been and continues to be proactive in seeking to create an environment of cross-academic collaboration supporting the integration of interdisciplinarity in traditional course curriculum and the creation of interdisciplinary courses and seminars. The purpose of this article is to discuss how the examination of research questions and educational content on HIV/AIDS has been used to leverage curricular modification and innovation at Spelman within four disciplines.

Justification for using HIV/AIDS as a topic

Spelman College is a historically black college and an elite global leader in the education and enlightenment of women of African descent. It is therefore culturally important for the authors to explore one of the most critical social issues that has negatively impacted the African and African-American community specifically—HIV/AIDS. The authors also chose a disease on which each had conducted extensive research.

HIV and AIDS have had a disproportionate impact on the African-American and African communities. In 2009, blacks/African Americans made up approximately 13% of the population of the 40 states but accounted for 52% of diagnoses of HIV infection (CDC, 2011). Further, in 2009, though adult and adolescent black/African-American females made up 14% of the female population and white/Caucasian females made up 71% of the female population, the percentage diagnoses of HIV infection among females for the two population groups were 66% vs. 17% respectively.

African-Americans have continued to have the highest rate of AIDS diagnoses as a race/ethnic group, replacing whites since the early 1990’s. The diagnosis rate in 2009 of African Americans living with AIDS was higher than that of all other races, and the rate of AIDS diagnoses for black women was 22 times the rate for white women (CDC, 2011).

HIV and AIDS have had an even more crippling impact on blacks living on the continent of Africa. UNAIDS reported that the highest prevalence rates of HIV/AIDS can be found in Africa’s developing countries, which represent only a small percentage of the global population (Joint United Nations Programme on HIV/AIDS, 2010). In both the African-American and African communities, the disease continues to disproportionately affect young women between the ages of 15 to 25. Lack of education, limited access to treatment, homelessness, poverty and distrust of the medical establishment are cited as the primary causal reasons for the continued disproportionate impact to the African-American and African communities. However, national and international organizations such as the Centers for Disease Control and Prevention (CDC), the National Minority AIDS Council, and the World Health Organization (WHO), cite the role of new and innovative research and increased HIV/AIDS knowledge exposure as being inextricably linked to the successful abatement of this life-threatening disease in African-American communities. These recommendations suggest the strong need for potent leadership and education around HIV/AIDS within the African-American community. In response to this need, the authors developed interdisciplinary seminars, course modules, and full courses designed to introduce Spelman students to current trends, theories, and proposed solutions in HIV/AIDS research. This paper presents two projects undertaken at Spelman that utilize HIV for interdisciplinarity pedagogy.

Project 1:Increasing the Awareness of HIV and AIDS to Prepare Emerging National Leaders Interdisciplinary Seminar

The Increasing the Awareness of HIV and AIDS to Prepare Emerging Leaders seminar uses an interdisciplinary approach to increase the awareness and intellectual knowledge of African-American women and women of color about the progression and prevalence of HIV/AIDS and impact of the disease on their communities. The primary purpose of the course is to build the professional competence of individuals from underrepresented groups to serve as future leaders. This seminar is geared toward the education of undergraduate students regarding three principle areas in which HIV and AIDS affect women of African descent: biology, psychology, and economics.

Biology and AIDS

The integration of biology as a discipline into interdisciplinary courses is well-documented in the education literature (Gross 2000, 2004). The diversity within the discipline serves to build bridges with core content in the natural sciences, humanities, and fine arts. The current model seeks to build from strategies and pedagogy outlined in the literature.

Understanding the biological constructs that mitigate the virulence of the human immunodeficiency virus is of extreme importance when educating students about the infection. These constructs also have profound effects on the prevention, diagnosis, spread, and treatment of HIV. The delivery of this information in an interdisciplinary course at the undergraduate level augments more traditional pedagogical practices. Some educators also would agree that the amount of content presented should also be limited to avoid information overload and non-integration of core concepts needed to solve complex problems (Ben-Shlomo, 2002; Hoskins, 2009). In keeping with Project 2061 of the American Association for the Advancement of Science (AAAS), the goal of the biology section for the interdisciplinary HIV course will be to reduce the number of major topics taught, prune unnecessary details or subtopics, de-emphasize technical vocabulary and eliminate repetition. In so doing, we hope to have a greater impact on the delivery and conceptual understanding of HIV by our students (Frat, 2002).

Our curriculum for the biology section of the seminar is designed to embrace a studio/student-centered pedagogy that will be the first discipline covered during the semester. Allowing time for the synthesis, manipulation, and analysis of information presented fosters critical thinking and mastery of competencies deemed necessary for solving complex problems. Examples of the goals and objectives of this module are:

• To increase undergraduate awareness of the molecular and structural aspects of the human immunodeficiency virus (HIV) physiology, diagnosis, and treatment;
• To increase undergraduate awareness of the development of acquired immunodeficiency syndrome and the opportunistic infections which are commonly associated with the syndrome;
• To increase undergraduate awareness of the impact of physiology and treatment on underserved communities at the local, national, and international level;
• To list steps of the HIV reproductive cycle; and
• To explain the relationship between viral load and T-cell count.

Psychology and AIDS

Living with HIV/AIDS has unique psychological implications. Following the initial diagnosis, many women must confront how to disclose their health status to their partners, children, family and friends; added to this is the difficulty of coping with the social stigma associated with the disease, embarking on the strict, lifelong medical regimen, and dealing with their personal response to living with a potentially life threatening illness (Fiest-Price & Wright, 2003; Olley, B. O., 2006; Wingood , et. al, 2007). For some women, this burden can create challenges that may lead to negative psychological outcomes, including depression. The consequences of poor mental health in women living with HIV/AIDS are far reaching. In addition to compromising their ability to adhere to medical care practices, family and work functioning are limited, quality of life is decreased, and the occurrence of HIV-related illnesses is increased (Fiest-Price & Wright, 2003; Olley, 2006; Wingood , et. al, 2008).

The psychology of HIV/AIDS component of this curriculum aims to introduce emerging scholars to literature, media, and activities that will provide a foundation from which they can explore the question of how to best promote and support positive mental health outcomes in women living with HIV. From the vantage point provided by evidence in psychology and public health and popular media, students are asked to read seminal articles authored by African and African-American researchers examining mental health and HIV in Africa and the U.S., to respond to challenging questions about how depression and other mental illnesses affect the trajectory of HIV, to critique American and South African narrative films depicting women living with HIV, and to create original works that explore the psychosocial implications of HIV/AIDS (including white papers, blog pages, and fact sheets).

These activities are designed to help students meet the following goals:

• To increase undergraduate understanding of how living with HIV/AIDS affects women’s psychological and social functioning;
• To increase undergraduate understanding of how family, intimate relationships, and other social relationships assist with the coping of the disease;
• To compare and contrast the psychosocial challenges of living with HIV/AIDS faced by women living in the U.S. and women living in sub-Saharan Africa; and
• To increase undergraduate understanding of the mental health sequelae associated with living with HIV/AIDS (PLWHA).

Economics and AIDS

Economics is a discipline that examines the production and consumption of goods and services in society and the choices behind the distribution of these goods and services. The economics of AIDS can therefore, for example, provide insight into an individual’s decision to engage in risky behaviors leading to an increased exposure to HIV such as unprotected sex and using unclean needles for intravenous drug use (Conrad and Doss, 2008); it can address the micro-level impact of AIDS on the consumption and saving decisions of households or the expenditure decisions of businesses and the government, the macro-level consequences of AIDS on the skilled labor force, and the relative efficiency of HIV and AIDS prevention and treatment programs to mitigate negative individual and societal health impacts.

The economics component of the seminar will explore how AIDS can have a greater impact on African-American and African women through the interaction of race and gender contexts. The course will specifically examine how the impact of AIDS is influenced by the socio-economic conditions of poverty that can be prevalent in communities and countries of color, by the reduced female sexual bargaining power that can be present in African communities, and by the incorporation of informal non-market labor activities such as care-giving and household care and household production of food (especially in developing countries) into economic analyses. In addition to lectures, reading of academic journal articles, guest speakers, and reflective writing, the economics component utilizes the case-study method of learning to review how economists and public health scientists translate changes in individual behavior into biological outcomes used in economic evaluations.

The objectives of the module are:

• To increase undergraduate awareness of the economic impact of AIDS on households, businesses, and government;
• To increase undergraduate awareness of the impact of AIDS on a developing country’s economy;
• To demonstrate the indirect influence of AIDS on long-term economic development due to the increased number of orphans, diminished skilled labor force, and reduced non-market activities; and
• To demonstrate how an economic evaluation is conducted on an HIV/AIDS intervention programs.

Project 2: Computer-based Learning in Chemistry

Similar to biology, chemistry can be used to extend the HIV conversation at the molecular level. Interdisciplinarity, in this instance, is approached as chemistry majors learn to leverage the knowledge of other disciplines to address a defined problem (in this case HIV). The HIV conversation in chemistry has been introduced through cheminformatics which by its nature does the following: addresses analytical, computational, and critical thinking skills; promotes a collaborative, student-centered learning environment; and implements project-based learning that is aided by computational modules. With this framework, a HIV module was developed for the medicinal chemistry course.

In the module, the students explore the molecular structure of the HIV-1 protease active site. This is accomplished qualitatively by accounting for the amino acid residues that are present. In addition, students determine the binding energies of HIV in its wild-type (original) and mutated forms when bound to the known HIV protease drug indinivir. The energies provide needed information that explains drug resistance or why some drugs may lose their effectiveness. To further illustrate this point, the students calculate the interaction distances between key residues for each HIV form. Student learning outcomes were assessed through pre and post quizzes and written report.

The objectives of the project are to:

• Make course material relevant and accessible;
• Broaden students’ understanding of the global impact of chemistry;
• Strengthen their ability to develop logical conclusions based on their analysis of data;
• Assist students to demonstrate an improved competency, which will assist them in communicating scientific information effectively;
• Develop in students the confidence needed to discover knowledge autonomously; and
• Enable students to apply the skills acquired in the course to solving problems in related areas.

Summary

Several departments at Spelman College (Chemistry, Economics, Biology and Psychology) have created interdisciplinary HIV-related course modules and projects which have drawn heavily upon each author’s past participation in the Faculty Research Network at New York University. The materials include several computational modules/case-studies and service learning projects which have been incorporated into the broader college curriculum. The components have been integrated into the HIV in Africa, Medicinal Chemistry, and Mammalian Physiology courses and the Increasing Awareness of HIV and AIDS to Prepare Emerging Leaders Seminar at Spelman College. Class materials included several computational modules/case-studies and service learning projects. The authors have recognized the benefit of interdisciplinarity in promoting thinking skills such as analysis, synthesis, expert evaluation, and self-evaluation using methods of debating and techniques designed for self-motivation (Lattuca, 2004, Newell, 1994). The authors have also expanded their understanding of HIV/AIDS to be inclusive of evidence from disciplines outside our own, resulting in more comprehensive and compete framework for our individual work.