Like so many adaptations made over the past year and a half, the prospect of a remote practicum left me feeling some sense of trepidation. How could I build relationships with work counterparts over Zoom? Would I be able to meaningfully contribute to my practicum organization from an apartment in Chapel Hill? Still, coming to Gillings after several years working in rural Panamá, I was eager to continue honing my global health experience in Latin America – and I’m fortunate to have the opportunity to do so this summer, as I begin supporting a research collaboration with Colectivo Amigos Contra el SIDA (Friends Against AIDS Collective, or CAS), a Guatemala City-based NGO that provides sexual health services for gay and bisexual men, who bear a disproportionately high burden of HIV infection in Guatemala. While the broader global health field, amidst the pandemic, has rightfully reflected on the necessity of boarding airplanes simply to foster productive international partnerships, I am excited to navigate these new challenges during a remote practicum with CAS. After all, every learning experience carries its unknowns and uncertainties.
In Guatemala, a country of nearly 17 million people, CAS is the only entity that provides HIV pre-exposure prophylaxis (PrEP) – and does so free of charge. In my practicum, I join a long-term collaboration between CAS and UNC researchers. Regular PrEP use is highly effective in preventing HIV transmission, but currently formulated as a daily medication, the logistics of taking PrEP can be onerous. This is only exacerbated by the social stigmas attached to PrEP use and sexual orientation. To address some of these concerns, CAS is partnering with UNC researchers to design a mobile app to serve as a kind of “one-stop shop” for PrEP information: anonymous peer-to-peer communication between PrEP users, information provided by medical providers, and clinical appointment reminders. I will be contributing to data collection about the preferences of CAS’s clinical clients and providers for the app.
Here is probably the point at which I should note that this is my first foray into public health research. I have an undergraduate degree in philosophy, but it was only after gaining practical exposure to HIV education, sustainable agriculture, and water and sanitation issues in the course of my time in Panamá that I felt the pull of global health. Yet the research enterprise is new to me, even as research holds immense value for community-based organization like CAS as they evolve to provide new services, like PrEP. Fortunately, I’ll have some latitude, taking part in – and really, learning about as I go – a range of research methods. On the qualitative side, I’ll conduct in-depth interviews with CAS staff about PrEP and their perspectives on using a mobile app. On the quantitative side, I’m helping to create the survey for PrEP users at CAS and analyze earlier survey data. Besides deepening my professional focus in Latin America, I look forward to gaining this broad experience with the full breadth of qualitative and quantitative skills while forming part of a multinational team.
At the moment, we’re waiting on Institutional Review Board (IRB) approvals at UNC and in Guatemala to begin engaging directly with participants. As much as my instinct is to jump in without looking, such approval processes are of course intended to protect people and their health – the ultimate aim of public health. Just as the pandemic has led me to reconsider the value of hopping on an airplane to “do” global health work, I’m coming to value pace and patience in global health research. Even here at a distance, I can still strive to learn something new every day.