Monthly Archives: March, 2021

Author: Kendall Lucero (MCH MPH ’22)

I recently received a grant from the UIC Center for Global Health to attend the HIV Research for Prevention Conference in February. The conference included a range of experts talking about HIV vaccines, microbicides, PrEP (pre-exposure prophylaxis), treatment as prevention, and biomedical interventions. These strategies represent evolving breakthroughs in the HIV pandemic, including providing medication options like PrEP that people can take to prevent infection from HIV even if exposed to the virus. I was excited to be able to engage with experts in the field of HIV research, which still represents a major portion of the global disease burden. As I continue to explore the intersection of global health and maternal health, I hope to integrate strategies to prevent and treat HIV. Using the Life Course perspective, we can account for the benefits the current population over time, as well as the additional dividends for the next generation. For example, understanding evidence-based interventions for dealing with HIV in the perinatal population can prevent mother-to-child viral transmission. Outside of the domestic context, the transformative power of preventing new HIV infections can have lasting impacts on the physical, mental, and economic health of countries with high HIV prevalence.

The opening session included an appearance from Dr. Fauci from his perspective as a practitioner during both the HIV and COVID-19 pandemics. One of the most salient parallels that he gave was the structure of the domestic and international research networks that ultimately led to effective treatment and prevention strategies. Specifically, the collaboration of researchers from multiple disciplines on the same teams (i.e. virologists, epidemiologists, and structural biologists working towards the same vaccine) was a major factor. Additionally, he highlighted the importance of engaging the communities most affected by disease in research. This is an essential component to ensure that effectiveness of treatments/vaccines in the lab lead to efficacy in the community setting. I appreciate the curricula within the Community Health Science Division for the emphasis on community engagement in research strategies. Learning more about the history and present-day structure of vaccine research design, including the registration of all clinical trials, will be very helpful to me going forward. Understanding how public health responses to pandemics, especially when they overlap, can help contextualize the current moment as I begin the next stage of my career.

The future direction of PrEP was a major theme of the conference overall. One session, “PrEP via Novel Delivery Systems,” focused on different forms of PrEP that are currently being studied. One group, backed by Gilead, is working on an injection of PrEP that can provide protection for up to one month. Gilead is responsible for producing most of the world’s PrEP pharmaceuticals under the brand name Truvada. Investing in the development of new options for PrEP delivery is an important strategy for user-based clinical care along the HIV continuum. Another strategy was trying to put PrEP in the same device (trocar) as the Implanon hormonal implant. There is even a possibility of putting PrEP and hormonal contraception in the same implant, so patients could be simultaneously protected from HIV and unwanted pregnancies. The adaptation and influence of contraception methods has shaped the demand for the development of HIV prevention drugs. The prospect of combining contraception and PrEP is very exciting, especially for people in lower-to-middle income countries with poor health infrastructures. The added convenience of a “one-stop shop” options for HIV and unwanted pregnancy prevention could significantly increase uptake of PrEP without sacrificing the primary health care delivery for vulnerable populations. Going forward, I am excited to see how health experts can integrate family planning and HIV care towards a more holistic and patient-friendly model. Hopefully, the growing availability of comprehensive and long-acting HIV prevention methods will increase uptake amongst the highest risk populations globally as these products are approved and scaled up.

Finally, I attended a session titled “Promoting HIV Prevention Among Black and African Migrants in North America, Europe, and Africa.” Among the speakers who presented, two main themes emerged. The first was migration being the strongest risk indicator for HIV for Black people globally. Working with migrants requires meeting their immediate needs first before strategies such as PrEP and U=U can achieve a population level effect. Secondly, there is a demonstrated need to increase the number and type of stakeholders in HIV prevention work. Some populations that were studied by the presenters included heterosexual men, trans sex workers, and pregnant people. Some of the prevention strategies that were mentioned in this session included expanding capacity for mobile healthcare workers, self-testing for HIV, and telehealth centers. I think that more healthcare services outside of HIV could benefit from these innovative program adaptations. For example, the lack of accessible prenatal and labor/delivery service during the COVID-19 pandemic are causing some families to seek care outside of the traditional hospital setting. As usual, finding solutions that work for the most vulnerable populations benefits all members of the population. I look forward to continue to explore the intersection of HIV and perinatal health during my MCH studies at UIC.

Author: Kate Yep (MCHEPI MPH ’21)

Never in my life would I have expected to pursue a career involving writing code. Even after my first year of classes in the Maternal Child Health Epidemiology (MCHEPI) concentration, I was admittedly insecure about my SAS coding skills. For my Applied Practice Experience (APE), I hoped to work at a health department and analyze data related to a perinatal health topic, since I am fascinated by pregnancy, childbirth, and the unique vulnerabilities this period poses for mothers and infants. My goals were to feel more comfortable in SAS and learn to organize and translate data into an understandable format to support change. I learned that Illinois Department of Public Health (IDPH) was looking for an intern to help develop a new infant mortality report for the state, and I was excited at the possibility to work on that project. I brought to my interview a sample of an infographic I had created in a class during my first semester at UIC to demonstrate my ability to translate raw data into an interesting and easily understandable format. Amazingly, I was chosen to be the IDPH intern for my summer APE. Little did I know, I would receive the best hands-on experience in epidemiology work at IDPH that I could have imagined.

I joined IDPH’s Office of Women’s Health and Family Services to create an updated infant mortality report for the state. I used the state’s vital records to analyze trends, leading causes of death, and risk factors and risk markers in infant mortality. The final report focuses on racial inequities in infant mortality and includes a special analysis called a Perinatal Periods of Risk. This analysis helps clarify where the greatest disparities in fetal and infant mortality lie between two groups and identifies opportunities for intervention. As the report details, if babies of black women in Illinois had fetal and infant mortality rates that were the same as babies of low-risk white women in Illinois, 212 black fetal and infant deaths would be prevented each year. The analysis goes on to suggest that the greatest opportunity to prevent black fetal/infant deaths and reduce racial disparities is to target preconception health, perinatal care, and social determinants of health for black women. Other strategies to prevent infant death include promoting safe sleep practices, breastfeeding, and injury prevention.

While this topic is heartbreaking, my hope is that this report is helpful to partners throughout Illinois and elsewhere working to improve perinatal health and decrease infant mortality and the racial disparities in infant mortality rates.

To any prospective or current student who may feel intimidated at learning a new skill in the MPH program (as I did with SAS), I would encourage you to push yourself to try. You might be surprised to learn what you like and what you can accomplish with a little effort and support. I am thankful to have had the opportunity to work on this important project under a great mentor, Dr. Amanda Bennett, the CDC Assignee in Maternal and Child Health Epidemiology at IDPH. Throughout my internship, Amanda not only helped me plan and execute my analysis, but she also connected me to many other professionals in the field who are passionate about improving maternal and child health (MCH). I am now more equipped and excited to join the MCH field as an applied epidemiologist after graduation.