From IMPOWER 022 to INSIGHT: HIV PrEP Still in Focus

Simon at the INSIGHT study site at the Kamwala Health Center in Kamwala, Lusaka, Zambia.
Simon at the INSIGHT study site at the Kamwala Health Center in Kamwala, Lusaka, Zambia.

It isn’t sheer happenstance. No. I don’t believe it. Doing my practicum with UNC’s Global Projects Zambia (UNC GPZ) comes to me like a déjà vu. When I was researching UNC, I learned about the summer practicum placements which are compulsory. I knew that I did not want to do my practicum in the US or Europe. It had to be Africa. I started eyeing opportunities that would bring me back to Africa right from the time I got accepted into UNC. I fixed my gaze on Lilongwe and Lusaka. I even started reaching out to professors about possible opportunities in South Africa. Later, other exciting opportunities came up – Uganda and Tanzania. For some reasons, I had to give up all other opportunities and head South of Africa.

Initially, I was going to work with IMPOWER 022 which is a third phase clinical trial project. This project assessed a promising once-monthly Pre-Exposure Prophylaxis (PrEP) drug against HIV as a substitute for the current daily regimen which presents adherence challenges due to the frequency of intake required for efficacy. An ideal PrEP should work like a contraceptive – offering choice–thus allowing for a single jab or swallow to last effectively for a longer period.  For some reasons, IMPOWER 022 is currently on hold in the Zambia study site even though it is continuing in other sites.

So, INSIGHT, another study which is just starting off is the one I got involved in. Led by researchers from the University of Washington and the University of North Carolina at Chapel Hill and funded by the Bill & Melinda Gates Foundation, INSIGHT aims to advance PrEP discovery and delivery for African women. It will be a multi-site study based in eSwatini, Kenya, Malawi, South Africa, Uganda, Zambia, and Zimbabwe.

I will be fortunate to participate in and learn more about the regulatory process since this project is just starting out with preparatory work being done to meet various IRB requirements here in the United States and in Zambia. My second objective is to understand the community engagement process in Zambia which yields high enrollment rates for various studies in the past. I am interested in understanding the strategies adopted and implemented by the Zambian research team in achieving low attrition and high retention of study participants.

Localization and decolonization of Global Health is an area that interests me most. The UNC Global Projects Zambia hub is a classic example of how global health can be decolonized, and I am excited to be part of this network at this juncture of my career and studies.

I am thankful to my faculty advisor Prof. Suzanne Maman, the Director of UNC GPZ, Dr. Margaret Kasaro, and the Vice Chair of Research and Innovation at the UNC Department of Obstetrics and Gynecology, Dr. Ben Chi, for the opportunity and mentorship before and at the commencement of my internship. I have learned so many valuable lessons thus far and find this opportunity as one that would open many doors for my public health career in the foreseeable future.