Researchers at the Yale School of Public Health are teaming up with colleagues at the University of Puerto Rico to improve access to testing, treatment and care for people living with HIV in the capital city, San Juan.
With support from the National Institutes of Health, the Yale Center for Interdisciplinary Research on AIDS (CIRA) and the University of Puerto Rico Medical Sciences Campus (UPR-MSC) are launching two projects designed to address Puerto Rico’s urgent HIV problem as part of the federal government’s Ending the HIV Epidemic initiative. The new grants are supported by an NIH program that aims to facilitate HIV implementation research in high-burden areas in the United States.
In the first project, a collaborative research team will work with men and women with HIV in San Juan to assess the feasibility of providing rapid oral fluid HIV self-test kits to partners of people living with HIV and to identify ways of overcoming existing barriers to treatment. Through focus groups and meetings, the team will also assess the feasibility of initiating Pre-Exposure Prophylaxis for HIV-negative partners.
“We are very excited about the ways in which these supplements will allow us to build a collaborative relationship with our partners at the University of Puerto Rico, while addressing some of the “Pillars” (Diagnose, Treat, Protect, and Respond) of the Ending the Epidemic initiative,” said Paul Cleary, the Anna M.R. Lauder Professor of Public Health, director of CIRA, and Yale’s principal investigator on the self-testing study.
The project is supported by a $172,000 grant from the National Institutes of Health (NIH).
In the second project, the researchers will develop education materials to increase awareness of the Undetectable=Untransmissible campaign among people living with HIV in San Juan. The materials will be introduced to care providers that support people living with or at risk of HIV to enhance their knowledge and skills related to the federal “Treatment as Prevention” initiative and U=U message, which signifies that individuals with HIV who have achieved an undetectable viral load through antiretroviral therapy (ART) cannot sexually transmit the virus to others. The program will later be evaluated for possible expansion to a larger group of stakeholders.
YSPH Professor Trace Kershaw is Yale’s Principal Investigator on the study, which is supported by a separate $172,000 grant from NIH.
“This second project will be an almost ideal complement to the first project and together, they will significantly increase our knowledge about how best to diagnose and treat vulnerable individuals in Puerto Rico,” Cleary said.
The University of Puerto Rico MSC research team is represented by Dr. Carmen Zorrilla, a leading HIV researcher and professor of obstetrics and gynecology at the UPR School of Medicine; Associate Professor Silvia Rabionet, of the UPR Graduate School of Public Health; and Assistant Professor Marcilyn Colón-Colón of the UPR Graduate School of Public Health. They have partnered with several organizations who provide care to people living with HIV and an organization of patient activists as well. The first project was proposed by the partners of patients receiving care as an alternative to testing at clinical facilities.
[These projects] will significantly increase our knowledge about how best to diagnose and treat vulnerable individuals in Puerto Rico.
Paul Cleary
The Yale Center for Interdisciplinary Research on AIDS is New England’s only AIDS research center funded by the National Institute of Mental Health. Faculty from Yale’s schools of public health, medicine, law and nursing, as well as the Yale Graduate School of Arts & Sciences contribute to CIRA research.
Yale University, particularly the Yale School of Medicine, has a long history of working for the betterment of Puerto Rico.
In 2006, Daniel Colón-Ramos, an associate professor of neuroscience and cell biology in the School of Medicine and an outspoken advocate for strengthening Puerto Rico’s policies through rigorous science and evidence-based practices, founded the nonprofit organization, Ciencia Puerto Rico. The organization seeks to promote scholarly interaction and support research and science education in Puerto Rico. Under the leadership of Yale scientist Giovanna Guerrero-Medina, Ph.D., CienciaPR has become one of the largest networked communities of Hispanic scientists in the world. In 2015, Guerrero-Medina launched the NIH-funded Yale Ciencia Academy for Career Development. The academy offers a free year-long program that provides biomedical and health sciences Ph.D. students at Yale and across the U.S. with mentoring, peer support and networking opportunities to help them advance their careers and contribute to their communities through science.
In 2017, after Hurricane Maria ravaged the island, Dr. Marietta Vazquez, an associate professor of pediatrics at Yale, organized a community-wide relief effort that resulted in over 100,000 pounds of humanitarian assistance—including 15,000 pounds of antibiotics, gauze, surgical kits, medications and other medical supplies—to be airlifted to Puerto Rico.
You can learn more about Hurricane Maria’s long-term impact on Puerto Rico’s health care system by listening to this New England Journal of Medicine 2017 interview with Dr. Zorilla: https://www.nejm.org/doi/10.1056/NEJMp1713196.
“We are most pleased to grow our partnership with the University of Puerto Rico, Ciencia Puerto Rico, and the city of San Juan. Over 7 percent of the population of Connecticut is of Puerto Rican ancestry, the highest proportion of any U.S. state,” said Sten H. Vermund, dean of the Yale School of Public Health.