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Reducing HIV Rates through Community-Based Research


As an aspiring physician, Occidental College graduate Zulema Iboa-Garcia was drawn to Uganda with an eye on further lowering that country’s reduction of new HIV infections. Through the Occidental Richter Scholars Program, she was able to pursue community-based research during the summer of 2017.

Her research took a sociological approach to determine factors affecting retention rates of patients who are HIV positive. While in Uganda, Zulema worked with community members enrolled in the antiretroviral therapy (ART) program at St. Francis Health Care Services. “I had an idea of the research I would be conducting, but it was not until I got to my specific site that I really knew what I would be doing,” she says. “I wanted to ensure that I was fulfilling the needs of the organization I would be working with before coming in with outside expectations.”

As part of her project, Zulema sought to determine factors that affected the retention of clients enrolled in the ART program, which provides both medication and counseling to patients. This was done in two parts; a retrospective quantitative analysis using patient data from January 2011 through December 2016, complemented by a qualitative study using focus group discussions and interviews that began in July 2017.

Zulema’s project focused on improving retention rates. As a result, she recommended sensitizing communities about HIV through the performing arts; educating schools about the negative effects of rumor mongering; debunking myths, and conducting workshops on income generating activities for patients living in poverty. In the short-term, her work provided St. Francis with relevant information that would help staff make these changes. In the long term, Zulema’s project aimed to decrease the high levels of stigmatization both internally and externally while increasing the level of understanding about what it means to be HIV positive.

Understanding the country’s history informed her scope of work and its modalities. Since Uganda’s independence in 1962, it has experienced multiple waves of political unrest. It was not until 1986 and the rule of Yoweri Museveni that the country began to see a positive shift in its economy and government. “From a development perspective this historical context is especially important,” Zulema says, “given that Uganda has also had to face other challenges pertaining to rapid population growth and combating the HIV epidemic. While organizations have been successful in reducing HIV prevalence among adults, there is still much work to be done in other health-related areas.”

“The level of support received from the FSD Program Director, Margaret, and site staff (Jonan especially) was immensely helpful,” Zulema advises. “They handled every situation with care and ease and made sure that we were safe and being looked after. The staff at St. Francis were also very welcoming and willing to help me out with anything I needed.

 With only nine weeks in Uganda, how did Zulema soak everything in? Taking a boda to work every day. “Uganda is a beautiful country,” she says, “so being able to take it all in on a motorcycle made my experience even more thrilling.”  Zulema also enjoyed learning about the country’s unique cultural traditions. “In general,” she says, “what surprised me most about Uganda was the importance of religion and the role that death played in individuals’ lives. There was a great level of diversity in religions, which was interesting, as it did not seem that one dominated over others.”

Learning about and experience a new culture pushed Zulema out of her comfort zone and helped her to grow as an individual and future physician. “Traveling to any country can be a very challenging experience in the sense that it will push you beyond your comfort zone and force you to learn immensely about yourself and how you deal with adversities. Moreover, it will allow you to develop interpersonal skills and adapt to a new cultural environment. Finally, it teaches you the importance of communicating despite barriers and the role that language plays in our everyday lives.”


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