Downs fellows around the globe

Last summer, at the end of her first year at the school of public health, Leah Hoffman traveled to the Vietnamese port city of Hai Phong to begin a study of sex workers. She wanted to know how well the workers communicated with their love partners—husbands or boyfriends—about condom use and risk of HIV. Only two-thirds, she found, told their partners that they were sex workers. While almost all sex workers reported talking about their HIV concerns with their love partners, only about half of their partners said that they had had such discussions. Couples who disagreed about what HIV risk issues they had discussed, Hoffman said, were half as likely to use condoms consistently as couples who were more in agreement.

“There is a major gap in communication between these couples,” Hoffman said in October at the Committee on International Health Downs International Student Travel Fellowship Fall Symposium. In Hai Phong Hoffman lived in a neighborhood between the shipyards and a cluster of establishments featuring sex workers, and carried out her research with the support of local public health workers.

Hoffman was one of 23 Downs fellows who traveled abroad last summer to do research, and one of four to give an oral presentation at the fall symposium. Among the four oral presenters was Derek McCleaf, a public health student, who traveled to Colombia to study sand fly populations, an important vector for leishmaniasis. The intersection of forests, pastures, and livestock provided fertile ground for the sand flies, he said. “If you could put the livestock away from the forest, that would decrease the risk for human transmission,” he said.

Medical student Stacey Kallem studied the circumstances under which families in Ghana told their HIV-infected children of their serostatus. “I wanted to look at what factors were associated with the decision whether or not to disclose,” she said. The major factor, she said, was “fear that the child would tell others. There was a fear that everyone would know this was an HIV family.”

Gabriel Rocha, a student in the Physician Associate Program, went to Israel and the West Bank to explore post-traumatic stress disorder (PTSD) among both Palestinians and Israelis affected by the ongoing conflict. Rocha, who was still analyzing his data in October, wanted to know whether personality, coping style, and culture were determinants of who develops PTSD. Although most people experience some form of trauma, he said, only about 10 percent of Israelis and about 23 percent of Palestinians will develop PTSD. Worldwide, only about half of those who experience trauma, he said, develop PTSD. [For more on Rocha's work, see “Yale's Physician Associate Program nears 40,” Yale Medicine, Autumn 2009.]

Fellows traveled to more than a dozen countries in Africa, Asia, Latin America, and Europe to pursue such topics as HIV transmission among drug users in St. Petersburg, sleeping sickness in Uganda, dengue fever in Venezuela, HIV risk among sex workers in Poland, and human bocavirus infection in Jamaica.