Stories From the Field:

INDIA

AIDS Research in India

Brian T. Chan, MD, a Clinical Research Fellow at Mass General and Brigham and Women’s Hospital joint Infectious Disease Fellowship Program received a Center for Global Health Travel Award  to work at the Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE) in Chennai, India.

I am currently in my research years of an infectious diseases fellowship at MGH/BWH. My interest is in the management of non-communicable diseases such as depression, diabetes, and heart disease in patients living with HIV/AIDS in resource-poor settings. During my first visit to Chennai in September 2012, I gained valuable clinical exposure. In addition, I initiated a study on the changing characteristics and behaviors of patients entering into HIV care and performed a clinical review of stroke among HIV-positive patients.

The goals of my second trip to Chennai were to gain further clinical experience, attend the annual Chennai ART (Anti-Retroviral Therapy) symposium, and most importantly, to lay the groundwork for a research proposal.  This proposal will form the basis for future career development award proposals I will need as I move from the status of a fellow to an independent investigator.

While at YRG CARE, I rounded daily in the hospital wards and saw patients in the outpatient clinic. I saw many interesting cases, including rare opportunistic infections seen infrequently in the United States. I attended the annual Chennai ART symposium, which draws expert researchers and clinicians from not only India but around the world. It was an excellent opportunity to learn about clinical and research updates in HIV as well as to network with renowned scholars.

Most importantly, in collaboration with the staff of YRG CARE, I began developing initial studies in the area of co-morbid HIV and depression. The research question that I am most interested in is how depression among HIV-positive patients can best be treated and whether such treatment can positively affect risky sexual behavior, retention in care, and adherence to medications. Surprisingly, this research question has not been studied in resource-poor settings. By studying this issue in Chennai, I hope to uncover knowledge that will be applicable to patients in all resource-poor settings.

During my trip, I was able to begin planning my first studies in this area, including studies on the prevalence of depression among patients with HIV at YRG CARE and assessments of the association between depression and risky behaviors and retention in care. I am currently obtaining Institutional Review Board approval for these studies and will return to Chennai in the autumn to execute them.

The funding provided by the MGH Center for Global Health Travel Award made this experience possible and has allowed me to move forward in my career as an infectious diseases researcher and clinician.