Keanan McGonigle, College of Arts and Sciences, Human Biology, 4th year and 1st year student in the Masters in Public Policy Program at the Batten School for Public Policy and Research, is a Pfizer Initiative in International Health-Center for Global Health Scholar in Research in Infectious Disease. Keanan spent the summer of 2013 at the University of Venda, South Africa. His project, "HIV Drug Resistance Patterns among HAART-Exposed Patients Failing First and Second-Line Treatment in Limpopo Province" was mentored by Denis Tebit, PhD, UVa Department of Microbiology.
I spent the past summer in the lab of Dr. Pascal Bessong, professor of microbiology at the University of Venda (Univen) in Limpopo, South Africa. I conducted research on HIV/AIDS using blood samples from HIV patients who are suspected of failing drug therapy. I sequenced the viral genome of these patients, in an attempt to determine the mutations that are causing this drug resistance. In combination with information about these patients' drug regimen and clinical history, I will be able to draw conclusions about the course of treatment in patients in Limpopo who are failing drug therapy, as well as the efficacy of current virus assessment in these HIV-positive patients.
This project really appealed to me for a variety of reasons. HIV/AIDS is fascinating as a public health issue because many of the reasons that the epidemic persists are societal and cultural rather than scientific. We have reached the point in our knowledge of the virus and the epidemic that we must translate scientific research into public health and public policy endeavors in order for this understanding to have any effect. In the case of my project, it is scientifically established that drug-resistance monitoring and viral genome sequencing should be standard practice in the treatment of HIV/AIDS. However, in underfunded, resource-poor settings this is often impossible. How then do health-care workers identify drug resistance and react appropriately? This is one of the questions I am interested in looking at through this project. I am interested in studying the biology of HIV/AIDS through the lens of public policy, so this project was ideal for me.
At the outset of the research I thought that it would be very straightforward. The scientific techniques needed for this assessment are not particularly challenging - I thought the true work would happen in the analysis back home. I was very mistaken. Between facing institutional challenges, like delayed ethics approval, to infrastructural problems, like almost-weekly loss of electricity in the lab, I was challenged on a regular basis to complete the project. But if there is one thing I have learned, it is how to adapt. If there is no power on Monday, maybe on that day I would do data analysis and make a powerpoint about accomplishment. Then when the power returns, the experiments continue in earnest. Overall these sorts of issues did not present a problem, and more importantly they taught me how to be patient in research.
The other striking characteristic I have noted is during my time here is the pace of the research. Researchers are subjected to institutional delays, dependent on forces outside of their control. This really dictates the pace at which their projects proceed - a situation I experienced first hand in trying to collect my samples. This requires researchers to be flexible and adapt as well.
Outside of the lab, I have truly enjoyed my time in South Africa. While my project does not necessarily involve me interacting with members of the community, I have managed to do so through extracurricular activities, like practicing with the Univen volleyball team on a regular basis. I have made several good friendships that will last beyond this trip and may bring me back to Limpopo one day. The trip has truly made me realize how similar I am to students here and vice versa. I was really surprised and excited to find how easy it was to make friends here - despite language differences, cultural discrepancies, etc.