July 15, 2011

And what do I do?

Seems like some people are interested in hearing a bit more about my job and work, which isn't totally off-limits to discuss (it's not like I work for the Gates Foundation), just the details relating to participants/results. So:

This is the outside of our offices at Kenyatta National Hospital, where we do our admin, non-clinic-based work. I think the colors and setting are simply lovely. Now, pretend to pivot about 150 degrees to your left. See that large gray building in front of you? That's the morgue. Really. On my first day of work, my boss said, "I'm sorry about the smell; it's just the morgue next door." Luckily, growing up with years of allergies seems to have stunted my olfactory development.

But all kidding aside (I'm actually not kidding; our offices are really next to the morgue), after a week of training, I feel a bit more equip to talk about the scope and background of my work. My job is that of assistant study coordinator/research assistant on a study regarding treatment of cervical neoplasia in HIV+ women. It’s a randomized trial comparing Chryotherapy vs. LEEP (Loop Electrosurgical Excision Procedure) for the removal of CIN (Cervical Intraepithelial Neoplasia) grades 2 & 3, and CIS (Carcinoma in Situ). The outcomes being evaluated are HIV viral shedding in the month following treatment and recurrence of lesions in the 2 years following treatment.

The rational is that, with the fairly recent roll-out/scale-up of antiretroviral treatment in Kenya, people with HIV are living much longer than they were in the days prior to ART access. However, this new life longevity opens the door to an array of other health complications, including cervical cancer, which is more common among HIV+ due to a suppressed immune system, and is the most prevalent cancer in Kenyan women. Chryotherapy and LEEP have both been shown to be effective treatments for pre-cancerous lesions, but have never been evaluated in an HIV+ population, where the immune response differs from the general population. Furthermore, treatment poses a form of trauma to the cervix, potentially resulting in increased viral shedding and increased infectiousness in the subsequent weeks.

Thus, this study is a public health evaluation to inform PEPFAR recommendations for the most effective treatment of precancerous cervical lesions among HIV+ women.

And what do I do? So far through training I’ve gotten the chance to sit in with every segment of the study team (reception/recruitment, screening/nurses/pap-smears, lab/specimen processing, doctors/treatment, data analysis/management). I guess I’ll be doing a bit of everything coordination-related… running meetings, compiling quarterly reports and IRB updates, communicating with investigators and staff, analysis of adverse events, etc.

And, to date, that’s what I know!

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