Guochun Jiang, PhD

A new study led by Guochun Jiang, PhD, assistant professor in the Department of Biochemistry and Biophysics at the UNC School of Medicine, and researcher with the Institute for Global Health and Infectious Diseases and UNC HIV Cure Center, has found that a drug named citarinostat is effective at disrupting latent HIV reservoirs. The findings, which were published in Science Advances, bring researchers one step closer to achieving eradication of the virus.

Read more from the UNC School of Medicine Newsroom.

The post UNC Researchers Demonstrate Drug’s Effectiveness in Drawing Out Dormant HIV from Immune Cells appeared first on Institute for Global Health and Infectious Diseases.

Thibaut-Davy-Mendez, PhD, MSPH

A new project led by Thibaut Davy-Mendez, PhD, MSPH, at the Institute for Global Health and Infectious Diseases, funded by the Gilead Research Scholars Program, is taking aim at a longstanding gap in HIV care: accurately predicting who is at highest risk for cardiovascular disease.

Backed by a two-year award from Gilead, the study will evaluate whether adding a specialized lab marker, lipoprotein(a), to existing risk calculators can better predict heart disease among people living with HIV. The work draws on large-scale data from the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) research network and could reshape how clinicians assess and prevent cardiovascular events in this population.

“We know that the risk scores doctors use in everyday practice tend to underestimate cardiovascular risk for people with HIV,” said Davy-Mendez, assistant professor of infectious diseases and epidemiology. “Our goal is to build something that actually reflects their true risk and helps clinicians act earlier.”

The Problem: Standard Risk Scores Miss the Mark in HIV

In routine care, clinicians use cardiovascular risk scores—tools that combine a patient’s age, sex, race, lab values, and other factors—to estimate their 10-year risk of heart disease. These scores guide decisions such as whether to start cholesterol-lowering medication.

But for people living with HIV, these general-population tools frequently fall short.

“There have been several attempts to create risk scores specific to people with HIV, but nothing that’s been a major improvement over what we already use,” Davy-Mendez explained.

One of the newest tools in broad clinical use, the PREVENT equation, was designed to be more accurate for the general population, reflecting declining rates of cardiovascular disease in recent decades. Ironically, that improvement has widened the gap for people with HIV: as the equation is recalibrated downward for healthier general-population trends, it further underestimates risk in the HIV population.

“The PREVENT equation is more accurate for the general population now, but that means it’s even less aligned with the reality for people with HIV,” said Davy-Mendez. “The gap has actually grown.”

The Innovation: Bringing Lipoprotein(a) Into the Equation

Davy-Mendez is centered on lipoprotein(a)—often written as lipoprotein(a) or Lp(a)—a specialized blood marker related to cholesterol. Elevated Lp(a) has emerged as an independent marker of high cardiovascular risk in the general population.

Clinicians are increasingly using Lp(a) when they’re uncertain whether to intensify treatment. A markedly elevated level can tip the balance toward starting cholesterol-lowering medication (statins), pursuing more aggressive lipid control targets and identifying patients who may need closer cardiovascular monitoring.

Despite its growing use, Lp(a) has been minimally studied in people with HIV.

Davy-Mendez will use CNICS/CFAR data to calculate existing cardiovascular risk scores for people with HIV and develop a new risk model that incorporates lipoprotein(a) alongside traditional risk factors. The study will compare how well the Lp(a)-enhanced model predicts actual cardiovascular events versus standard tools like the PREVENT equation and PCE.

“If adding lipoprotein(a) meaningfully improves prediction, that’s a strong signal that we need HIV-specific tools and routine measurement of Lp(a) in clinical care,” said Davy-Mendez.

Ultimately, the goal is to identify patients at higher risk earlier, tailor preventive strategies, and reduce heart attacks, strokes, and related complications among people living with HIV.

About the Gilead Research Scholars Program

The Gilead Research Scholars Program supports early-stage investigators through two-year awards in key disease areas, including HIV and cancer. Unlike product-focused studies, these awards fund independent, investigator-initiated projects that can address a wide range of scientific and clinical questions—from HIV prevention to chronic disease management in people living with HIV.

This Gilead-funded study could provide more accurate cardiovascular risk prediction tools tailored to people with HIV, encourage routine measurement of lipoprotein(a) in HIV clinical care, inform treatment guidelines on statin initiation and other preventive strategies and lay the groundwork for AI-driven models that further refine risk assessment.

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Lina Rosengren, MD, MPH

When people leave prison, they enter one of the highest-risk periods for acquiring HIV—often with the least support, the fewest resources, and the greatest uncertainty about where to turn for care. It’s this critical gap that Lina Rosengren, MD, MPH, an infectious diseases physician and researcher with the Institute for Global Health and Infectious Diseases is determined to close.

“There has been very little investment in understanding how justice-involved populations can access biomedical interventions to prevent HIV,” said Dr. Rosengren, associate professor of medicine.  “As they re-enter their communities from incarceration, they enter a period of extraordinary HIV vulnerability. Gilead has committed to helping us understand and support these individuals with access to one of the most exciting new long-acting medications for PrEP.”

In a unique partnership with Gilead that combines in-kind support with an implementation grant, leveraging UNC’s deep clinical roots in the prison system, Dr. Rosengren’s RELEASE study is poised to answer a critical question:

Can we reliably deliver long-acting HIV prevention to people before they ever lose contact with the carceral health system—and in doing so, fundamentally change their risk trajectory after release?

Long‑Acting PrEP at the Prison Gate

The RELEASE study is straightforward but novel–providing a long‑acting HIV prevention injection just before release that offers six months of protection during a period of high HIV vulnerability.

Within North Carolina’s prison, HIV prevention needs are relatively low—more than 99% of people living with HIV are virally suppressed, resulting in essentially no in‑prison transmission. After release, however, risk rises sharply due to unstable housing, disrupted healthcare, limited access to prevention services, and lack of awareness about HIV risk. The immediate post‑release period is consistently one of the highest‑risk moments for HIV acquisition.

RELEASE is designed as an implementation study rather than a traditional clinical trial. It seeks to identify the real‑world barriers to delivering long‑acting PrEP in a carceral setting and to build systems that support continuity of prevention once the initial protection period ends. The goal is not to prove drug efficacy, but to understand how this approach could actually work at scale.

Lenacapavir is a long‑acting HIV prevention shot given twice a year that received FDA approval in June 2025. In Phase 3 studies including cisgender women, men who have sex with men, and transgender people, the results showed close to 100% efficacy as PrEP.

Securing Drug Access Where No Payer Exists

One of the most striking aspects of Dr. Rosengren’s study is how it challenges the usual funding model for implementation studies. In the North Carolina prison system, Medicaid is suspended while prisons cover medical care needed during the incarceration period—but PrEP is not offered, in part because prisons do not formally recognize consensual sex and because in‑prison transmission rates are so low. As a result, no existing payer is positioned to cover a pre‑release dose of long‑acting PrEP, requiring the study to address—and innovate around—a gap where conventional implementation models break down.

To bridge this gap, Gilead has agreed to donate 50 doses of long-acting PrEP. The study will also examine how the upcoming 1115 Medicaid waiver—which may allow Medicaid to cover some services inside prisons—could create a sustainable payer path for PrEP in the future.

A Hidden Strength, Integrated Care and Research in Carceral Settings

Patients are seen at prison facilities through UNC’s robust statewide HIV and infectious disease telehealth network that delivers HIV care and high‑volume ID consultations across the state. As associate director of Infectious Diseases and HIV Services for the North Carolina Department of Adult Corrections, Rosengren  works closely with program director Becky White, MD, to oversee telehealth operations and advance statewide care, while supporting advanced practice providers with complex HIV cases while also handling general infectious disease consults via telehealth. Christopher Sellers, MD, also provides on‑site, non‑HIV infectious disease consultations at Central Prison, managing hospitalized patients and ensuring continuity of care as individuals return to their home facilities.

The program is supported by a multidisciplinary team that includes Liz Aronin, NP, and Denise Carpenter, PA, who focus on HIV care; Amy Jones, PharmD, an infectious diseases pharmacist based at the prison; and collaborative partnerships with UNC specialty services such as OB‑GYN, surgery, podiatry, and others providing care within the prison system.

Anchored in Care for the Underserved

Dr. Rosengren says her career has been defined by a consistent commitment to underserved populations. She began working in prisons as a fellow in 2018, entering a high‑security facility that was initially intimidating. She stayed because of the lasting relationships she formed and the deep trust of her patients. Over years of care, she has guided individuals through long incarcerations and the anxiety of release, especially fears about losing access to HIV medications, spending significant time educating and reassuring them about ongoing, no‑cost care.

“One long-term patient, incarcerated for more than 20 years and preparing to leave, ended a telehealth visit by saying, ‘Thanks for being there for me. I’ll miss you, friend.’”

Rosengren says sustained connections like this—marked by gratitude, trust, and mutual respect—are the most meaningful moments in her work.

The post Protection at the Prison Gate: A Long‑Acting HIV Prevention Study at Release appeared first on Institute for Global Health and Infectious Diseases.

Laika Maganga (center) with a groups of research assistants in Lilongwe.

How has your training and clinical work shaped your approach to gender, culture, and HIV stigma?  

As a PhD candidate in the School of Nursing doing my dissertation research at UNC Project Malawi in Lilongwe, I’m focused on understanding the implications of culture, specifically gender, on the HIV stigma experienced by young Malawian women (aged 15 to 24) living with HIV. In my exploration of this intersectional stigma, my formative research will inform the future development of an intervention rooted in the lived experiences of young Malawian women living with HIV, helping them cope with stigma and achieve and maintain healthy outcomes.  

I joined the Hillman Scholars in Nursing Innovation Program in 2021, as an undergraduate student. This program is an accelerated BSN-PhD program to produce the next generation of nurse scientists. In my honors project, I explored the effects of stigma among older Black women living with HIV in Malawi, and this cemented my commitment to addressing stigma among marginalized populations. From 2022-2023, I worked as a bedside nurse on a medicine-psychiatric unit at ECU Health. There, I saw how the culmination of social disadvantages and chronic illness manifest in our patient populations.   

What made this feel like the right move for you, and what has living in Malawi actually been like? 

Laika visited the Kandewe Bridge which hangs over the South Rukuru River.

Adjusting to life in Malawi has definitely come with a learning curve—from driving on the opposite side of the road and figuring out roundabouts, to fully embracing the slower, more relaxed pace of life. Seeing a lizard in my house is now a regular thing, though I still scream every once in a while when one catches me off guard. I’ve loved taking in the country’s natural beauty, from the stunning landscapes of Lilongwe to the mountains in Zomba and Rumphi, and of course, Lake Malawi. I’m also working on my Chichewa (the national language of Malawi) ‘pang’ono pang’ono’ or ‘little by little.’ Overall, it’s been such an eye‑opening, grounding experience, and I’m incredibly grateful for it. 

How did mentorship and timing come together to steer you toward HIV research? 

The biggest influence has been my dissertation chair and mentor, Dr. Natalia Villegas, who supported me throughout this entire process. During conversations with my dissertation committee, I learned about the UJMT Fogarty LAUNCH Program through the Institute for Global Health and Infectious Diseases. I put together my application shortly after, and a few months later, I was accepted. 

As a nurse, I truly believe in holistic care—not just treating disease but understanding how the social and psychological side of illness impacts people’s lives. That belief is what pushed me toward studying stigma among people living with HIV. In 2023, I visited Malawi briefly before starting my PhD and had conversations with my family about my research interests. Those conversations sparked curiosity about HIV and stigma in Malawi, especially among young women.  

Laika’s dad (front) traveled with her, staying for the first two weeks to visit with family in Malawi.

Soon after, I met Dr. Ashley Leak‑Bryant, who leads the Global Affairs office at the School of Nursing and connected me with folks at UNC Project Malawi. Through that network, I was fortunate to meet Dr. Agatha Bula and Dr. Melissa Stockton, who later became mentors and members of my dissertation committee. Around the same time, I was taking coursework and realized I wanted to do qualitative research, which is when I gained another mentor, Dr. Jessica Williams, who also now serves on my committee. Overall, it’s been a mix of mentorship, timing, and listening to the questions that kept coming up for me—and each step made the direction of my research feel more and more clear. 

How did this experience shape where you want your work to go next? 

 Long term, I want to lead my own program of research as an independent nurse scientist focused on advancing health equity—specifically by studying the intersections of HIV and stigma among marginalized populations in a global context, with a strong focus on Malawi. As someone who is originally from Malawi, this work feels deeply personal. Young Malawian women living with HIV often experience stigma in their relationships, communities, and society at large, and that stigma can seriously impact their ability to stay healthy and thrive.

Laika (right) participating in study protocol training with research assistants, personnel from the Qualitative Unit and personnel from the ethics office at UNC Project Malawi. “This was a full day training in which I taught them about my study and they taught me about the logistics of actually carrying out the research activities!”

As a nurse researcher, I’m motivated by the idea of expanding care beyond one patient at a time to entire communities. Through research and stigma‑reduction interventions, I hope to improve health outcomes for young Malawian women living with HIV in a way that’s meaningful and sustainable. 

The UJMT fellowship has been a huge part of shaping that vision. It gave me hands‑on experience in global health research—something no amount of coursework or reading could fully prepare me for. I’ve had the privilege of working alongside incredible people, from research assistants and collaborators to mentors, community advisory board members, and teams in finance, administration, and internal supply. While I came to Malawi with a research plan, the people I worked with brought invaluable lived experience and local expertise that made the project stronger and more grounded. 

Looking ahead, I’m excited to build on my dissertation findings and continue collaborating in Malawi as I grow my research program. This experience didn’t just align with my goals—it helped clarify them. 

The post Fogarty Fellow Returns to Her Roots in Malawi appeared first on Institute for Global Health and Infectious Diseases.

Ashley Wade

Ashley Wade is a medical student at Icahn School of Medicine at Mount Sinai and is mentored by Ross Boyce, MD, MSc. In many parts of Sub‑Saharan Africa, malaria is still one of the main reasons children are hospitalized. In a recent study, Wade and Annika Gunderson, a UNC Epidemiology PhD student, examined how flooding and its disruptions to daily life drive pediatric malaria hospitalizations in rural, flood‑prone communities in western Uganda.

Drawing on baseline data from an ongoing clinical trial, the Uganda-based team collected information from over 9,000 children in 79 villages across three river catchment areas. They asked whether each child had been hospitalized for malaria in the past year and linked that to household flooding, socioeconomic status, bed net use and condition, and malaria rapid test results. About 16% of children had been hospitalized, and those from flooded homes were disproportionately represented. Flood‑affected children missed nearly twice as many days of school, and their caregivers lost more than double the days of work compared with families whose children were not hospitalized.

Methdos used for trial

When the team ran multivariable models, they found that children with indirect flooding exposure, defined as household disruptions to work, healthcare, market, or school access, had a 49% higher risk of hospitalization, while those whose homes were directly flooded had a 77% higher risk. Among all factors, caregiver work disruption showed the strongest link to hospitalization, suggesting that when floods undermine livelihoods, families may delay or struggle to access timely care, allowing malaria to become severe. Bed nets were common in both groups, but hospitalized children were far more likely to sleep under damaged nets, pointing to net quality as a possible mediator of infection in addition to net usage.

Preliminary analysis results

The team’s findings acknowledge that malaria hospitalization isn’t just about exposure to mosquitoes; it’s about where families live, how floods reshape their lives, and whether they can access care quickly. This study points toward geographically targeted interventions in flood‑prone communities—protecting caregiver livelihoods, improving bed net quality, and planning for access to care during and after floods—as key drivers for reducing severe malaria in children.

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Gail Henderson, Gui Xi’en, and Myron Cohen, during a visit to the UNC School of Medicine in 2007.

In the 1990s, a hidden epidemic spread among poor farming villages in central China, fueled by unsafe blood and plasma collection practices. Hundreds of thousands were infected—yet few were willing to investigate, acknowledge, or care for those infected. Dr. Gui Xi’en did all three.

“Courage, Conviction, Resolve: The Story of Dr. Gui Xi’en” is a new essay by Gail E. Henderson, PhD, published in Perspectives in Biology and Medicine. It tells the story of an infectious disease physician who chose to act when silence was easier, safer, and expected.

Drawing on interviews with more than 30 colleagues, students, and collaborators, Henderson traces Dr. Gui’s journey—from delivering medical care on horseback in remote regions, to identifying China’s blood‑borne AIDS crisis in Henan province, to treating patients that others refused to touch. When hospitals turned people away, he brought them into his own home. When fear and misinformation spread, he answered with facts, education, and compassion.

“I wanted to tell Dr. Gui’s story because his life shows what medicine looks like when guided by conscience,” said Henderson. “He acted when it was uncomfortable, risky, and unpopular. In a time of fear and misinformation, he chose education and compassion. Those lessons still matter.”

Right–This 2001 photo shows Dr. Gui Xi’en with AIDS patients from Henan, in his home in Wuhan (Credit: Chang Ailing/ China Daily)

A brief look at the history behind the story

• 1950s–60s: Sexually transmitted infections are largely eliminated in China through national campaigns, only to surge as China opened to the West in the 1980s
• 1980s–90s: Unsafe plasma collection explodes in rural areas, exposing donors to HIV and hepatitis
• 1999: Dr. Gui confirms HIV infections in villages where no epidemic officially “exists”
• Early 2000s: Despite resistance and stigma, he provides care, trains clinicians, conducts research, and reports cases to national authorities
• 2004: His work is nationally recognized, helping push forward free HIV testing and treatment policies

More than a biography, this essay shows what can happen when someone refuses to look away. Dr. Gui’s work reshaped HIV care, pushed back against stigma, and trained generations of clinicians to balance scientific precision with real human compassion. His story proves that progress rarely begins with policy—it begins when someone chooses patients over the status quo.

Find the essay here.

Gail E. Henderson, PhD, is a medical sociologist and longtime scholar of global health and bioethics. Early in her career, she lived and worked in Wuhan, China, with her husband, infectious disease physician Dr. Myron “Mike” Cohen, and their young daughter while participating in one of the first post‑1949 U.S.–China medical exchange programs. In 1979, they met Dr. Gui Xi’en, an infectious disease physician at Zhongnan Hospital. That experience, living in a Chinese hospital community during a period of rapid medical and social change, shaped her lifelong engagement with China’s health system, infectious disease policy, and international collaboration. Over subsequent decades, Henderson maintained close professional and personal ties to China and its medical community, providing the foundation for her deeply informed account of Dr. Gui Xi’en’s life and work.

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Lauryn Ursery and Emily Ciccone, MD, MHS

The team enrolled 300 HIV-positive participants from three antiretroviral therapy clinics. To be enrolled in the study, participants had to be HIV positive, over 12 years old, presenting to one of the district’s antiretroviral therapy clinics, and able to provide consent. Once the patient was enrolled, they would complete demographic questionnaires, and we would extract medical information from their medical records. They were trained to collect their own nasal swabs and asked to contact the study team within 48 hours of flu-like symptoms, such as cough, runny nose, or headache. The team then collected swabs, followed up after 14 days (often at home), and made monthly calls to catch any missed episodes.

The cohort’s median age was 41.5, most were women, average household size was about five, and the majority owned bed nets. Notably, 91% had received at least one COVID-19 vaccine. After six months,137 participants reported 215 ARI episodes, with 56 individuals experiencing two or more.

Chart of the cohort results.

The study found an incidence rate of 27.6 episodes per 1,000 person-weeks, higher than in some other Sub-Saharan African studies. The most common symptoms were rhinorrhea, cough, and headache, and influenza A and B were commonly detected, though many samples were negative. A clear seasonal pattern emerged: cases increased during the dry season, when flu A and B appeared more often.

Map that shows the distribution geographically of the different cases that are reported.

By mapping where cases occurred, the team identified areas that could benefit most from targeted public health interventions, such as influenza vaccination for people living with HIV in rural communities. The next steps include deeper geographic analysis and using the findings to guide vaccination and prevention strategies.

Ultimately, this work shows how careful, community-based research can inform smarter, more targeted responses to respiratory infections among people living with HIV in rural settings.

The post Tracking Respiratory Infections in People Living With HIV in Rural Uganda appeared first on Institute for Global Health and Infectious Diseases.

Zepeda presenting his findings on the effect of Zika and Dengue on pregnant women and their babies.

Omar Zepeda is a PhD student studying at the University of Costa Rica and a fellow of the Nicaraguan Emerging and Endemic Diseases (NEED) program. He is mentored by Filemon Bucardo, PhD. At the recent 4^th Annual Global Health Symposium Zepeda presented his findings on the Zika and Dengue viruses focusing on infant and maternal antibody dynamics. In Nicaragua, families live with the daily reality of viruses like Zika and Dengue, and the risks are especially high during pregnancy and a baby’s first year of life.

Zepeda presented a longitudinal study where researchers followed pregnant women and their babies to understand how these infections and the immune response to them present over time. Additionally, his team conducted a study on acute dengue cases, to better categorize disease progression and evaluate the role of pre-exiting immunity.

During the 2017 Zika epidemic, about 55% of pregnant women showed evidence of Zika infection, and around 21% were infected during pregnancy itself. Roughly 17% of births had some type of adverse outcome, but only 1.5% of infants met the criteria for congenital Zika syndrome. The timing of infection during pregnancy did not clearly predict which babies would have complications, challenging early assumptions about trimester-specific risks.

Chart of Zika virus infection during pregnancy during the 2017 epidemic in Nicaragua.

Study focused on antibody dynamic after birth on the mother and their infants.

The study also examined how long maternal antibodies protect infants. They found that Zika antibodies persisted in most mothers for at least two years. However, babies lost most of that protection by 6–9 months of age, creating a vulnerable window in a setting where Dengue is endemic. Another observation from this study is that IgG3 levels were higher than the IgG1 level. This is a naturally maternal antibody transfer when IgG1 is typically the dominant subclasses. Because Zika and Dengue antibodies cross-react, some rises in Zika antibodies in older infants were driven by Dengue infections, complicating diagnosis and vaccine decision-making.

Looking at a 2022 Dengue outbreak, the team found that most cases occurred in children with prior Dengue exposure, while past Zika infection did not appear to increase Dengue disease risk. Using insights from prenatal data, the team built a practical algorithm to better identify Zika infections during pregnancy and improve serological surveillance in resource-limited, Dengue-endemic settings.

Together, these findings highlight how maternal immunity, viral cross-reactivity, and population history all shape which children are most at risk—and how public health strategies can better protect them.

The post Tracking Zika and Dengue: Insights into Maternal and Infant Immunity in Nicaragua appeared first on Institute for Global Health and Infectious Diseases.

At the Fourth Annual Global Health Scholars Symposium, three student researchers working in China showcased a forward‑looking portfolio of studies focused on digital health, HIV prevention, and community‑engaged sexual health interventions. Their work showed how technology, behavioral insights, and innovative service models can transform the landscape of HIV and STI prevention for key populations across the country. The symposium was sponsored by the Institute for Global Health and Infectious Diseases and the Gillings School of Global Public Health. Find an overview of the event here.

Core Themes

China Scholars Ye Liu and Lan Li

From randomized controlled trials using “pay‑it‑forward” strategies to improve gonorrhea testing uptake, to implementation research evaluating how community settings can adopt and scale these approaches, this year’s symposium projects highlighted a growing intersection of digital platforms, user‑centered design, and equity‑focused public health strategies. Ye Liu, MSPH presented “Pay-It-forward gonorrhea testing randomized controlled trial.”  Lan Li, PhD, UNC Project China Postdoc contributed “Implementing Pay-It-Forward for STI Testing in Community and Clinical Settings: A Qualitative Analysis of RE-AIM framework.”

Across the presentations, several themes emerged: the critical role of digital tools in reducing stigma and expanding access, the effectiveness of community-powered interventions that increase testing and engagement, and the importance of scalable models that can adapt to diverse clinical and community environments. Together, these student-led projects reflect a rapidly evolving Chinese public health context—one where technology and social innovation play central roles in reaching marginalized groups with timely, high‑quality preventive care. One oral presentation stood out for its novel vision and potential to reshape HIV prevention in real time: Zhuoheng Yin’s development of the Tally PrEP WeChat mini app for Chinese MSM.

Research Spotlight: Digital Support for PrEP Use

Yin introduced an innovative digital health tool: Tally PrEP, a WeChat mini app designed to help men who have sex with men (MSM) start and maintain effective HIV pre‑exposure prophylaxis (PrEP). Under the mentorship of Weiming Tang, PhD, and Joe Tucker, MD, PhD, co-directors of UNC Project-China, Yin has taken a user‑centered approach to addressing a major challenge in PrEP implementation in China—ensuring that individuals who access PrEP, often outside formal clinical pathways, have the information and support they need for consistent, correct use.

Zhuonheng Yin gave his presentation remotely.

In his presentation, Yin highlighted a rapidly growing trend: many Chinese MSM are now purchasing PrEP online, sometimes without medical oversight. While this demonstrates strong demand for HIV prevention tools, it also reveals critical gaps in sexual health services—limited guidance, difficulty managing side effects, and structural stigma that discourages in‑person care. The Tally PrEP app aims to bridge these gaps by embedding PrEP guidance directly into WeChat, China’s most ubiquitous digital platform for communication, commerce, and community life. Through this integration, the app provides discreet, convenient access to sexual health resources; offers practical support for medication adherence; and helps users incorporate PrEP into their daily routines with privacy and ease.

“Digital platforms let us deliver sexual health services conveniently, safely, and privately,” he said, connecting with users where they are: online, on their phones, and within trusted platforms they already use every day.

This year’s work, whether through “pay‑it‑forward” models that expand access to testing or app‑based approaches that support safe, consistent PrEP use, demonstrated how emerging scholars are expanding the reach, relevance, and impact of HIV prevention efforts in China.

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Zambia: Core Themes

Monica Diaz, MD (left) and Cedra Ali (right), who was the only undergraduate student in the program.

Collectively, student research showed how stroke care, clinical diagnostics, patient experiences, and health‑seeking behaviors intersect in a setting where rapid response, accurate classification, and long‑term management can mean the difference between life and death. From analyzing door‑to‑CT times and echocardiogram utility to exploring discharge readiness and fever-related outcomes, students illuminated the realities of stroke care in Zambia’s hospitals—revealing both the progress made and the gaps that persist.

Across the presentations, a set of core themes emerged: the essential role of accurate diagnosis, the importance of timely acute care, the influence of environmental and social factors, and the growing need for evidence‑based, low-resource interventions. Together, these projects reflect a maturing research ecosystem in Zambia—one shaped by strong mentorship, close clinical partnerships, and a commitment to improving outcomes for patients facing neurological disease. Among these contributions, one project stood out for its depth, scope, and potential to inform clinical practice across the region: Dr. Nana Boakye Agyeman Badu’s pioneering work on non‑traditional risk factors and stroke mortality.

Research Spotlight: Shaping Stroke Survival

Nana Boakye Agyeman Badu

In his oral presentation, Dr. Nana Boakye Agyeman Badu, a neurology resident and recent MPH graduate, reframed how clinicians understand stroke mortality in Zambia. While hypertension, diabetes, and smoking are well‑known contributors to stroke burden, Badu recognized how traditional risk factors alone could not fully explain the devastating outcomes he observed during his clinical rotation in Lusaka. Inspired by real‑world experiences, working closely with his mentor neurologist Deanna Saylor, MD, MHS (member of the Institute for Global Health and Infectious Diseases), Badu launched a prospective cohort study to evaluate how diet, household air pollution, and physical activity affect survival after stroke—an essential but largely understudied question in Sub-Saharan Africa.

His study followed 532 adults admitted with stroke between 2019 and 2022, tracking both in‑hospital and one‑year mortality. The findings were striking. Patients with high pre‑stroke physical activity experienced a 41% reduction in the risk of dying during hospitalization, highlighting how routine movement may build physiological resilience that carries into the acute recovery period. High vegetable consumption, especially leafy greens, emerged as one of the strongest protective factors, associated with a roughly 50% reduction in in‑hospital mortality and a 46% reduction at one year. In contrast, high red meat consumption was linked to nearly double the risk of death at one year—echoing global concerns about red meat and vascular health, but grounding these concerns in locally generated evidence.

Just as important were the structural insights: patients whose stroke type could not be confirmed, due to lack of imaging, faced almost four times higher in‑hospital mortality, and those with severe disability at baseline were at dramatically greater risk both immediately and over the long term. These findings underscore a dual reality: lifestyle and environmental factors shape recovery, but health system capacity—from imaging to rehabilitation—remains equally critical for survival.

Badu’s portrayal of stroke care in Zambia showed a complex interplay between individual behaviors, household environments, and structural health system constraints. His study not only expands the evidence base on stroke mortality but also identifies practical, context‑appropriate opportunities for intervention—from dietary promotion and physical activity campaigns to investments in diagnostic capacity and early rehabilitation.

Participating Scholars

Malya Sahu

Following is a listing of participating scholars and their topics.

• Evaristo Kunka, MMed – “Accuracy of Optic Nerve Sheath Diameter and Optic Disc Elevation for Discrimination Between Patients with Hemorrhagic and Ischemic Stroke at the Adult Hospital of The University Teaching Hospitals in Lusaka, Zambia”
• Theresa Shankanga, MBCHB
  “Impact of fever on outcomes of stroke patients in Lusaka, Zambia”
• Madalitso Nthere, MBBS, Research Fellow
  –“Evaluating the Utility of Echocardiogram in the Diagnostic Work Up of Stroke Patients in Resource-Limited Settings” and
  –“Gaps in Evidence-Based Stroke Care in Zambia: Opportunities For Low-Resource Interventions to Improve Outcomes”
• William Tembo, Research Coordinator
  –“Door-to-CT Intervals in Acute Stroke Care in Sub-Saharan Africa: A Scoping Review Protocol with Preliminary Findings” and
  –“An Evidence-Based Approach to Stroke Unit Development in Zambia”
• Diwell Mwansa, BMBS, UNC Project-Zambia Research Coordinator
  “Patients’ Perceptions of Their Readiness for Hospital Discharge From Zambia’s First Stroke Unit.”
• Yohanna Gebreyohanns, Medical Student
  “Health-Seeking Behaviors and Outcomes Among Hospitalized Adults with Stroke in Lusaka, Zambia”
• Malya Sahu, PhD, Postdoctoral Fellow
  “Narrative Inquiry to Explore Delays to Care-Seeking for Symptoms of Multiple Sclerosis Among Healthy Individuals in Zambia”

Together, Zambia-focused projects showed a health system in transition—one where clinicians, researchers, and trainees are collaboratively defining what high-quality stroke and neurological care can look like in low‑resource settings. Whether improving diagnostic accuracy, reducing critical delays, evaluating care pathways, or identifying modifiable predictors of survival, these studies collectively point toward a future in which care decisions are increasingly informed by local data and lived patient experience.

The post Zambia Scholars Drive New Insights in Neurological Health appeared first on Institute for Global Health and Infectious Diseases.

Dr. Go showing a word cloud of presentation topics.

A cohort of emerging global health research scholars are advancing HIV prevention, substance use, mental health, and implementation science. Presented at the 4th Annual Global Health Scholars Symposium on Feb. 13, their projects shed new light on how Vietnam’s health system is addressing intertwined epidemics—HIV, methamphetamine use, depression, alcohol‑related harm—and how digital platforms and behavioral interventions are reshaping prevention and care. The scholars shared a common mission, to understand the lived experiences of key populations and to build practical, scalable solutions that can strengthen service delivery.

The event was sponsored by the Institute for Global Health and Infectious Diseases and the Gillings School of Global Public Health. Vivian Go, PhD, Vietnam Country Director opened the program and introduced Myron Cohen, MD, director of the Institute for Global Health and Infectious Disease. Read more here.

Core Themes

Vivian Go, PhD, and Myron Cohen, MD

Mental health, substance use, and stigma featured prominently, with Thuy Dao examining the long‑term relationship between methamphetamine use and depressive symptoms among people receiving methadone, Trang Nguyen identifying the unmet mental health needs of women who use methamphetamine, and Ngan Nguyen documenting provider perspectives on addressing unhealthy alcohol use among people with HIV.

In implementation science, Hue Nguyen explored how contingency management strategies can be adapted to methadone programs in resource‑constrained settings—illustrating how behavioral economic approaches may enhance treatment engagement.

Under health equity and social determinants, Thi Huong Dang’s innovative work mapped how online platforms shape or hinder chemsex behaviors among key populations, raising new questions about digital risk environments and prevention strategies.

Spotlight: A Blueprint for Better Counseling in Vietnam

Linh Pham

In her oral presentation, Linh Pham, MPH, introduced a fidelity assessment tool designed to strengthen psychosocial counseling for people living with HIV who inject drugs. Pham’s talk addressed a central challenge in global health scale‑up: ensuring evidence-based interventions retain their effectiveness once transferred from controlled research settings into busy, diverse clinics.

Her work builds directly on the success of the KC 074 trial, which demonstrated that the SNaP intervention—combining systems navigation with structured psychosocial counseling—significantly improved ART uptake, viral suppression, and risk reduction among people who inject drugs and live with HIV. With Vietnam now working to scale this model nationwide, Pham and the research team recognized the critical need for a tool that could reliably measure fidelity, not only checking whether essential counseling tasks were completed but assessing how they were delivered—whether counselors used motivational interviewing, responded to participant needs, and maintained fidelity to the model’s core components.

To address this gap, Pham developed a unique fidelity assessment instrument through a rigorous, multi‑phase process. With researchers at UNC Project Vietnam, she reviewed existing fidelity frameworks, adapted them to the SNaP model, and identified four essential dimensions: content adherence, counselor competency, quality of delivery, and participant responsiveness. They then built an evaluation system that blended task‑based scoring with Likert‑scale ratings of counseling skills—capturing both clinical precision and interpersonal quality.

After extensive training, multiple raters assessed mock and real counseling sessions, producing exceptionally strong inter‑rater reliability (ICC = 0.89). This level of agreement demonstrated that even complex psychosocial interventions can be measured objectively at scale when paired with structured tools and thorough rater preparation. The model is already being applied to other studies involving counseling components, with potential national relevance as Vietnam expands supportive services for key populations. Pham’s work will not only strengthen HIV service delivery today, but it will also chart a path for future adaptation of evidence‑based behavioral interventions across Southeast Asia.

Participating Scholars

Kim Ngan Nguyen

Following is a listing of participating students and their topics.

• “Mental health needs of women who use methamphetamine in Vietnam: Preliminary findings from a qualitative study” – Trang Nguyen, VISA/LMIC Senior Fellow
• “Perspectives on the role of providers in addressing unhealthy alcohol use among people with HIV in Vietnam: a qualitative study” – Kim Ngan Nguyen, MSc, UNC Project Vietnam
• “The longitudinal association between methamphetamine use and depressive symptoms among people in methadone treatment” – Thuy Dao, PhD student in EpidemiologyVISA/LMIC PhD
• “Translating Contingency Management into Routine Methadone Care: Implementation Lessons from a Resource-Constrained Setting” and
• “Applying contingency management to improve treatment engagement in the methadone program in Hanoi and Haiphong, Vietnam” – Hue Nguyen, PhD, VISA D43 Postdoc
• “How do online platforms facilitate or inhibit chemsex among key populations: A scoping review” – Thi Huong Dang, MD, Visiting Scholar

Altogether, scholarly work reflected a united commitment to improving care for populations navigating overlapping vulnerabilities. Student projects illustrated how scientific inquiry, community engagement, and innovative implementation strategies can reinforce and transform Vietnam’s health system.

The post Vietnam Scholars Take Center Stage appeared first on Institute for Global Health and Infectious Diseases.

Predictions from spatial models adjusted for survey covariates that include include a spatial random effect.

Gaither combined detailed data from a 2017–2018 survey of artisanal mines with nationally representative malaria prevalence surveys across Tanzania. Mapping these together, she saw no obvious pattern suggesting that living closer to mines meant more malaria. When she moved beyond distance and examined the number of pits at the nearest mine site, an unexpected signal appeared: communities near mine sites with more pits tended to have lower malaria prevalence, while those near sites with fewer pits had higher predicted prevalence.

Why might that be? Many mine sites in the study area use mercury and cyanide for mineral processing, and about half reported using these chemicals. While these substances are serious environmental hazards, they may also disrupt mosquito breeding and survival, indirectly dampening malaria transmission. Satellite images from the region also show loss of vegetation around active mines, which can further reduce suitable habitats for malaria-carrying mosquitoes. In other words, the same disturbances that raise other health concerns might, paradoxically, make the immediate environment less hospitable to malaria vectors.

Chemical use and pit density at artisanal mines in relation to malaria exposure.

Gaither noted that association is non-significant rather than definitive, and more work is needed to understand the mechanisms at play. Her findings don’t cast mining as beneficial—far from it—but they do challenge simple narratives about land use and disease. Instead, they highlight how chemical use, ecological change, and human activity intersect in unexpected ways.

For policymakers and public health practitioners, this kind of nuanced, data-driven evidence is essential for designing interventions that reflect the realities of communities where mining and malaria are both here to stay.

The post Exploring the Link Between Gold Mining and Malaria in Tanzania appeared first on Institute for Global Health and Infectious Diseases.