1020- Senegal- Casamance research programme on HIV-resistance and sexual health (CARES)

The CARES project is an initiative that focuses on skills development and operational research to enhance the diagnosis and treatment of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and human papillomavirus (HPV), which is associated with cervical cancer. The project aims to improve the healthcare of people living with HIV, especially women, and decrease mortality rates related to HIV, hepatitis B and cervical cancer in the southern region of Senegal (Casamance) and Guinea-Bissau. It is co-funded by the Ministry of Foreign and European Affairs of Luxembourg and implemented by ENDA Santé. The project's primary objective is to provide assistance to medical facilities and train healthcare professionals in the clinical and community management of diseases associated with these infections.

The Luxembourg Institute of Health (LIH) is responsible for overseeing the research and training aspects of the project, while ENDA Santé oversees the operational coordination with health structures and partner organizations in Senegal and Guinea-Bissau. The Centre Hospitalier de Luxembourg (CHL), the Luxembourg National Health Laboratory (LNS), and the AIDS Research Foundation will all be involved in research, training, and support efforts at universities and hospitals in Bissau and Ziguinchor. The Luxembourg NGO Stop Aids Now/Access (SAN/ACCESS) will focus on evaluating the impact of stigma and discrimination on access to health care, in collaboration with Johns Hopkins University.
As part of this multiparty project, in addition to on-site program interventions, three research studies have been conducted to improve healthcare for the local population. The details of these studies are as follows:

1. Treatment failures and antiretroviral resistance among people living with HIV, as a part of the test and treatment strategy.
2. Improving access to cervical cancer/HPV screening in the Ziguinchor region and Guinea Bissau, Senegal.
3. Optimizing the management of HBV-infected individuals in Ziguinchor.

The student will work collaboratively with JHSPH faculty and team members based in Baltimore as well as Enda Santé, the primary in-country collaborating organization, to ensure the successful conduct of the research project. The position will be based in Ziguinchor, Senegal, with the potential for travel within Senegal or West Africa.
They will have the opportunity to engage with work aiming to understand 1) interventions aiming to increase the clinical competency of healthworkers in the management of infectious diseases; 2) Cervical cancer prevention programs in rural settings; and 3) stigma and discrimination experiences among people living with HIV, particularly vulnerable populations.

The activities will consist of providing technical support to the local implementers for the successful implementation of the project. The main activities are as follows:
The following tasks will be undertaken as part of this project:

1. Creation of study materials, such as research protocols, study instruments, standard operating procedures, and other relevant documents.
2. Assistance with data management, including data cleaning and development of codebooks
3. Support quantitative data analyses, including complex analyses under the guidance of faculty
4. Development of data dissemination products, such as study reports, presentations, abstracts or manuscripts
5. Provision of recommendations for program and intervention development in the form of briefs

Additionally, the student will have an opportunity to observe and engage in additional public health programs, including interventions to improve access to care led by ENDA Santé, targeting the specific health needs of vulnerable populations, including key populations and women, in a middle-low-income country.

This project offers an intersection of professional and academic opportunities in driving evidence-based public health programming in a low-income country. Working in the field with local counterparts allows the applicant to observe current research methods, what is efficient and effective, and critically analyze how they would design future projects. The ability to apply academic theory that the applicant is learning in epidemiology and biostatistics classes, to the practical application of developing evidence-based projects from epidemiological data will be an invaluable experience to the student.

The professional work environment at the site is positive and fosters productivity across team members, study and program staff. The workplace operates in a mature, respectful manner and collaboration and team work occurs across the study and program staff at ENDA Santé. The research team – both at ENDA Santé and here at Johns Hopkins – is supportive, unified, and communicative.

This placement would be a good fit for someone who is motivated, enjoys working as part of a team in a multicultural environment, and can take the lead on projects. A person who is able to quickly troubleshoot and come up with innovative strategies. Finally, an individual should be flexible and easily able to work in a foreign environment.
Regular mentoring and supervision will be provided in person and/or remotely by JHU faculty and staff; however, it will be the responsibility of the student to use the ideas and advice provided by the investigative team to move aspects of the project along, requesting additional support along the way when needed.

Epidemiology and biostats (620 series or above preferred); data management; infectious diseases; reproductive health; human rights; courses in design of community trials and/or cluster randomized trials and implementation science a plus, but not required.

Experience working with marginalized populations and on sensitive topics preferred.
A minimum of 20 weeks is required unless COVID-19-related travel restrictions prohibit this duration, although students who wish to stay longer are encouraged to do so, and expenses will be covered to support this. Students who continue to work with the project for longer than 20 weeks will likely have more of an opportunity to assist with data analysis and manuscript development.

Name: Stefan Baral, Department of Epidemiology, gturpin@jhu.edu

I would describe my communication and mentorship styles as... 

I am very responsive, flexible, and open to all forms of communication including email, phone, and in-person. Our research team work closely with our in country partners, ensuring all our members are supported and are able to fully engage in this work in a productive and meaningful way. We work as a unified team and provide support and mentorship across multiple levels.

A complementary student would have a working style and mentorship expectations that are..

A complementary student will be interested in the work, hardworking, and able to work independently and collaboratively in a multicultural environment. We are looking for students that are excited about the work, willing to learn, and interested in integrating within the partner organization.

The monthly stipend is sufficient to cover housing, food, and use of public transport. Students wishing to travel internally for personal reasons may incur out-of-pocket expenses.

We will work with the student to develop a budget to cover monthly expenses, including housing, transportation, groceries, and other basic living expenses. Any living expenses not covered by the GHEFP grant will be covered by the project. Flights to and from Senegal will be covered by the project if appropriate, and all required vaccinations and health visits separately from the GHEFP stipend.