Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE) is located in Chennai, the capital of Tamil Nadu state and one of the epicenters of the Indian HIV epidemic. YRG CARE is one of the largest private organizations providing HIV care in India, having treated over 20,000 PLHIV since its founding in 1993. YRG CARE serves patients who are newly diagnosed with HIV as well as experienced patients referred from other HIV providers. The catchment area of YRG CARE primarily includes Tamil Nadu and Andhra Pradesh states. YRG CARE boasts a well-established research infrastructure as a study site for the HIV Prevention Trials Network and AIDS Clinical Trials Group.
In India, which has the world’s third largest HIV epidemic, loss from the HIV care continuum leads to excess morbidity and mortality among people living with HIV (PLHIV) and jeopardizes the promise of "treatment as prevention.” Common, co-morbid psychosocial and structural conditions—including depression, violence, poverty, and food insecurity—may be important factors contributing to loss to care in India. In 2019, we will continue implementation of the National Institute of Mental Health-funded project, Syndemics and Loss from the HIV Care Continuum in India (PI: Brian Chan).
In this phase of the project, we will begin rolling out a pilot intervention designed to reduce loss from the HIV care continuum among high-risk PLHIV. This intervention will involve 30 PLHIV (approximately 15 men and 15 women) presenting or re-presenting to care at YRG CARE. Although the specific content of the intervention has not been finalized, it will likely include cell phone reminders, an HIV knowledge intervention, a peer navigator system, peer support groups/adherence clubs, a family disclosure/”treatment” buddy intervention, a microenterprise incentive, and transportation incentives. The results of this pilot intervention will inform the creation of a larger, multi-center project to formally test a multi-faceted intervention to reduce loss from the HIV care continuum related to syndemic conditions that will be scalable in the Indian context. The goal of this pilot intervention is to test the feasibility and acceptability of the components that may comprise this intervention.
The interns will assist in designing and adapting the pilot intervention components, managing initial study logistics, recruiting subjects, and conducting pre-intervention measures of depressive symptoms, internalized stigma, self-efficacy, and mental and physical health scores.
Students will be able to shadow Dr. Chan and/or YRG CARE HIV clinicians and counselors during rounds and clinic sessions and may also wish to get involved in related projects such a women’s livelihood project, community outreach initiative, and children’s camps. Depending on interest and availability, the students will also have an opportunity after the internship period is completed to analyze data and write abstracts and manuscripts under Dr. Chan’s direction.
Prior experience living/working in a low/middle-income country and interest in global health and/or HIV would be helpful, but are not strictly necessary. Experience managing complex teams and projects is a plus.
India is a colorful and interesting place to work, but can be chaotic, unpredictable, and occasionally frustrating. Thus, open-mindedness and flexibility, in addition to eagerness, humility, and ability to be culturally sensitive, are necessary qualifications.
YRG CARE is described above and can be best thought of as a busy, urban health care and research facility. There may be other interns involved in other YRG CARE projects.
On a scale of 0 to 5, the level of internship supervision from very little (0) to a great deal (5) will be a 2.
- Online CITI training
- Indian visa
- Travel clinic appointment
Quotes from Previous Fellows
“My name is Andrew Yang, and I am a rising junior at Harvard studying Bioengineering. This summer, I am interning at the Y.R. Gaitonde Center for AIDS Research and Education in Chennai, India. I am working on a study that looks at the effectiveness of Electronic Patient Reported Outcomes (ePRO) and Computer-Assisted self-interviewing (CASI) as ways for patients to self-report their information at the beginning of every doctor's visit. Compared to the current method of Electronic Health Records (EHR), where the healthcare provider records the data from the patient, there is the potential for ePRO to be more accurate and save time for the doctor. In addition, I will be helping out with other projects at the hospital.” Andrew Yang, Summer 2018
“This summer, Andrew and I are working on designing a survey to test the 1) feasibility and 2) usefulness of having patient recorded outcomes (PROs) instead of having a clinician record this data at patient check-up visits. PROs in other settings has been shown to provide better, real-time data unaffected by the business of the clinic and limit social desirability bias. By making this survey and testing it out on 50 patients, we will gain a little knowledge into the effectiveness of PROs in low-income HIV/AIDS hospitals in India and similar places.” Nishita Sinha, Summer 2018
“This summer I am interning at YRG Centre for AIDS Research and Education in Chennai, India. I am working on a study that aims to better understand the psychosocial and structural factors that impact loss from the HIV care continuum in India. I also spend time shadowing the clinicians and counselors to gain insight into the many aspects of care for people living with HIV.” Isabella Colocci, Summer 2017
“Along with an incredible team of Indian and American coworkers, I am spending this summer at the Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE) researching how and why people living with HIV either adhere or stop adhering to their treatment regimens. Our research, which will include interviews with over 60 patients, will add to the vast body of research produced at YRGCARE that has helped lead the fight against the HIV/AIDS epidemic in India and beyond. I am also lucky enough to be involved in YRGCARE's mission to empower the wider HIV/AIDS community by participating in children's camps and community cooking programs for underprivileged community members.” Jared Perlo, Summer 2018