Institute for Global Health & Infectious Diseases
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Lillian Brown, MD/PhD student, is working to curb the spread of HIV in Malawi

brown and hiv counselorsLillian Brown with two HIV testing counselors, Pearson Mmodzi (left) and Angela Mwaipape

September 18, 2009 -- Lillian Brown is an ambitious student with a long list of accomplishments. Not only has she has taken on the challenge of earning a medical degree and a doctorate in epidemiology at the same time, but she has also recently been awarded a prestigious individual training grant from the National Institute of Mental Health (NIMH) to support her graduate studies. But right now the thing Brown is most proud of is that after 14 months in Malawi, she can deliver more than half of the standard health talk at the STD clinic in Chichewa, the local language. "The patients think it’s hilarious," she said.

Brown is in Malawi completing her dissertation research on HIV partner notification. Studies of partner notification of HIV status in the developed world have shown concrete benefits by locating previously undiagnosed partners and getting them into care, but there have not been similar studies of partner notification in the developing world.

Her research is based in an outpatient STI clinic in Lilongwe, Malawi where an estimated 17% of adults aged 25-49 are infected with HIV, and approximately two-thirds of the clinic’s patients are infected. The study’s objective is to determine the best method for getting the sexual partners of patients who are diagnosed with HIV in the clinic to go to the clinic for HIV counseling and testing. Brown is also examining community-level factors influencing HIV counseling and testing behavior in Lilongwe in order to learn more about the individual and societal factors that influence HIV testing.

brown and study teamLillian Brown with her study team in Malawi

Getting Malawians to talk about their sexual partners, particularly if it involves admitting to infidelity, can be difficult and requires a good degree of cultural awareness and attention to language and nuance. Brown worked closely with the clinic staff and community health workers in Lilongwe to develop a study protocol that was sensitive to Malawian culture and social mores.

“I really love my team in the clinic,” Brown said. “I have learned so much from them.” In particular, Brown says, her colleagues have shown her “what our research actually means for the people of Malawi and how it improves their lives.”

After finishing her Ph.D. research, Brown will return to Chapel Hill for her last two years of medical school. As for her long-term goals, Brown is not sure yet. She enjoys teaching and mentoring: she mentored two Morehead-Cain scholars in Malawi this summer and has developed an epidemiology and research methods course that she teaches to visiting students and Malawian clinicians at UNC Project.

But Brown is also drawn to field work. “I want to be on the ground doing the research and seeing the results,” she said.

- Lisa Chensvold