RESEARCH POSTER PRESENTATION DESIGN © 2012 www.PosterPresentations.com • HIV/AIDS clinic and research center in Santo Domingo, Dominican Republic • Clinic team includes doctors, nurses, pharmacists, lab technicians, administrators, a social worker, and a psychologist, among others • Treats HIV-positive patients through the Dominican Republic’s national program • Advances pharmaceutical research through enrollment in stage 2 and 3 clinical trials of novel antiretroviral agents Instituto Dominicano de Estudios Virológicos (IDEV) • Build Spanish language skills • 488,334 (7.9%) MA residents speak Spanish at home (2012, census.gov) • Experience Dominican culture • 103,292 (1.6%) Dominican Americans in MA (2010, census.gov) • Understand social and cultural views that affect HIV transmission and care • Improve medical interviewing and physical examination skills • Observe opportunistic infections characteristic of HIV infection and AIDS • Understand how HIV infection is diagnosed and treated in the Dominican Republic • Understand the availability and selection of antiretroviral regimens at IDEV and compare/contrast with clinics in the United States Objectives • Visited hospitalized patients at the Centro Medico Dominico-Cubano, where they received care for life-threatening, AIDS-related opportunistic infections • Participated in rounds at Robert Reed Cabral Children's’ Hospital • Visited specialized dengue unit • Observed case of neonatal Chikungunya virus infection • Attended Dr. Carlos Adón’s lecture on the role of evidence-based medicine in HIV care at Hospital Padre Billini Additional Medical Experiences • Attended morning meetings with IDEV physicians • Session topics included emerging infectious diseases, current HIV clinical knowledge, NEJM case studies, and safety information for research drugs • Observed and assisted in medical interviews, physical exams, and vital signs • Observed 10 different physicians conduct interviews in 3 languages (Spanish, English, and Kreyol) • Observed various opportunistic infections via physical exam and imaging • Pneumocystis jirovecii pneumonia (PCP), Toxoplasma gondii encephalitis, reactivation TB, Herpes zoster, oral candidiasis • Completed an introductory lecture series on HIV biology, pathology, epidemiology, and therapy with Dr. Carlos Adón, sub-director of IDEV • Participated in community outreach activities in several local barrios • Administered questionnaires to drug users to understand the risk factors for HIV transmission within these communities • Provided counseling about reducing one’s risk of infection • Enrolled participants in free HIV rapid tests • Assisted in a study that sought to identify clinical differences between HIV+ and HIV- patients with Chikungunya virus infections • Identified patients who had fallen ill with suspected Chikungunya virus infection within the previous 2 weeks • Guided patients through informed consent process and questionnaire • Collaborated with laboratory team to obtain patients’ blood samples for CHIKV IgM test Clinical/Research Experiences at IDEV “Physician as a Person” • Santo Domingo • Made many new friends from IDEV and local medical schools (Universidad Nacional Pedro Henríquez Ureña (UNPHU) and Universidad Iberoamericana (UNIBE)) • Enjoyed Dominican food, music, and television during my homestay • Danced merengue, bachata, and salsa in the Zona Colonial • Went running along the seaside Malecón • Explored the caves of Tres Ojos • Navigated the city’s transportation system, including guaguas, carros públicos, and a new subway system • Samaná Peninsula • Enjoyed the beaches and restaurants of las Terrenas and las Galeras • Went horseback riding to Salto del Limón, a waterfall and swimming hole • Isla Saona • Saw dolphins and giant star fish, swam in the piscina natural, enjoyed fresh fish at a beachside restaurant Conclusions and Next Steps • The IDEV family provided me with support and guidance for the entirety of my experience in the Dominican Republic. • I learned how a clinic is run, and how clinical trials are conducted. • I plan on familiarizing myself with HIV/AIDS care in the US to compare/contrast and to build on my current knowledge. Acknowledgements • Dr. Ellen Koenig – Director, IDEV • Dr. Carlos Adón – Sub-Director, IDEV • Sr. Aldo Erazo – Head of International Affairs, UNPHU • Dr. José J. Asilis-Záiter – Dean of Faculty of Health Sciences, UNPHU • Dr. Douglas Golenbock – Chief of Infectious Disease & Immunology, UMMS • Rosa Ramírez & Jennifer Piña – my loving homestay family • All of my wonderful teachers, mentors, and friends at IDEV • Please direct questions and comments to Andrew Wilbur: • [email protected], 617-959-1157 Andrew Wilbur, MSII Global Health Pathway HIV/AIDS Care in the Dominican Republic