Mombasa

Greetings Friends and Family!

I’m home from Mombasa and enjoying our wet fall weather. I wanted to give an update on my trip since I had little time to write once I got there. The weather was beautiful, in the upper 80’s-mid 90’s with a few rain showers but never any thunder or lightning (which is one of my favorite things about Africa so I was disappointed we didn’t have any). I was conducting a training for the first 3 days for an ancillary study we are starting at 3 of my Uganda sites looking more closely at adherence to PrEP. The remaining 3 days we had our annual PrEP workshop with our site staff. Every year we have this workshop and each of our 9 clinical sites gets to invite 9 of their staff (usually the lead counselors, clinicians, pharmacist, data, recruitment, etc) to attend the workshop. This year we had almost 150 people in attendance. The days are packed with talks and mini workshops and fly by quickly. I usually leave my room at 7:15 in the morning and don’t return until 11:00 at night.

For a quick review of what I do- I am working with a group, called the International Clinical Research Center (ICRC) which is part of the Department of Global Health at UW. We conduct large scale clinical trials in East and South Africa on HIV Prevention. We are currently doing a study called PrEP which stands for Pre-exposure Prophylaxis. The idea is similar to taking birth control or malaria prophylaxis—taking a pill each day to prevent something from occurring or taking root in your body, in this case HIV infection. We work with couples, where one person is HIV positive and the other is HIV negative. The HIV negative person takes a pill a day in the hopes that they will stay negative, this of course is in the context of all the other best prevention practices such as condoms and counseling. We currently have over 2700 couples enrolled in Kenya and Uganda, that is over 5000 people! There are other groups conducting PrEP trials, but we are conducting the largest and the only group looking at heterosexual couples. If you are interested, you can check out www.prepwatch.org which is a website managed by AVAC which is an advocacy group for HIV prevention, or our website www.uwicrc.org. I am proud to say that our study has more HIV negative females enrolled than any other PrEP study. Why is this important you ask? Women will benefit the most if PrEP works. PrEP would allow them to protect themselves when their HIV infected husbands or partners refuse to use condoms (which is very often the case). The workshop was a great success and it was great to see the staff from my 5 sites in Uganda. For most of the staff coming from Uganda, this was their first trip on an airplane, their first time out of their country, their first time staying at a fancy resort and their first time seeing an ocean.

Some tidbits from the trip-

· I almost walked into a spider web in the dark that had a spider in it that was bigger than a baseball…that was exciting!

· After the site staff left, the Seattle based staff (the Coordinating Center) had a little team building time which included camel racing on the beach. Camels are very tall, I hadn’t really realized that until I was on top of one of them. My camel came in second place.

· Most people left on Saturday for the airport but those of us that were still around went into old town Mombasa for dinner. We ate at this great local Swahili place and had the best local food I’ve had on any of my Africa trips (this was trip #9). There were cockroaches running around that we flicked off of our table but the food was still superb. My medical director announced after the meal that he couldn’t guarantee that we wouldn’t all get really sick from this meal but luckily that didn’t happen. There’s nothing worse than being sick when you are sitting on an airplane for 25 hours.

· The Indian ocean was very warm (with pockets of hot water) and was a joy to wade in and swim.

· Beach boys are a pain- they are men that comb the beach trying to make money. They are trying to sell you’re their goods or services (yes, they make quite a living selling sexual favors to tourists). As soon as you step foot on the beach, you are approached by at least 5-10 of them.

· The nights are warm and very pleasant in Mombasa. There is a constant breeze from the ocean. Many nights after the sessions and dinner was done a few of us would head to a spot near the orange cat (see the pictures) and listen to the waves and watch the beach boys and ladies of the night walk back and forth down the beach. The stars were amazing and the sand crabs would having boxing matches over sea weed.

· I’ve posted pictures (follow the link below) of my trip.

Overall it was a good trip. My next trip will be in either December or January and I will be heading to Uganda.