Here is what most people know: A person diagnosed with HIV, who two decades ago would almost certainly have died within a few years, now can take medicines to control the disease and stay healthy for decades.
Here is what many people don’t know: People today have a greater than 90 percent chance of preventing HIV all together — simply by taking a preventive pill every day.
Yet many, many people who are in danger of contracting HIV — especially gay and bisexual men — aren’t aware of the pill. What’s worse: many physicians aren’t aware of the pill either.
How can that be? And how can we change that?
Those are the sort of questions Christina Sun likes to ask in her public health research. They’re also among the questions she is studying now.
Sun, who has a Ph.D. in social and behavioral sciences, is an assistant professor with the OHSU-PSU School of Public Health. Her research background is in the study of sexuality and sexual health, and includes a focus on studying populations with HIV and on the prevention of HIV.
As Sun learned of the evidence on the HIV prevention pill, she wanted to understand why more patients and physicians weren’t aware of it. She is now the principal investigator of a study that seeks to answer that and other questions.
Taking the pill to prevent HIV infection is called pre-exposure prophylaxis, or PrEP. The actual pill, sold under the name Truvada, is a combination of two HIV medicines. The Food and Drug Administration approved the pill for PrEP in 2012. Sun is working to find and interview men who are using PrEP, or seeking to use it, or have used PrEP in the past.
The study is seeking to determine what helped men get the pill when they were interested in taking it, and what hindered men who weren’t able to get it. It is also looking at psychological effects of using PrEP.
Sun says many physicians may have limited knowledge about PrEP. And physicians also need to be aware of the periodic follow-up testing that needs to be done with patients to ensure the pill is not affecting patients’ kidney function, Sun says.
“Health care providers need more support and training around this,” Sun says. “Instead of the onus being on the patient, we need to ask: What can health care systems do to help communication go both ways on important health issues like this?”
As of the spring of 2017, Sun and her associates had enrolled 25 Oregon men into the study; they were hoping to enroll another 15, including more men from rural Oregon.
Sun has also recently won some significant awards for other research.
She and Travis Lovejoy, Ph.D., M.P.H., an assistant professor at the School of Public Health and in OHSU’s Department of Psychiatry, were awarded a grant from the School of Public Health Research Pilot Grant Award Program, intended to grow collaborative research among OHSU and PSU faculty. They will look at the role of opioids and marijuana for pain and symptom management for HIV positive patients.
Throughout her research – especially on HIV/AIDS issues – Sun says she has worked to focus on why some people have more limited access to medicine and treatment that could help them. “I think there’s a larger social justice issue here. With all we know on how to prevent HIV, why are there still groups that aren’t getting the same access?” she asks. “I think that’s a really big issue.”
It’s also important to search out, and then collaborate and partner with the underserved communities that often aren’t helped, or listened to, she says.
“I think, especially when we work with underrepresented and underserved communities, understanding the perspective of those communities is really important,” she says. “That diverse perspective will help improve the health of our communities.”