Spotlight On… Sylvia Shangani, PhD

As told to URBAN ARCH Admin Core staff, March 2024

Tell us about your background and what led you to the field of HIV research.

I am a public health behavioral scientist focused on HIV prevention among socially vulnerable populations in the United States and sub-Saharan Africa. This interest is rooted in my fieldwork experiences at the height of the HIV epidemic in western Kenya, where I grew up. Virtually every family I knew, including my own, was affected.  My work involved close interactions with people living with HIV, their families and communities. I quickly realized that the most common health challenges we encountered had behavioral and social underpinnings. This motivated me to seek further study and expertise in behavioral and social aspects of health and disease.

What is your role in the recently funded THAU 50/50 study?

Part of what attracted me to BUSPH is the presence of colleagues who share my interest in understanding the social and behavioral risk factors for health inequities in HIV outcomes and developing interventions to address these factors. I learned about research opportunities related to this from Drs. So-Armah, Stein, and Kim. I started collaborations through an analysis that uses data from the Boston ARCH cohort to assess social vulnerability and mental health outcomes among people with HIV and substance use. THAU provided an opportunity to extend that work—I am helping the team apply social vulnerability measures in the THAU project. We will explore the impact of social vulnerability on health outcomes among aging people with HIV, focusing on the intersection of HIV, TB, and alcohol.

Some of your previous work focuses on HIV prevention among vulnerable populations in sub-Saharan Africa. The THAU 50/50 study will take place in Mbarara, Uganda (the current site of the TALC study). What are some things that are important for us to remember about the context of research in this region, compared to the US?

My previous work includes studies of HIV prevention among sexual minority men in Kenya and stigma and discrimination associated with HIV infection in the sub-Saharan Africa (SSA) context. It is important to remember that SSA encompasses diverse cultures and societal norms, which significantly influence perceptions of HIV, healthcare-seeking behaviors, and the acceptability of prevention strategies. Understanding these differences is essential for effective engagement and successful intervention implementation. Also, the healthcare infrastructure is less well-resourced, both in terms of equipment and personnel, and we need to approach research conduct with this in mind so as to be most helpful to providers, scientists, and communities. In addition, there may be differences in the prevalence and types of comorbidities. In all settings, however, engagement with and respect for all stakeholders is fundamental.

What are you most excited for looking ahead to the future of the THAU 50/50 study? Any ideas for future directions of research?

I look forward to establishing collaborations and conducting the analyses once we have actual study data. I am curious to understand how similar or different the impacts of social vulnerabilities are in the two settings. I am eager not only to help advance our research into the best tools for assessing social vulnerabilities, but also to develop setting-appropriate interventions that can mitigate these impacts in order to improve community health.

Tell us one thing about yourself that readers might find surprising.

I like to cook and enjoy experimenting with new recipes. I own a collection of cookbooks, but I often can’t resist buying one more whenever I visit a bookstore.

Any other comments?

I am looking forward to this year’s URBAN ARCH Annual Meeting. It will be my first, and I see it as an opportunity to meet many people with whom I can establish collaborations and discuss new ways to move HIV prevention forward.