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SMNTY Interviews: Dr. Sika Dedo · Stuff Mom Never Told You

0:05
Speaker 1: Hey, this is Anny and Samantha. I'm what kind of
0:07
Speaker 1: stuff I never told your production of iHeartRadio.
0:18
Speaker 2: And y'all, I'm so excited because I think we've been
0:21
Speaker 2: working on this episode for a minute, especially like in
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Speaker 2: my head, because we are bringing on one of my
0:27
Speaker 2: good friends who has done an amazing amount of work
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Speaker 2: and recently graduated with her doctorate. Yes, doctor, she is
0:36
Speaker 2: a doctor, and we must celebrate all those things. We
0:39
Speaker 2: are bringing on doctor Sika Debt. Oh, we're gonna call
0:43
Speaker 2: her doctor Debto, although sometimes you know, I might call
0:46
Speaker 2: her by Ceci because we close like that, right, CEC. Absolutely,
0:52
Speaker 2: But for this episode, you have earned that title of
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Speaker 2: doctor Debto because you have done so much amazing work
0:59
Speaker 2: and I'm so exc to talk about the research that
1:01
Speaker 2: you have been doing and has finished.
1:04
Speaker 3: But it's never finished. Let's just be real honest, right.
1:06
Speaker 2: But first, before we get into it, because obviously I'm
1:08
Speaker 2: jumping ahead because I'm too excited about this episode, can
1:11
Speaker 2: you introduce yourself for our listeners?
1:14
Speaker 4: Thank you so much, Samantha for the introduction. I would
1:17
Speaker 4: love to introduce myself. Hello everyone, my name is doctor
1:21
Speaker 4: Sika or Ccdetto, and I'm really happy to be here
1:24
Speaker 4: with you today. Samantha. You are right. We've been talking
1:28
Speaker 4: about this for a while, and I'm excited to finally
1:31
Speaker 4: share a bit more about my work and my journey.
1:34
Speaker 4: My academic focus centers on maternal health and public health,
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Speaker 4: and my dissertation explored antenato care utilization and HIV AIDS
1:43
Speaker 4: awareness among women of reproductive agent Senegal. So really quickly,
1:48
Speaker 4: I want to give you key definitions. Intonato care refers
1:52
Speaker 4: to the routine healthcare women receive you during pregnancy, including
1:56
Speaker 4: medical checkups, health education, screenings, and support aimed at ensuring
2:01
Speaker 4: the health and well being of both the mother and
2:03
Speaker 4: the baby and women of reproductive age. And the study
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Speaker 4: is the finest women between the ages of fifteen to
2:10
Speaker 4: forty nine years old. I mentioned that my dissertation topics.
2:14
Speaker 4: I recently graduated in December from Georgia State University located
2:18
Speaker 4: in Atlanta with my doctorate of Public Health. I started
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Speaker 4: the program in twenty twenty one and I graduated in
2:27
Speaker 4: twenty twenty five. So for beautiful years working to receive
2:34
Speaker 4: my degree, which I'm very proud of and very excited about.
2:38
Speaker 4: And as you know, Samantha, who I've been talking to
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Speaker 4: you about this dissertation for a while now. So I
2:46
Speaker 4: also want to give some information about who I am.
2:49
Speaker 4: Who is this person speaking with you today. So I
2:52
Speaker 4: come from both Togo, a beautiful country located in West Africa,
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Speaker 4: and the United States. My father is Total Lees and
3:00
Speaker 4: my mother is from here. Tog is a western country
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Speaker 4: bordered by Ghana, Benin and Burkina Faso. I lived in
3:10
Speaker 4: Togo for the first six years of my life, and
3:12
Speaker 4: after that my family and I relocated to the US
3:16
Speaker 4: and we continue to visit Togo regularly thereafter, which really
3:19
Speaker 4: allowed me to maintain strong cultural and personal ties that
3:23
Speaker 4: really continue to inform my work in perspective in public health.
3:28
Speaker 4: Living in Togo and visiting regularly has deeply shaped how
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Speaker 4: I see health, culture and access to care across different settings.
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Speaker 4: I selected Senegal for my dissertation because of its unique
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Speaker 4: public health landscape, its regional importance in West Africa, and
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Speaker 4: the valuable lessons it offers for improving maternal and HIV
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Speaker 4: related health outcomes. Senegal is a success story for HIV.
3:53
Speaker 4: They have a very low prevalence rate under one percent.
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Speaker 4: For those who may not know, Senegal is located on
4:00
Speaker 4: the western coast of Africa along the Atlantic Ocean, and
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Speaker 4: it's bordered by Mauritania to the north, Molly to the east,
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Speaker 4: Guinea and Guinea Bissau to the south. In the Gambia,
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Speaker 4: which is almost entirely surrounded by Senegal, Senegal plays a
4:15
Speaker 4: key role in public health research in the region. I'm
4:18
Speaker 4: looking forward to this conversation into sharing insights, experiences and
4:22
Speaker 4: ideas with you all.
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Speaker 2: And it's such a big topic. I remember when you
4:27
Speaker 2: were telling me about your work. I had to kind
4:29
Speaker 2: of stop you and look at you real straight, like wait, wait,
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Speaker 2: back up, back up. I need to hear more clarification
4:35
Speaker 2: about your work because it was so amazing, like it's
4:39
Speaker 2: so needed. But it's very like concentrated you have, which
4:44
Speaker 2: is probably why you doctor Ebody. You had so much
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Speaker 2: in this research. You traveled for this research, You've done
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Speaker 2: so much data, and you did so much work within
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Speaker 2: the field that I was like, oh my god, this
4:56
Speaker 2: is amazing.
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Speaker 3: We have to talk about it. And when you were
4:59
Speaker 3: telling me.
5:00
Speaker 2: About your research, you sit us like your outline and
5:05
Speaker 2: so I'm going to read the title here. Make sure
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Speaker 2: I get this right, okay, doctor Detta, make sure I
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Speaker 2: am clarifying in the title saying looking at antenatal care
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Speaker 2: and knowledge of HIV transmission among reproductive age of women
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Speaker 2: in Senegal.
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Speaker 4: Correct, Yes, that is correct? All right?
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Speaker 3: Can you tell us what this is?
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Speaker 4: Absolutely I'll be happy to share more about my research
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Speaker 4: as discussed. I've been engaged in this type of research
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Speaker 4: for over sixteen years and this work was conducted from
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Speaker 4: my Doctor of Public Health dissertation at Georgia State University
5:40
Speaker 4: and it focuses on two closely connected areas INTNADO care
5:44
Speaker 4: utilization and knowledge of HIV transmission among women of reproductive
5:49
Speaker 4: age and Senegal. I'll start with intonado care, often referred
5:53
Speaker 4: to as A and C. An C is incredibly important
5:57
Speaker 4: because the timing and the number of visits during pregnancy
6:00
Speaker 4: can significantly affect the health and well being of both
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Speaker 4: the mother and the baby. For pregnant women, and C
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Speaker 4: is the main entry point into the healthcare system. It's
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Speaker 4: really where they receive medical care, health education, screening, and support,
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Speaker 4: including services that help prevent mother to child transmission of HIV.
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Speaker 4: So the World Health Organization recommends eight or more intonatal
6:24
Speaker 4: care visits, with the first visit occurring during the first trimester.
6:29
Speaker 4: Of pregnancy. Research shows that when women receive adequate and
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Speaker 4: timely AC outcomes improve. These visits help the health providers
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Speaker 4: identify and treat complications early, and evidence suggests that having
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Speaker 4: eight or more visits can reduce perinatal mortality. So, really, overall,
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Speaker 4: an C plays a critical role in supporting healthy pregnancies
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Speaker 4: and healthy births. The second part of my research focuses
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Speaker 4: on HIV AIDS awareness and knowledge of HIV transmission. Awareness
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Speaker 4: of HIV in understanding how it is and is not transmitted.
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Speaker 4: Both of those are key to prevention. Research consistently shows
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Speaker 4: that knowledge of HIV transmission pathways influences health behavior, while
7:16
Speaker 4: limited understanding of HIV prevention contributes to ongoing transmission. In
7:22
Speaker 4: this study, to measure HIV knowledge, the study used five
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Speaker 4: key questions that together define what's known as comprehensive knowledges
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Speaker 4: of HIV. These questions assess whether individuals understand accurate modes
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Speaker 4: of transmission and also can reject common misconceptions. For example,
7:44
Speaker 4: participants were asked whether consistent condom use can reduce the
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Speaker 4: risk of HIV, whether having one uninfected and faithful partner
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Speaker 4: lowest risk, whether HIV can be transmitted through mosquito bites
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Speaker 4: or sharing food, and whether a person who looks healthy
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Speaker 4: can still have hip. As you can see, this research
8:03
Speaker 4: is robust and there's a deeper dive I can take
8:07
Speaker 4: into each section, but I will pass it over to
8:10
Speaker 4: you and see if you have any other questions.
8:12
Speaker 2: For me, I want to back up just real quick,
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Speaker 2: because you said you've been in this public health bold
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Speaker 2: for sixteen years and then you jumped into this.
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Speaker 3: How did you get into all of this?
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Speaker 4: That's a great question, and for me, this type of
8:23
Speaker 4: research is deeply personal. My interest in public health and
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Speaker 4: global health really began with my lived experiences. Like I
8:31
Speaker 4: said earlier, I spent the first six years of my
8:33
Speaker 4: life in Togo, and after that my family and I
8:36
Speaker 4: continue to visit to go regularly, and being immersed in
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Speaker 4: that environment gave me an early and very real understanding
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Speaker 4: of health and how health is shaped not only by
8:47
Speaker 4: our biology, but by where you live, your resources, your education,
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Speaker 4: and your access to care. During that time, my family
8:57
Speaker 4: experienced a loss of a loved one as we went
8:59
Speaker 4: back in for if. I think I was about as
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Speaker 4: a teenager at that time, and that moment was pivotal
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Speaker 4: for me. It raised so many questions. I have questions
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Speaker 4: about the health system's access to care, prevention, and why
9:11
Speaker 4: outcomes can look very different depending on the context. This
9:17
Speaker 4: pushed me to start asking deeper health questions and I
9:21
Speaker 4: started to look beyond like someone's individual behavior and I
9:25
Speaker 4: took a broader approach to what shades health outcomes. That's
9:31
Speaker 4: really when I began to understand and connect the concept
9:34
Speaker 4: of the social determinants of health and the social determinants
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Speaker 4: of health. It's the idea that there are factors like income, education, culture,
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Speaker 4: health access, geography, factors like that they really play a
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Speaker 4: major role in one's health and well being. I personally
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Speaker 4: saw fer ashand how these social detail perminents impact my
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Speaker 4: family's health. During my academic journey at Georgia State, I
10:07
Speaker 4: knew I wanted to focus on making a difference, and
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Speaker 4: I particularly wanted to focus on HIV AIDS and I
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Speaker 4: wanted to emphasize women because I feel like their voices
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Speaker 4: and experiences are often underrepresented in research. That desire really
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Speaker 4: led me to study Antennado care utilization and HIV AIDS
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Speaker 4: awareness and knowledge of HIVH transmission among this population of
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Speaker 4: women in Senegal. This research really allowed me to explore
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Speaker 4: how access to care, knowledge, and structural factors intersect, and
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Speaker 4: how strengthening systems and education can lead to better health outcomes. Altimately,
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Speaker 4: this work is about more than data. For me, It's
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Speaker 4: about honoring lived experiences, addressing inequities, and contributing to solutions
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Speaker 4: that are informed by evidence, culture, and compassion. That's what
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Speaker 4: continues to motivate me and guide me through my work
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Speaker 4: and public health and global health.
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Speaker 3: That's amazing.
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Speaker 2: I'm sorry for your loss, but I love that that
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Speaker 2: grew into a passion. Obviously with you doing such important work,
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Speaker 2: because when you were talking about how Senegal did have
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Speaker 2: a successful story, it's obvious that you are looking at
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Speaker 2: this as a broader picture.
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Speaker 3: Am I correct?
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Speaker 4: Absolutely, yes, I definitely am.
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Speaker 2: How would that translate into worldwide care?
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Speaker 4: That's an important question and it's one that I thought
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Speaker 4: about a lot while conducting this research. While my research
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Speaker 4: focuses on Senegal, the issues that examines, which are access
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Speaker 4: to INSINATO care and knowledge is HIV transmission. There are
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Speaker 4: global challenges and they're not limited to a single country. Really, like,
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Speaker 4: at its core value, this research highlights how early adequate
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Speaker 4: and in tonato care can serve as a powerful entry
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Speaker 4: point and so health care system for women everywhere around
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Speaker 4: the world. INTNATO care is often where women first receive
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Speaker 4: health education, screening, and preventing services. The patterns we see
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Speaker 4: in Senegal, such as the impact of the timing and
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Speaker 4: frequency of visits and access barriers, they mirror what we
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Speaker 4: see in many low to middle income settings. These fightings
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Speaker 4: they reinforce the idea that strengthening maternal health systems has
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Speaker 4: ripple effects far beyond pregnancy alone, and for the HIV
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Speaker 4: component of the research, this also translates globally. Knowledge of
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Speaker 4: HIV transmission and the ability to reject common misconceptions is
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Speaker 4: a key driver of health behavior everywhere. Whether it's in Senegal,
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Speaker 4: whether it's in other countries in West Africa or elsewhere
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Speaker 4: in the world, misinformation can increase, while accurate knowledge empowers
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Speaker 4: people to protect themselves and their families. Senegal success in
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Speaker 4: HIV prevention offers lessons that can be adapted globally, particularly
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Speaker 4: around integrating education into routine health services like Intinado care.
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Speaker 4: Also another way this research translates worldwide is it's focused
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Speaker 4: on the social determinants of health, so we know these
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Speaker 4: are factors such as education, social economic status, geography, and
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Speaker 4: health systems access. All of these influenced outcomes no matter
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Speaker 4: where you resign. When we are identifying how these determinant
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Speaker 4: shape intenado care use, and HIV knowledge and senegal the
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Speaker 4: research really provides a framework that policymakers, practitioners, public health specialists, researchers,
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Speaker 4: and other stakeholders how they can apply these in the
13:54
Speaker 4: context to identify gaps and design more equitable interventions. Over All,
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Speaker 4: this research shows that I'm improving maternal health and HIV
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Speaker 4: outcomes isn't just about individuals choices, It's about systems. When
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Speaker 4: health systems are accessible, culturally responsive and grounded and evidence
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Speaker 4: they can support healthier outcomes for women and families everywhere.
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Speaker 1: Yes, and it really is a lot to consider when
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Speaker 1: you're looking at different populations and communities, and I imagine
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Speaker 1: that that can take a while to consider all of
14:27
Speaker 1: those things. How long have you been doing this research?
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Speaker 4: So I started the research in twenty twenty three and
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Speaker 4: I completed it in twenty twenty five, so a little
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Speaker 4: over two years.
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Speaker 1: Let's not do bad comfort a lot of ground in
14:44
Speaker 1: two years.
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Speaker 2: I mean, that's still a lot of work obviously, because
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Speaker 2: I know when I was talking to you throughout the process,
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Speaker 2: You're like, I have to redo this, I have to
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Speaker 2: revamp this, I have to redo this, Like I don't
14:55
Speaker 2: like every weekend was like, oh my god, I have
14:56
Speaker 2: to stay up to do this and this. So I
14:58
Speaker 2: already know the amount of work that you had to
15:01
Speaker 2: put in there, but still you are fast tracking in
15:04
Speaker 2: your own like getting it out there, which is impressive.
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Speaker 2: Which is so impressive when you look at the scale
15:11
Speaker 2: of work, and you kind of already talked about some
15:14
Speaker 2: of this. But let's talk about with your dissertation being presented,
15:18
Speaker 2: was there a result of this research.
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Speaker 4: Of course, I'm more than happy to discuss that with
15:23
Speaker 4: you quickly. I would like to rewind and discuss the
15:27
Speaker 4: objectives and clearly state what each objective is. So I
15:31
Speaker 4: had three research objectives. The objective for the first piece
15:36
Speaker 4: is to look at Incinato care intensity. This was looking
15:40
Speaker 4: at the number of times a woman receives her Intonado
15:44
Speaker 4: care visits and we're looking for eight or more. As
15:47
Speaker 4: you recall, the World Health Organization recommends that women receive
15:50
Speaker 4: eight or more visits. The second objective is also related
15:54
Speaker 4: to Intonato care and we're looking at the timing of
15:56
Speaker 4: the first visit. You also recall that I'm mentioned earlier
16:01
Speaker 4: that the World Health Organization recommends that the first visit
16:04
Speaker 4: occur within the first trimester of pregnancy. The third objective
16:09
Speaker 4: is for HIV AIDS awareness and knowledge of HIV prevention.
16:15
Speaker 4: This was assessed by asking respondents questions such as, have
16:19
Speaker 4: you ever heard of HIV or AIDS? Can people reduce
16:24
Speaker 4: their chance of getting HIV by using a condom every
16:26
Speaker 4: time they have sex? HIV is a virus that can
16:30
Speaker 4: lead to AIDS. Can people reduce their chance of getting
16:32
Speaker 4: HIV by having just one unaffected sex partner who has
16:36
Speaker 4: no other sex partners? Can people get HIV from mosquito bites?
16:40
Speaker 4: Can people get HIV by sharing food with a person
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Speaker 4: who has HIV? Is it possible for a healthy looking
16:46
Speaker 4: person to have HIV? So these types of questions were
16:49
Speaker 4: asked and responses determine one's level of knowledge of HIV
16:56
Speaker 4: transmission and one's awareness of HIV AIDS. So this brings
17:00
Speaker 4: me to your initial question discussion of my results. When
17:05
Speaker 4: I analyzed the results, one of my main goals was
17:07
Speaker 4: to understand which factors were meaningfully associated with intinnatal care
17:11
Speaker 4: use and knowledge of HIV transmission. In other words, which
17:15
Speaker 4: relationships were statistically significant and not happening by chance. Starting
17:21
Speaker 4: with INTONADO care. The results showed some important patterns. I
17:25
Speaker 4: will highlight a couple of them. It showed that women
17:29
Speaker 4: with higher education, greater wealth, and women who were employed
17:33
Speaker 4: within the previous year were significantly more likely to attend
17:37
Speaker 4: eight or more visits, and these factors stood out even
17:41
Speaker 4: when other variables were taken into account. We know that
17:44
Speaker 4: education plays a key role in early access to care.
17:48
Speaker 4: Women who were more educated and women whose husbands or
17:51
Speaker 4: partners at higher levels of education were more likely to
17:54
Speaker 4: begin INTNATO care in their first trimester, which is crucial.
17:59
Speaker 4: It's really critical for identifying and managing potential complications early
18:03
Speaker 4: in pregnancy. I also look closely at knowledge of HIV
18:06
Speaker 4: transmission and awareness of HIV AIDS, because awareness and accurate
18:10
Speaker 4: information are both essential to prevention. Across nearly all measures
18:15
Speaker 4: of HIV knowledge, education and wealth consistently mattered. For example,
18:22
Speaker 4: women who were more educated, wealthier, literate, and implored had
18:25
Speaker 4: higher odds of knowing that consistent condom use reduces the
18:29
Speaker 4: risk of HIV transmission. When I focus specifically on women
18:33
Speaker 4: who had recently given birth, younger age, along with education, wealth,
18:37
Speaker 4: and employment was also associated with the higher levels of
18:41
Speaker 4: this knowledge. I saw similar patterns emerging when I looked
18:44
Speaker 4: at knowledge related to having one uninfected sexual partner as
18:49
Speaker 4: a way to reduce HIV risks among all women. Increased education, wealth,
18:54
Speaker 4: and employment were linked to better understanding of HIV transmission
19:00
Speaker 4: women with recent births, those who were younger, more educated,
19:03
Speaker 4: and wealthier had higher odds of this knowledge. So overall,
19:08
Speaker 4: we see patterns that really show us that social determinants
19:11
Speaker 4: of health, social demographic factors, they all impact health knowledge wellbeing.
19:20
Speaker 4: So what does this all mean? The takeaway I would
19:23
Speaker 4: say is social and economic factors matter, and they matter
19:27
Speaker 4: a lot. Access to education, financial stability, and employment consistently
19:32
Speaker 4: shape both the use of INTNADO care and knowledge of
19:36
Speaker 4: HIV prevention. From a public health perspective, this tells us
19:41
Speaker 4: that increasing intonado care utilization requires intentional and strategic efforts
19:46
Speaker 4: that address the needs of the most disadvantaged populations, particularly
19:51
Speaker 4: across access, availability, and timing of services. It also shows
19:57
Speaker 4: that improving HIV awareness isn't just about delivering it information
20:00
Speaker 4: but about addressing the broader social determinants of health, all
20:04
Speaker 4: while respecting the cultural contexts. Ultimately, when intinad O care
20:09
Speaker 4: and HIV education are both accessible, timely and culturally responsive,
20:15
Speaker 4: they become powerful tools for improving health outcomes, not just
20:19
Speaker 4: for women but for their families and communities as a whole.
20:23
Speaker 2: That's really interesting, Like the overall conversations that we've had
20:27
Speaker 2: and we're still having even in the United States, is
20:29
Speaker 2: that comprehensive sexual and reproductive education really can make a
20:35
Speaker 2: giant difference if allowed. And this is like obvious in
20:39
Speaker 2: every other country, but yet even here in the US,
20:42
Speaker 2: we don't acknowledge that.
20:44
Speaker 3: I say we broadly, we'll leave it to that.
21:00
Speaker 1: Well, one thing we love to do when we have
21:03
Speaker 1: people who have such expertise on the show is kind
21:08
Speaker 1: of get a peek behind the curtains and get a
21:12
Speaker 1: better understanding of the process and kind of the personal
21:17
Speaker 1: aspect of the process. So for you, can you tell
21:21
Speaker 1: us what your experience was doing this research.
21:25
Speaker 4: I found this research to be incredibly rewarding, and I
21:28
Speaker 4: was especially impressed by Senegal's ability to use data to
21:32
Speaker 4: guide HIV prevention efforts, specifically by them focusing resources on
21:38
Speaker 4: key populations. These are populations at higher risks of acquiring HIV.
21:45
Speaker 4: So key populations are disproportionately affected by HIV and they
21:49
Speaker 4: play a critical role in reducing transmission. Overall, research shows
21:54
Speaker 4: that when HIV prevention efforts successively reach these populations, HIV
21:58
Speaker 4: rates decline only within those groups, but also in the
22:02
Speaker 4: general population. In Senegal, some key populations include men who
22:06
Speaker 4: have sex with men, female sex workers, and people who
22:09
Speaker 4: inject drugs. These groups carry a higher burden of HIV,
22:13
Speaker 4: but they also face significant barriers to prevention and care stigma, discrimination,
22:18
Speaker 4: and in some cases criminalization. In Senegal, sex work is
22:23
Speaker 4: legal and regulated. On the other hand, same sex relationships
22:28
Speaker 4: are criminalized, and that difference has real public health consequences.
22:34
Speaker 4: The criminalization of same sex relationships can really create barriers
22:39
Speaker 4: to HIV prevention among men who have sex with men,
22:43
Speaker 4: and there are a population that carries a disproportionately high
22:47
Speaker 4: burden of HIV in Senegal. Discriminalization it can feel stigma, fear,
22:54
Speaker 4: and it discourages people from seeking care, and it limits
22:57
Speaker 4: access to testing, treatment and prevention services even when targeted
23:02
Speaker 4: HIV programs exists. So overall, this entire process was very rewarding.
23:08
Speaker 4: I learned a lot and it made me want to
23:12
Speaker 4: explore topics more, one being sex work being legal and senegal,
23:17
Speaker 4: another being the criminalization of same sex relationships.
23:22
Speaker 2: Right in your time of research, did you have anything
23:25
Speaker 2: that you would consider like roadblocks or difficulties as you
23:28
Speaker 2: were going through this process.
23:31
Speaker 4: I would definitely say that anyone that says they did
23:33
Speaker 4: not have any roadblocks while they worked on their dissertation,
23:37
Speaker 4: I am ready to present them with an award. The
23:40
Speaker 4: answer is yes, I did have roadblocks. I would say
23:43
Speaker 4: one of my biggest roadblocks was trying to stick to
23:49
Speaker 4: a topic and not trying to expand it so much
23:53
Speaker 4: that it ends up being more than one dissertation. What
23:58
Speaker 4: I'm trying to say is, like I mentioned earlier, my
24:01
Speaker 4: dissertation is really three different papers and one. There were
24:06
Speaker 4: points in my study where I wanted to continue adding
24:09
Speaker 4: various topics. As I researched more and gain an interest
24:14
Speaker 4: for more, I wanted to add topics. So when I
24:18
Speaker 4: learned about the criminalization of same sex relationships, I wanted
24:23
Speaker 4: to discuss that and really take a deeper dive into
24:27
Speaker 4: how that impacts the HIV landscape in Senegal, so I
24:33
Speaker 4: did discuss it in my dissertation. However, I didn't make
24:36
Speaker 4: it a completely separate topic. I also wanted to discuss
24:40
Speaker 4: sex work and how sex work is legalized and this
24:44
Speaker 4: impact on the HIV landscape and how it facilitates with
24:50
Speaker 4: first of all, treating HIV amongst a population that is
24:56
Speaker 4: a key population in the country, and how it all
25:00
Speaker 4: soul support with the population overall. So there was a
25:07
Speaker 4: lot that I found that I wanted to take a
25:09
Speaker 4: deeper dive in. However, I have a great committee I have.
25:14
Speaker 4: I had a committee of three people, and I had
25:17
Speaker 4: a wonderful cheer as well. Everybody was supportive, and my
25:20
Speaker 4: chair really allowed me to see that the dissertation is
25:23
Speaker 4: not the end of the road. It's just the beginning.
25:26
Speaker 4: So there's a lot more that I can write on.
25:29
Speaker 4: Even after submitting the dissertation, there's more than I can publish.
25:33
Speaker 4: There's more that will be done. This is only the beginning,
25:36
Speaker 4: and you know, I really wanted to do other topics,
25:39
Speaker 4: but I just did not have the time. I would
25:42
Speaker 4: be working on this dissertation for like ten years if
25:45
Speaker 4: I wanted to cover the entire ground. I wanted to cover,
25:47
Speaker 4: there was just not enough time. The chair of my
25:50
Speaker 4: dissertation committee, so this is the person that leads a
25:53
Speaker 4: dissertation committee. The committee had three people, all very supportive
26:00
Speaker 4: throughout the entire process. So my chair did a really
26:03
Speaker 4: good job at also keeping me focused and reminding me
26:08
Speaker 4: that I should try to tailor my dissertation to specific
26:12
Speaker 4: topics and try to keep it together because expanding too
26:15
Speaker 4: much can really take my dissertation to a whole nother level,
26:21
Speaker 4: and that wasn't necessary. Furthermore, it will take more time,
26:25
Speaker 4: like I discussed earlier, and there just was not enough time.
26:28
Speaker 4: I will continue need you to focus exactly we needed to,
26:32
Speaker 4: And he even said we can publish later. We can
26:36
Speaker 4: publish later on various topics, but for this specific dissertation,
26:40
Speaker 4: let's focus. And I that was a great idea.
26:43
Speaker 2: Well, obviously you kind of already mentioned something that you
26:45
Speaker 2: wanted to expand with. Is there other things, like have
26:49
Speaker 2: you already kind of started an outline.
26:51
Speaker 3: Of like this is the next step for this research.
26:56
Speaker 4: I haven't started an outline of next steps per se. However,
27:00
Speaker 4: I do have like there's a section where I talk
27:05
Speaker 4: about what other studies can go into and that could
27:10
Speaker 4: be either for me or for the next researcher, and
27:14
Speaker 4: talked about how I looked at the number of anti
27:17
Speaker 4: natocare visits that women received, and the World Health Organization
27:21
Speaker 4: recommendation is eight or more. So I didn't look into
27:25
Speaker 4: what services that were actually received during each visit. So
27:29
Speaker 4: I know, let's say someone received eight visits, that's great,
27:33
Speaker 4: but what services did this person actually received during the
27:37
Speaker 4: eight visits and were those the services that were needed
27:41
Speaker 4: or was something missing? So I think there are other
27:44
Speaker 4: sections I can dive into an addition to what I've
27:48
Speaker 4: already done.
27:50
Speaker 2: In addition, like you're not you haven't done a giant
27:52
Speaker 2: amount of work already.
27:53
Speaker 3: I love that.
27:54
Speaker 2: I was just asking because you seem to have already
27:56
Speaker 2: like an idea of where it was all Going back
28:00
Speaker 2: with the research, is that something that surprised you doing
28:03
Speaker 2: your research or something that you discovered that you didn't
28:05
Speaker 2: know outside of you. I know you talked about the
28:07
Speaker 2: same sex and what was legal and what wasn't legal.
28:10
Speaker 4: Yes, outside of that, I'm trying to think what else
28:14
Speaker 4: surprised me. I think those two would be the big pieces. Yes,
28:20
Speaker 4: as far as what surprised me, But I will say,
28:22
Speaker 4: although this was not surprising, I did unexpectedly find out
28:27
Speaker 4: more about like their HIV AIDS communications because that was
28:32
Speaker 4: I was wondering how they're communicating to the general population
28:37
Speaker 4: about HIV AIDS, and doing that, I really went into
28:41
Speaker 4: a rabbit hole and almost wanted to write another paper
28:45
Speaker 4: on this, but of course I didn't. Yes, But doing that,
28:49
Speaker 4: I learned like they have a very very strong way
28:52
Speaker 4: of communicating to the public. It's done in schools, it's
28:57
Speaker 4: done within religious institutions. The Ministry of Health even works
29:05
Speaker 4: with religious leaders to educate them about HIVAS and ask
29:10
Speaker 4: them to educate their people. It's like a community effort.
29:15
Speaker 4: I thought that was interesting that they're actually working really
29:17
Speaker 4: well with the community for this education.
29:22
Speaker 1: So you've kind of touched on this already, and I
29:25
Speaker 1: think that you know, hopefully there's a lot of reasons
29:29
Speaker 1: why this is obvious to people, But can you tell
29:34
Speaker 1: us why this type of research is so important for
29:37
Speaker 1: the health of women and pregnant people internationally?
29:42
Speaker 4: Absolutely, I think that this is super important because if
29:48
Speaker 4: we want to know how to keep someone healthy, so
29:52
Speaker 4: I'm focusing on antenato care, if we want to know
29:54
Speaker 4: how to keep someone healthy. How to keep women healthy
29:58
Speaker 4: while they are bringing into the world a new life.
30:01
Speaker 4: We really need to understand how that can happen. So
30:06
Speaker 4: we already know that anti natal care is important. Research
30:10
Speaker 4: has showed it. We know that. We know that having
30:13
Speaker 4: eight or more visits is critical, having the visit being
30:16
Speaker 4: in the first trimester is critical. So we know all that.
30:19
Speaker 4: Now the question is, well, why isn't this happening. It's
30:23
Speaker 4: more than just oh, the person doesn't can't afford it.
30:27
Speaker 4: Access is more than just being able to afford something.
30:29
Speaker 4: There can be systems in place where actually the government
30:33
Speaker 4: provides provides these services for you. And that's something I
30:38
Speaker 4: didn't mention that Senegal has a great way of providing
30:42
Speaker 4: important antenatal care services to women, which is very important
30:48
Speaker 4: because it increases access. So I think this is important
30:51
Speaker 4: to know what's working and what's not working, and it
30:56
Speaker 4: really helps keeping people healthy. And that's the goal.
31:00
Speaker 3: How do we keep people healthy right?
31:03
Speaker 2: And that is caring for both the mother and the infant,
31:06
Speaker 2: like understanding the bigger picture and education and making sure
31:11
Speaker 2: that people have access to information, which is such a
31:15
Speaker 2: huge part of.
31:17
Speaker 3: Any type of healthcare.
31:18
Speaker 2: And with that, I feel like we have to talk
31:21
Speaker 2: about the fact that we often see women and especially
31:24
Speaker 2: women of color, being left out of important research like this,
31:29
Speaker 2: And obviously y'all tapped in and making sure that we
31:34
Speaker 2: did see some bigger picture and better research in this.
31:37
Speaker 2: In your experience with people like you, have you seen
31:41
Speaker 2: that change where we're actually including marginalized people into this conversation.
31:47
Speaker 4: So for the type of work I do, we do
31:50
Speaker 4: include marginalized populations. For the type of research that this was,
31:57
Speaker 4: they use us like they use the sensus to really
32:02
Speaker 4: understand the different populations, the different regions and make sure
32:06
Speaker 4: that the survey was representative of the entire country. So
32:10
Speaker 4: for this specific study, Yes, speaking of other studies, I
32:15
Speaker 4: can't really speak on that behalf. But what I can
32:17
Speaker 4: say just in general for women, especially black women for
32:22
Speaker 4: those who don't know, I'm a black woman, So especially
32:26
Speaker 4: for black women, there have been many times where like
32:30
Speaker 4: the implementation of research, often it left us out, Like
32:36
Speaker 4: we have often been underrepresented in clinical and scientific studies.
32:41
Speaker 4: That's due to like multiple factors, but strecchal inequities is
32:45
Speaker 4: one and we're just excluded and this this is harmful
32:51
Speaker 4: to our health and well being. You can't generalize findings,
32:55
Speaker 4: research findings.
32:56
Speaker 5: If you're missing key people for these studies.
33:12
Speaker 2: You've been in this field for sixteen years. Do you
33:14
Speaker 2: feel like it's changed at all since the beginning?
33:17
Speaker 4: That is a good question.
33:19
Speaker 3: Yes, that's a big question.
33:22
Speaker 6: It is a huge question. Do I feel that it
33:26
Speaker 6: has changed. I think there's constant change in this field opening.
33:33
Speaker 4: Whether we're talking about numbers, whether we're talking about like
33:37
Speaker 4: the incidents, which is like new cases of HIV for instance,
33:41
Speaker 4: or the prevalence, like the overall numbers. The prevalence, depending
33:47
Speaker 4: on the region, is either increasing or decreasing. And I
33:52
Speaker 4: wanted to mention that for incidents as well, it really
33:55
Speaker 4: depends on the region. For instance, we see in the
33:59
Speaker 4: Global Nor for the United States, for instance, we've seen
34:03
Speaker 4: a lot of improvements. However, there's certain areas where we
34:06
Speaker 4: are still having challenges. Atlanta, where we reside, is one area,
34:11
Speaker 4: and we also see the same in the Global South,
34:14
Speaker 4: and specifically if I'm focusing on Sub Saharan Africa, we
34:18
Speaker 4: do have populations that in various countries that are still
34:23
Speaker 4: having challenges. For instance, I talked about key populations. These
34:27
Speaker 4: are like the sex workers, men who have sex with men,
34:30
Speaker 4: and other people who inject drugs, and other key populations
34:35
Speaker 4: that are disproportionately impacted by HIV, so we do see
34:40
Speaker 4: improvements in some regions. In some regions we've seen improvements
34:44
Speaker 4: and then we've seen a reversal as well. Globally, however,
34:50
Speaker 4: we've made a remarkable and measurable progress in the fight
34:54
Speaker 4: against HIV, but challenges still remain. Over the past few decades, AIDS,
35:01
Speaker 4: we've seen new HIV infection, so the end CHIV incidents
35:06
Speaker 4: and age related deaths have dropped drastically. We can attribute
35:11
Speaker 4: a lot of these successes to expanded access to testing, treatment,
35:16
Speaker 4: and life saving antiretroviral treatment. According to UNA's and the
35:22
Speaker 4: World Health Organization, new infections have really declined more than
35:27
Speaker 4: half since the peak of HIV in the mid nineteen nineties,
35:33
Speaker 4: and AIDS related deaths have also fallen to about seventy percent.
35:39
Speaker 4: They've fallen about seventy percent since the early two thousands.
35:43
Speaker 4: I mentioned this earlier, but one of the critical pieces
35:47
Speaker 4: to this is prevention and treatment anti retroviral therapy. It's
35:54
Speaker 4: really has changed the game and transformed HIV from a
35:57
Speaker 4: fatal disease into a more manageable chronic condition, and there
36:02
Speaker 4: are tens of millions of people around the world today
36:06
Speaker 4: on treatment and that allows them to live long, healthy lives.
36:11
Speaker 4: And the treatment actually suppresses the virus, it prevents transmission.
36:16
Speaker 4: So there's a concept called you equals you. It's undetectable untransmittable.
36:21
Speaker 4: So for people that are on treatment and the treatment
36:26
Speaker 4: works effectively for them and they take the medication as prescribed,
36:32
Speaker 4: they can become undetectable. This means that their viral load
36:37
Speaker 4: and their body is so low that it is undetectable.
36:41
Speaker 4: So what I'm really trying to say is overall, we
36:43
Speaker 4: have seen progress because of data driven and targeted approaches
36:49
Speaker 4: that focus prevention and care efforts on populations at hy risk.
36:53
Speaker 4: We call these the key populations, and we see that
36:57
Speaker 4: when we combine strong health systems, community engagement, HIV outcomes,
37:04
Speaker 4: and we really focus to improve the health and wellbeing
37:08
Speaker 4: of people through the entire population. This works because if
37:15
Speaker 4: you focus on improving one's health, it really helps improve
37:22
Speaker 4: the health of everyone. We talked about this briefly with
37:25
Speaker 4: sex workers, legalizing sex work and preventing HIV and providing
37:31
Speaker 4: treatment for people in with HIV, engage in sex work
37:35
Speaker 4: that really protects the entire community. So we've seen progress overall,
37:42
Speaker 4: but it's not the same progress all over. There are
37:46
Speaker 4: gaps that still remain. Some of the gaps are due
37:49
Speaker 4: to stigma and legal barriers and funding challenges, and these
37:52
Speaker 4: definitely impact women, young people, and key populations overall. What
37:59
Speaker 4: we know is is that when science pausing equity comes together,
38:04
Speaker 4: progress has been made and that's really an important lesson
38:07
Speaker 4: for public health going forward.
38:10
Speaker 2: Yeah, I know in Florida they have made it a
38:14
Speaker 2: little more difficult for those who have been going through
38:17
Speaker 2: treatment HIV and age treatment to getting their medication because
38:21
Speaker 2: of the new administration and things that are happening, which
38:23
Speaker 2: is really unfortunate. You like, for a minute, it feels
38:27
Speaker 2: like everything was okay and we were like, oh, we're
38:29
Speaker 2: getting better, we're acknowledging, we're normalizing treatment, we're having a conversation.
38:33
Speaker 2: All of a sudden we have all like a rollback,
38:35
Speaker 2: and you're like, oh no, we got to figure out
38:39
Speaker 2: this out.
38:39
Speaker 3: We got to keep talking about it.
38:40
Speaker 2: We got to keep making this conversation, which is why
38:42
Speaker 2: work like yours is so important. And seeing countries like
38:47
Speaker 2: Senegal being able to be a light and be like, Hey,
38:51
Speaker 2: we can do this if we just keep on track.
38:54
Speaker 4: So this is an interesting topic and I am not
39:00
Speaker 4: like the policy expert for US policies for HIV. However,
39:06
Speaker 4: this topic is very important and from the basic imbond
39:14
Speaker 4: of information that I know, I did learn about that.
39:19
Speaker 4: I did learn how Florida has restricted access to their
39:23
Speaker 4: Age Drug Assistance Program ADAP and they've changed eligibility requirements,
39:29
Speaker 4: and they've also removed big TARV from the coverage, and
39:35
Speaker 4: there are other changes that were made which are very
39:37
Speaker 4: concerning to me because it limits access to life saving
39:40
Speaker 4: drugs and this is needed for HIV prevention and treatment.
39:48
Speaker 4: So this type of decision impacts the lives and the
39:52
Speaker 4: well being of people living with HIV. I feel like
39:56
Speaker 4: this change really shows us how policy and funding this
40:00
Speaker 4: decisions can quickly disrupt and interrupt access to life saving
40:05
Speaker 4: HIV treatment in a high income setting.
40:09
Speaker 3: It's a lot fun fact.
40:11
Speaker 2: I found out that the Asian people's my people's I
40:16
Speaker 2: am missing an enzyme that causes me to turn very
40:18
Speaker 2: bright red sometimes with alcohol, to the point that looks
40:22
Speaker 2: like I'm not having an allergic reaction. I found out
40:24
Speaker 2: that that actually affects a lot of the medications that
40:27
Speaker 2: we are prescribed, and a lot of.
40:29
Speaker 3: Doctors don't know that.
40:32
Speaker 2: This is going back to like the marginalized people who
40:34
Speaker 2: were like not noted being part of the research. They
40:38
Speaker 2: really just like slapped on to be like white people
40:40
Speaker 2: can do this, so everybody else like this. And I
40:43
Speaker 2: found out, I'm like, oh, really, I did not. Really,
40:46
Speaker 2: you're not supposed to have certain medications like heart blood
40:49
Speaker 2: pressure medications, like it's not effective from Asian some Asian
40:53
Speaker 2: people because of the enzymes. And I was like, well, damn,
40:57
Speaker 2: why didn't I know about this earlier.
40:59
Speaker 3: I'm into that.
41:00
Speaker 4: Absolutely, any Absolutely, I think it's important.
41:04
Speaker 3: To put myself in here.
41:05
Speaker 4: No, No, you're completely right. I think it's important to
41:08
Speaker 4: That's why we need to be included in the relevant
41:11
Speaker 4: research studies. That's all important.
41:13
Speaker 2: Yes, come on, come on what you're doing and we
41:17
Speaker 2: are very very grateful for obviously.
41:21
Speaker 4: Thank you.
41:24
Speaker 1: So you've talked about some of the future ideas you
41:27
Speaker 1: have of what you're going to do, But what is
41:30
Speaker 1: what is your hope for the future with this type
41:34
Speaker 1: of work that you're doing.
41:37
Speaker 4: Yes, So, what I would really like to see come
41:42
Speaker 4: out of this I want to see more cross sector
41:47
Speaker 4: approaches to improving the health and wellbeing of populations. So
41:52
Speaker 4: when I say cross sector, I'm talking about different different agencies,
41:58
Speaker 4: different groups working together. So the religious leaders, the ministries
42:02
Speaker 4: of health, the education departments, all of these, even transportation,
42:08
Speaker 4: transportation is critical to accessing healthcare. The medical professionals, the
42:12
Speaker 4: public health people, all of us sitting at the round
42:15
Speaker 4: table and discussing this together and seeing how we can
42:19
Speaker 4: combat all and this isn't just HIV, how we can
42:23
Speaker 4: combat any illness, any disease, how we can help people
42:27
Speaker 4: live happy and healthy lives. I feel like even in
42:31
Speaker 4: creating policies, we should be considering there's a concept called
42:38
Speaker 4: health in all policies, and this health and all policies
42:43
Speaker 4: make sure that all the right people are at the
42:45
Speaker 4: table when we're making policies, because all too often policies
42:49
Speaker 4: are made and then we're like, whoops, we forgot something.
42:52
Speaker 4: So I would like to see that when decisions are made,
42:55
Speaker 4: when policies are made, the right people are at the
42:58
Speaker 4: right table. Oh and when I'm saying the right people
43:02
Speaker 4: left out by XM one important population, we should have
43:04
Speaker 4: people living with AIDS at the table, people live with
43:07
Speaker 4: HIV at the table, who best to advocate for themselves
43:11
Speaker 4: and say what they need other than these people. And
43:14
Speaker 4: then when we're talking about pregnant people or anything about
43:20
Speaker 4: women's health, like women should be at the table. Pregnant
43:22
Speaker 4: people should be at the table. So let's be inclusive.
43:26
Speaker 2: Yes, yes, that's the big statement, Like that's such a
43:32
Speaker 2: level of understanding that we're not going to understand how
43:35
Speaker 2: to treat it if the people who are not affected
43:38
Speaker 2: by it are not.
43:39
Speaker 3: At the table.
43:40
Speaker 2: That is such a big conversation that we need to
43:43
Speaker 2: have repeatedly and often in this kind of research, in
43:47
Speaker 2: any research, in any job, that we need to have
43:51
Speaker 2: those people being present. Oh you're doing a lot of work,
43:55
Speaker 2: they see, and I appreciate doctor Detto. I'm coming back,
43:59
Speaker 2: and we preciate you taking your time and coming to
44:02
Speaker 2: talk to us about your work because we want to
44:04
Speaker 2: be able to have a bigger conversation of what this
44:07
Speaker 2: looks like, how this impacts so many people, and what
44:11
Speaker 2: we can do in order to make sure this conversation
44:15
Speaker 2: is getting out there. So we definitely appreciate that. Now
44:19
Speaker 2: we want to bring it back because this is a
44:22
Speaker 2: lot and I remember again just watching you having to
44:25
Speaker 2: do through go through all the work and presenting your
44:28
Speaker 2: dissertation and all of that, I have to ask, how
44:32
Speaker 2: do you take time for yourself and what do you
44:35
Speaker 2: do for like yourself and and self care?
44:39
Speaker 4: That is a great question. So number one on the
44:43
Speaker 4: list is Zoomba.
44:46
Speaker 3: Yeah, that's right.
44:49
Speaker 4: Absolutely, I love Zoomba. I probably do zoombam. I do
44:54
Speaker 4: zombo mouncicle times a week, so love it. I just
44:57
Speaker 4: got into pilates, which I'm like a newbie. Love it
45:01
Speaker 4: as well. I love to just hang out with my friends,
45:06
Speaker 4: whether we're just at a coffee shop anywhere really we're shopping,
45:11
Speaker 4: whatever we do, we always have a good time talking
45:15
Speaker 4: catching up. Yeah. So just spending time with friends, loved ones.
45:20
Speaker 4: That's really what I do.
45:22
Speaker 3: And I like to look your jet setter too, like
45:25
Speaker 3: you trying.
45:26
Speaker 4: Oh yeah, I do travel, yes, that is that is
45:30
Speaker 4: another passion of mine. Yes, I'd love to travel.
45:33
Speaker 3: I love seeing those pictures.
45:35
Speaker 2: I'm like, oh, look she's there on the beach or
45:37
Speaker 2: with the you know, being all fancy in her background
45:41
Speaker 2: of like wherever you are that day. I'm like, that's nice.
45:45
Speaker 2: I get jealous, absolutely.
45:47
Speaker 3: I look at her. I get jealous.
45:50
Speaker 4: To put your in a suitcase.
45:51
Speaker 3: We talked about that. We're like, we gotta do something right.
45:54
Speaker 1: Yes, yes, well, thank you, thank you so much for
46:01
Speaker 1: being here. We would love to have you back and
46:04
Speaker 1: check in later see what you're up to. But before
46:11
Speaker 1: before we close out completely, where can the good listeners
46:15
Speaker 1: find you?
46:15
Speaker 2: Do you?
46:16
Speaker 1: Do you have anything you want to shout out? Yeah?
46:19
Speaker 4: Absolutely so. Samantha just mentioned I'd love to travel. I
46:22
Speaker 4: actually have an Instagram It's called Her Boarding Pass. It's
46:26
Speaker 4: all one word, just the word her, then the word
46:30
Speaker 4: boarding and then pass, all one word. So you can
46:33
Speaker 4: find me there.
46:35
Speaker 3: See her travels and be jealous with me.
46:37
Speaker 1: Yes, yes, listeners do that. Well, thank you so much
46:44
Speaker 1: again for being here. It was a wonderful conversation. If
46:48
Speaker 1: you would like to contact us, you can or email
46:50
Speaker 1: is hello at stuff I've Never Told You dot com.
46:52
Speaker 1: We're also on blue Skype, Mom Stuff podcast, or on
46:54
Speaker 1: Instagram and TikTok at stuff I've Never told You.
46:56
Speaker 4: We have a YouTube channel.
46:59
Speaker 1: We have some merchandice at Coppon Bureau, and we have
47:01
Speaker 1: a book you can get where if you get your book,
47:04
Speaker 1: Thanks as always to a superducer Christina Executive Prus.
47:06
Speaker 4: And Maya and our Contrbudor Joey.
47:08
Speaker 1: Thank you and thanks to you for listening Stuff Never
47:10
Speaker 1: Told You Instruction by Heart Radio. For more podcast from
47:12
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