Two years ago, the School of Nursing's Associate Dean of Research was making the rounds in a Nigerian hospital when she met a 7-year-old girl. The young patient, suffering from HIV/AIDS, was failing second- line therapy and facing near-certain death. That didn't come as a surprise to Smith. What did give her pause was that the girl's father, a physician, and her mother, a nurse, had both succumbed to AIDS.
That incident lent an increased sense of urgency to Smith's HIV/AIDS research in Africa, which aims to prevent the occupational transmission of HIV in nurses and other health care professionals. In the eight years that Smith has been pursuing HIV/AIDS research efforts and relief in Africa, she has witnessed progress in some areas. But in others, serious impediments like the pervasive stigma associated with HIV/AIDS persist.
Back in 2002, Smith was first invited to travel to Zambia as part of an AIDS research endeavor with the University of Alabama at Birmingham's Center for Infectious Disease Research. Given the widespread presence of AIDS there, the scientists knew they would need to narrow their research focus. They chose to concentrate on the risk of occupational transmission of HIV in midwives, nurses, and other health professionals.
Though the concept was sound, a lack of resources prevented the project from being funded.
At the time, antiretroviral medications were not widely available to patients in sub-Saharan Africa. Therefore, Smith and her research counterpart in Zambia, Margaret Maimbolwa, felt it would be unethical to advocate for HIV testing among the nurses they planned to study. Ironically, the proposed study was denied funding, at least in part, because it failed to include HIV testing of subjects.
Today, Zambians with HIV/AIDS have far greater access to antiretrovirals. But many continue to go without-even those who understand the medicines' benefits. "We have a lot of nurses and other health care workers who become infected and are not treated until late stage. They're afraid of being 'found out,'" Smith says.
