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Master of Public Health student Kimberly Levitt (center) with Greg Owen and Liam Beattie from the Terrrance Higgins Trust.

Kimberly Levitt MPH ’18 Conducts Research on PrEP Availability in England

  • Kimberly Levitt MPH ’18 is focused on making an impact, and as someone who is passionate about global health, she has her eye on the big picture. She just returned from an independent research trip to London, England, a trip made possible by an Ambassador Scholarship through the Center for International Studies at Massachusetts College of Pharmacy and Health Sciences (MCPHS).

    “Global HIV/AIDS education and prevention is something that I have been interested in for a long time,” said Levitt. Before beginning the Master of Public Health program at MCPHS, Levitt worked for the U.S. Department of State under the President’s Emergency Plan for AIDS Relief (PEPFAR) in Washington, DC.

    “Through my position I had the opportunity to work with countries to promote prevention through condom use, circumcision, and PrEP (pre-exposure prophylaxis), and to promote treatment through antiretroviral treatment regimens, care and access to healthcare, and support of human rights priorities,” said Levitt.

    Now that she has the opportunity to do her own HIV prevention work, she looked to other countries affected by the epidemic. That led her to focus on PrEP availability in England as part of an independent research project.

    “I am good friends with an American living in London who would like access to PrEP,” said Levitt. “Through talking with him, I learned that the country’s healthcare system (NHS England) does not currently endorse PrEP under its guidelines. The only way to access PrEP is to enroll in a research trial.”

    According to the US Centers for Disease Control and Prevention (CDC), PrEP allows people at very high risk for HIV to lower their chances of getting infected by taking HIV medicines daily. The medicines can stop HIV from taking hold and spreading throughout the body, and can be highly effective if used as prescribed, reducing the risk of HIV from sexual contact by more than 90% and the risk to people who inject drugs by more than 70%.

    Levitt was surprised to discover that doctors told her friend to buy the drug online or in another country.

    “This was extremely surprising to me,” said Levitt. “While London is a well-developed, progressive city and its healthcare system is admired by many, I felt like there were some shortcomings when it came to HIV prevention, and I wanted to understand why. HIV rates continue to grow in England, especially among gay men, and PrEP is a prevention tool that is more cost-effective than placing someone on treatment for a lifetime,” said Levitt.

    Levitt knew what she wanted to research, so she met with Kathleen Head, Director of the Center for International Studies, to apply for the prestigious Ambassador Scholarship. Head was impressed with Levitt’s proposal.

    “Kimberly really pushed the boundaries,” said Head. “It was evident from our first meeting that she had a vision as to how she wanted to use the scholarship funds.

    The Ambassador Scholarship is designed to empower students like Levitt to make their research goals a reality, explains Head. “Ultimately our goal in the CIS is to foster and support global engagement and student success in pursuit of excellence in the field of healthcare,” said Head. “Our scholarships, and particularly the Ambassador Scholarship, help to achieve those goals by empowering students and giving them a voice.”

    We sat down with Levitt to learn more about her research and her experience in London.

    You met with policy makers, members of the academic and medical communities, and those in the LGBT community during your time in London. Tell us about that.

    If I could sum it up in one word, it would be inspiring. I met with Will Nutland, a professor at the London School of Hygiene and Tropical Medicine and founder of PrEPster, a movement and website that aims to educate and advocate for PrEP access in England and beyond. Will has a great deal of knowledge when it comes to the LGBT community in London. He explained the NHS in detail and how difficult it is for government authorities to agree on something as simple as PrEP.

    Who else did you meet with?

    I visited the Terrence Higgins Trust (THT), a British charity that provides services related to HIV and sexual health. Through THT, I met Greg Owen, founder of I Want PrEP Now, a website that includes all the information you need to know about PrEP and where to buy it online safely. I also met Liam Beattie, a campaign officer, and his colleague, Taku Mukiwa, who work with the community of color in London. Visiting THT was one of the best days of the trip!

    Why is it so important to connect with many different stakeholders from different communities when conducting research like this?

    It is important to acknowledge that people have different interests, attitudes, and priorities. Meeting and speaking with different organizations and members of the community allowed me to have various perspectives and a better-rounded viewpoint on the topic.

    What do you want people (both in the United States and in England) to know about PrEP?

    PrEP is one of a number of HIV prevention strategies for people who are HIV negative but also have a comparatively high risk of contracting HIV. This includes not only men who have sex with men, but people who engage in injection drug use, including women, and serodiscordant sexually active couples. If you are living in the United States, PrEP is an FDA-approved regimen and is accessible through a prescription from a healthcare provider. In England, PrEP is accessible only through online venues or the PrEP Impact research trial, which is enrolling only 10,000 people in certain sexual health clinics.

    What most surprised you about your experience in London?

    One thing that surprised me was how large a role the media plays in public health. Liam Beattie (from THT) was recently interviewed on BBC and asked about “the controversial drug called PrEP.” There seems to be a lot of discomfort and debate around the topic, and the media constantly sheds a negative light on the regimen.

    What was the biggest challenge?

    The biggest challenge was leaving London at the end of my trip!

    What was your biggest takeaway from your time in London?

    My biggest takeaway from my time in London is that I feel prepared and confident that my personal experiences and my time at MCPHS have given me all the tools and skills I need to succeed and make a difference in public health.

    What are your next steps?

    I will be submitting my findings in the form of a report as a part of my independent research study, and I hope to present my findings to my MPH cohort. I am also interested in submitting my report to a public health journal.

    Your independent study trip to London was made possible by an Ambassador Scholarship through the Center for International Studies. What was it like to work with CIS both to define your international research goals and to meet them?

    Working with CIS was great! From the very beginning I felt like I was being supported and encouraged. They gave me the flexibility to submit a proposal and plan my trip the way I wanted to. It was a noteworthy experience, and I would highly recommend working with CIS if you are interested in conducting research abroad.

    How do international study and learning experiences enhance your knowledge as a public health student?

    Studying or conducting research abroad is a very rewarding experience. You have the opportunity to travel and encounter new cultures and communities you have never experienced. Most than ever before, we live in a globalized society, so it’s important to develop a comprehensive world view. A multinational perspective will help you face challenges and come up with creative solutions. As you learn to view the world through different perspectives, you’ll also learn new things about your own culture and community, even if it means visiting different communities within the United States.

    Caption: Master of Public Health student Kimberly Levitt (center) with Greg Owen and Liam Beattie from the Terrrance Higgins Trust.