The Accelerating Excellence In Translational Science (AXIS)Charles Drew University of Medicine and Science

Dr. Nina Harawa

Dr. Nina Harawa faces the HIV epidemic with courage and hope. By going directly to those in the community affected by the epidemic, she is improving lives and empowering those that need help.

“My goal has always been to do research with people,” Dr. Harawa said, “They are engaged in the research process and they should benefit from the results.”

Dr. Harawa found her calling while training as an epidemiologist at UCLA. Studying the factors that influence health and disease in populations, she learned how she could help.

“Prior to learning about the Public Health field, I thought there were only two options—to be a physician or do biomedical research,” she said. “But then public health intrigued me. It is a field that merges science and social justice, with a wider potential impact than just treating individual patients.”

Dr. Harawa heard voices of the HIV epidemic while working for an immunologist who studied pregnant women with HIV. She would attend Grand Round meetings where doctors and nurses discussed particular patients’ cases. Stories of people here in Los Angeles affected by HIV grabbed her attention. Soon, she recruited patients from a local community-based organization for a research study. Those strong men and women spoke to Dr. Harawa’s need to make a difference. “There are many compelling issues surrounding HIV,” Dr. Harawa said. “Sexuality, gender, race, homophobia— epidemiology is a good way to study all of the issues, and I enjoy the math and working to understand the patterns.”

After her time at UCLA, she was recruited to work at the Los Angeles County Department of Public Health’s HIV Epidemiology Program.

“Our task was understanding the shape of the epidemic,” Dr. Harawa explained. We were studying “risk behaviors, how the epidemic was changing, and who was most affected.”

The Human Immunodeficiency Virus (HIV) can cause Acquired Immunodeficiency Syndrome (AIDS), where the immune system starts to fail and is vulnerable to lifethreatening infections. The Department of Public Health reports that more than 62,000 people in Los Angeles County are infected with HIV and AIDS. Though African Americans are approximately 9% of the population, they make up 22% of those living with HIV/AIDS.

Now as an Assistant Professor at Charles Drew University, one of Dr. Harawa’s big studies involves the Men of African American Legacy Empowering Self (MAALES) Project. With MAALES, Dr. Harawa created a unique academiccommunity collaboration that has developed a culturally based intervention aimed at reducing the risk of HIV/AIDS in African American men who have sex with men and women.

MAALES empowers men with the knowledge and courage they need to be HIV/AIDS aware. Prevention measures like condom use and safe sex are discussed as well as how to seek help if participants are infected with HIV. “The program is tailored to this community,” Dr. Harawa said. “A lot of issues came up when we started revolving around what it means to be a black male. We give participants an opportunity to discuss issues of gender, race, and sexuality in a safe environment.”

Working with a number of organizations (AmASSI—a non-profit, community based health, wellness, and cultural affirmation center; JWCH Institute Inc. —a private non-profit health agency focused on community-based health education and social support programs; and Palm’s Residential Care Facility – a housing and treatment program for people dually diagnosed with HIV and drug dependence), Dr. Harawa and other researchers have enrolled over 360 men in a randomized trial to test the effectiveness of the MAALES program.

“We’ve been very pleased with the numbers,” Dr. Harawa said. “We are ahead of our target but would still like to see better retention between the initial interview and the first group meeting.”

The greatest effect that Dr. Harawa’s team is observing is a potential decrease in the number of sexual partners the men are reporting. As an epidemiologist, she knows that this alone can have a great impact on the spread of the disease.

“I think it has been successful so far,” Dr. Harawa said, “because of our great collaborators: John Williams at UCLA; the people in the county department of public health; JWCH; and our wonderful community based organizations. Senior faculty who are part of EXPORT, the center for excellence in health disparities have provided guidance and support. And I have a great team in our staff, made up of people with incredibly diverse racial and sexual backgrounds. We have each other’s backs.”

Based on the experience with MAALES, Dr. Harawa has started a second program for African American females.

“Some were critical of adapting the MAALES program for women, but I think it depends on how careful you are to change the program to accommodate the needs of the new group,” Dr. Harawa explained. Much of the structure—group discussions lead by a skilled facilitator who is a part of the community—was kept, but some of the emphasis was changed. The women needed more focus on negotiating risk with a partner.

Though the program for women is newer than the MAALES program, Dr. Harawa noted that the participants are already giving positive reviews. “We’ve received hand-written letters saying they want to see the program succeed, reach farther, and enroll more and younger women,” she said.

Dr. Harawa is also in the process of developing a program for incarcerated and post-incarcerated HIV-positive men, in a partnership with the Center for Health Justice. She wants to include targeted HIV screening for men entering the system and access to resources for reentry into society post-incarceration.

With so many projects to keep track of, Dr. Harawa is always busy, but not so busy that she isn’t thinking ahead to her next project. “I’ve always wanted to study the relationship between ethnicity and HIV among black Americans,” she said. “Many HIV prevention messages today are targeting African American communities, but there are many subgroups—West Indian, Caribbean, Nigerian, The MAALES team Ethiopian, and other African-descended immigrants—that may not be getting the message. I want to know what the epidemic looks like for them and to understand that diversity.”

“I try to keep my research basic and practical,” Dr. Harawa said. “That is what is needed most, and is sometimes the hardest to do.”