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DRUG TEST: Sim hopes tenofovir
will help protect sex workers.
Courtesy Soleak Sim |
Soleak Sim’s family
fled the terror of the Khmer Rouge in Cambodia and came
to the United States when she was just 21 months old.
Twenty-eight years later, armed with an MD, Sim has
returned to her native country to fight another ruthless
enemy: AIDS.
Sim and her colleague Margery Lazarus, ’83, moved
to Phnom Penh in 2003 to conduct a clinical research
study among commercial sex workers. They will be trying
to determine whether the antiretroviral drug tenofovir
can prevent the transmission of HIV. If proven safe
and effective in this function, the drug would offer
hope for controlling the spread of AIDS worldwide.
Tenofovir, marketed under the name Viread, already
is widely used in the treatment of AIDS. Preliminary
animal studies indicate that tenofovir may also block
HIV transmission. However, “tenofovir is in no
way intended to replace condom use,” Sim emphasizes.
“Every study participant will receive free condoms
and training in their usage at every visit.”
Cambodia has one of the highest rates of HIV infection
in Southeast Asia, with sex workers at the greatest
risk. Sim and Lazarus are laying the groundwork for
the study, which will monitor 960 participants on a
monthly basis. The study is a collaboration among the
Cambodian National Center for HIV/AIDS, Dermatology
and STDs; UCSF; and the University of New South Wales
in Australia.
After Stanford, Sim attended medical school at Albert
Einstein College of Medicine, graduating with highest
honors. She completed a residency in pediatrics at UCSF,
then accepted a position at San Francisco General Hospital.
Even before she heard about this HIV prevention study,
the Khmer-speaking Sim planned to work as a doctor in
Cambodia. “I’m so thankful for the opportunities
I’ve had in life. I wanted to be able to do something
to help the Cambodian people,” she says.
Nonetheless, Sim already has encountered difficulties
working in a country that “simply doesn’t
have the infrastructure you take for granted in the
developed world.” For example, researchers typically
would send postcards to study participants to remind
them of their monthly appointments. This isn’t
an option in Cambodia, where postal delivery is unreliable.
In some cases, even the concept of an address is difficult
to grasp. “People usually refer to the place where
they live as ‘the wooden house in the market next
to where they used to sell roasted chickens,’
” Sim explains. “We’re definitely
being forced to think outside the box.”
Sim faces challenges in Cambodia not only in her work,
but also in her personal life. She’s happy to
be living with her parents, who left their San Diego
County home to return to Cambodia five years ago. However,
Sim says that people there expect her to act and dress
as conservatively as local Cambodian women would. Her
father, who works in the government, insists that a
driver and unofficial bodyguard accompany her wherever
she goes. “So if I so much as go on a date, everybody
in my extended family knows about it!”
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