STAR II

What is STAR II?

STAR II is the competitive continuation of the Social Science Training and Research (STAR) Partnership, and will build on the platform for the realization of policy-relevant social science and HIV research created by the successful implementation of STAR I.  STAR II is emblematic of Mailman’s partnership approach to global health work and draws upon the strengths of the Sociomedical Sciences Department’s interdisciplinary policy-engagement research strategies within the field of HIV, and will create research opportunities in Vietnam for faculty across Columbia University. It is co-sponsored by Mailman’s Department of Sociomedical Sciences, Hanoi Medical University (HMU), and the Vietnam Public Health Association (VPHA), with funding from the Eunice Kennedy Shriver National Institute for Child Health and Human Development.

The aim of creating a national center of excellence in social science approaches to HIV prevention, treatment and care in Vietnam, set out in STAR, has been fulfilled by the Department of Medical Ethics and Social Medicine (DMESM) and the Center for Research and Training on AIDS (CREATA) at Hanoi Medical University. To support the development of evidence-based HIV prevention and AIDS-care policies in Vietnam, however, there is still crucial work to be done. Advances need to be made to build the capacity of the Vietnamese social science research community, support HMU as the emerging national hub of activity for this community, strengthen and integrate the network of social scientists working on HIV across Vietnam, and facilitate their engagement with the global scientific community.

STAR II aims to enhance the infrastructure for development, realization, and dissemination of research at HMU; use innovative technologies and collaborate with other training initiatives to support ethical public health research; and amplify national efforts to integrate social science with HIV research. 

STAR II’s focus is on the HIV epidemic’s effect on highly vulnerable populations, such as men who have sex with men (MSM), injecting drug users (IDUs), and commercial sex workers (CSWs). There is a need for national evidence-based policy surrounding HIV and for research on how to effectively implement such policies. We are also interested in exploring how fluctuations in donor priorities affect the sustainability of HIV policies and programs in Vietnam so that whatever policies are created have the most positive, lasting effect.

The infrastructure core activities at HMU will support an enhanced IT platform for research, provide training in funding mechanisms and the craft of grant-writing, and build capacity in theoretically-grounded interdisciplinary social science and HIV research, including developing (in collaboration with the Columbia Population and Research Center and the Center for Health Systems Research at HMU) a Health Data Repository to enhance access to and analytic work on population-level data sets. Lastly, through a journal-to-journal partnership between Global Public Health and the Journal of Medical Research, Vietnam's flagship venue for biomedical and health sciences research, we hope to support the implementation of key improvements in the journal’s scientific and administrative processes. The infrastructure core also emphasizes research ethics, working with the Collaborative Institutional Training Initiative (CITI at University of Miami) and Fogarty-funded AIDS training programs to support the translation of such online programs into Vietnamese. Drawing on the expertise of Columbia’s Center for the History and Ethics of Public Health, modules in public health ethics will also be translated and contextually adapted to be used by research teams across Vietnam.

Pilot Projects

STAR II will support three pilot social science and HIV research projects, led collaboratively by Columbia faculty and senior and mid-career Vietnamese researchers, which will build capacity in under-utilized research methods. The three fields of research that will be emphasized are behavioral science research, health services research, and policy research.

These pilots will draw on theory across the range of social science to answer critical questions for evidence-based responses to the Vietnamese HIV epidemic.

STAR II’s three pilot projects include:

1. theory-based HIV prevention for men who have sex with men (MSM)
2. research exploring engagement with anti-retroviral therapy (ART) care among injecting drug users (IDUs) with AIDS
3. policy research on the sustainability and scalability of Vietnam’s national HIV prevention and care programs, which is particularly vital given the forthcoming withdrawal of PEPFAR funds from the United States.

Dissemination and Network Building

A key strategy for STAR II will be building research communities through networks of social science researchers focusing on HIV/AIDS in Vietnam. Our goal is to go beyond a simple network structure linking individual researchers, and move forward to support the development of a fully realized Vietnam Knowledge Network (VKN) on HIV/AIDS, Social Science, and Public Health. The purpose being to bring together knowledge and the people involved in creating and using that knowledge.

Knowledge networks utilize information and communication technologies that exchange knowledge, with the ultimate goal of adding value to the creation, dissemination and application of knowledge on a given topic. In this case, the goal is to increase information on HIV policy in Vietnam. These networks disseminate knowledge by overcoming a range of institutional and disciplinary boundaries. They lead to knowledge that is more accountable to people and groups because of the fundamentally collective or social process involved in generating knowledge.

In addition to developing a nationwide knowledge network (functioning primarily in Vietnamese), the second major dimension of the VKN will be to link the Vietnamese HIV/AIDS research community to international HIV/AIDS researchers and provide ongoing bidirectional flows of information about the HIV/AIDS epidemic and the response to it in Vietnam for the global HIV/AIDS research community, and also disseminate  international developments and lessons learned for the Vietnamese HIV/AIDS research community. The South-South partnerships and Knowledge Network flows will be especially important in relation to increased capacity for policy-relevant social science research translation as a key goal of STAR II. Both by building individual and institutional ties within the country, as well as South-South partnerships to facilitate bidirectional learning, this dimension of the VKN will provide a major contribution to STAR’s goal of emphasizing knowledge translation for public health impact.

The potential for policy-relevant research to shape responses to HIV/AIDS has been particularly evident in a number of developing country contexts, especially in Latin America, where a long tradition of socially-engaged public health research has been associated with “sanitary reform movements” in public health and social medicine. This approach has been particularly important in Brazil, where engaged, policy-relevant social research on HIV/AIDS has had an especially successful track of contributing directly to what is widely considered to be one of the most successful responses to the HIV/AIDS epidemic in any developing country. A goal of the proposed training program would be to draw on the Brazilian and other LMIC experience and to stimulate greater horizontal (South-South) cooperation and information exchange in relation to successful national policies to develop social scientific research capacity and to connect these researchers to the national response to AIDS.

The development of a strong VKN, with an emphasis on both North-South and South-South connections and collaborations, is especially important in light of PEPFAR’s plan to wind down its activities in Vietnam. As HIV programs and policies are streamlined in Vietnam, the country lacks genuine local/indigenous capacity to think critically about national events to engage with global dialogues on HIV/AIDS and to draw from lessons in other countries to prepare for what will come next both in terms of the epidemic itself and in terms of the responses to it. Our team was struck by comments at a recent meeting on MSM and HIV in which a CDC team based in Ho Chi Minh City expressed concern that they don't know to whom they can transfer the know-how and experiences acquired through PEPFAR: the Provincial AIDS Committee is far too busy implementing programs to really have time to develop their own capacity to think independently. This is especially important as the shape of the epidemic is changing quickly, and the communities affected by it are changing too.

Another important goal of STAR II is to build the capacity for Hanoi Medical University and organizations like the Vietnam Public Health Association.  We aim to create a think-tank role at this level that will help sustain Vietnamese responses to the epidemic in the future.  Having North-South and South-South technical support is critical in that regards, and the three pilot studies to be developed as part of STAR II are exactly the kinds of studies that can help nurture this capacity.