Koenig, Leah

School of Public Health



Situation Assessment: PrEP/Combination HIV Prevention

The epidemiology of sex work and HIV in Thailand highlights the potential benefits of the implementation of pre-exposure prophylaxis (PrEP) among female sex workers in the country.  However, substantial formative research must be conducted to understand appropriate mechanisms of implementation, acceptability, and other aspects critical to uptake and adherence. This study is a rapid situation assessment, inclusive of qualitative and quantitative exploration of PrEP-related knowledge, scientific literary, and considerations for use among female sex workers.  We engage with key stakeholders to understand their PrEP-related considerations, as well as needs for other aspects of HIV prevention and care. In doing so, we will generate the acceptability and feasibility data necessary to plan and launch a combination prevention trial inclusive of PrEP for female sex workers in Thailand.  Two sites are the focus of this work: Bangkok and Pattaya.

Global Health Mentor/PI: Michele Decker, ScD

A significant part of my decision to enroll in JHSPH centered on the extended internship component of the Masters of Science program, and specifically on the opportunity to participate in global health research for part of this program. Upon interviewing with Dr. Decker and Wirtz, I was confident that the GHEFP position working on a study that explored feasibility and interest of extending HIV PrEP (Pre-Exposure Prophylaxis) medication and services to Female Sex Workers in Bangkok and Pattaya, Thailand, was an ideal position for me to gain the skills I hoped to attain during my internship.

A number of aspects of the study and study team made me confident that this position would be the best choice for me. The topic of the study was a natural extension of reproductive health research in which I had previously engaged. Conversations with the members of the study team highlighted the fact that gender justice was a focus of this study, a lens that is not only very important to me in my research, but also one I felt had been absent from my previous research endeavors. Much of my prior research has centered on women’s and reproductive health issues in South and Southeast Asia, and I was excited about the opportunity to return to Bangkok and forge connections in a different community of public health professionals. 

It was clear from our first conversations that this was a diverse study team, with a great deal of experience, trust and amity. I felt confident that the rigorous design of the study, which involved both quantitative and qualitative methods, would enhance my skillset and experience in data collection and study management. Because of the size of the study, this was a unique opportunity to participate in a research study from protocol development through data analysis and publication.

I have benefitted in many ways from this opportunity to spend three months working in Bangkok. Of note, I have gained confidence in my skills as a researcher. I feel fortunate to have gained first-hand experience in randomized sampling with key populations, survey design, electronic survey programming, data collection, policy-concerned writing, data analysis, and manuscript development.  Further, this placement allowed me to develop both professional bonds and friendships with Thai colleagues. Perhaps the most beneficial part of my experience was the opportunity as an aspiring researcher to be on-site for data collection, which allowed me not only a deeper understanding of the public health problem our study seeks to address—the individual, social, and structural barriers and facilitators of HIV prevention for female sex workers—but also of international research partnerships, and of the logistics of carrying out a research plan on the ground.

Following my time in Bangkok, I am very invested in the cause of extending government coverage of a comprehensive range the HIV prevention services to women. My time in Thailand last summer married my skills-focused courses at Hopkins with an improved understanding of issues in global health.

Data Collection Team, Pattaya, Thailand:


Reclining Buddha, Ayutthaya, Thailand:



View from the TREAT Asia office during Rainy Season, Bangkok:


Data Collection Training, IPSR, Mahidol University, Thailand:


Bayon Temple, Angkor Wat, Siem Riep, Cambodia:


Limestone Mountain near Nam Song River, Vang Vien, Laos:


Coconut Sticky Rice in Bamboo Tubes:


September 2020




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