Dr. Marta Mulawa first came to Duke University as a postdoctoral scholar at the Duke Global Health Institute after receiving her PhD in Health Behavior at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. Shortly thereafter, she transitioned to her faculty position at the Duke University School of Nursing.
Dr. Mulawa has been conducting HIV related research since 2007, beginning with her Master’s degree in International Health at Johns Hopkins. It was during her experience coordinating a community-based mobile HIV testing study in Tanzania following her Master’s degree, and the mentorship she received during that experience, that motivated her to pursue a career in HIV research.
“One component of the intervention was community mobilization and I really enjoyed seeing the dynamics between the researchers and community leaders and community members all coming together. That was really the starting point for me.”
“My first mentor, Dr. Michael Sweat, was amazing…he involved me in so many aspects of the study even though I was a newbie in research. His mentorship was instrumental in solidifying ‘this is what I want to do’.”
For her PhD, Dr. Mulawa focused her research on intimate partner violence (IPV) prevention and engaging men in HIV and IPV prevention interventions. This experience exploring group-based norms and network dynamics helped to solidify her interests in social network analysis and how social networks influence health behaviors, particularly those related to HIV prevention and treatment.
My PhD mentor, Dr. Suzanne Maman, had identified these groups of young men who socialized together in an urban area of Tanzania and she received NIH funding to engage them in group-based intervention. I had the opportunity to be involved right from the start and enjoyed reading up on the best approaches to engaging and measuring social networks. This was a really unique dataset and I was motivated to take advantage of those data to increase our understanding of how social networks shape HIV-related behaviors in that setting.
In 2019, Dr. Mulawa was awarded a K01 award to support her training and mentorship while identifying how social networks are associated with antiretroviral therapy (ART) adherence among adolescents living with HIV. Having established a new research collaboration at the University of Cape Town (UCT), Dr. Mulawa was presented with an opportunity to understand appropriate and exciting ways to engage the population. Her collaborator and mentor at UCT, Professor Jackie Hoare, shared that her patients were often isolated, and she was excited to collaborate with Dr. Mulawa to try to use mobile technology to provide a different way to foster meaningful peer connections and support.
When she was developing her K01 award, Dr. Mulawa reached out to Dr. Lisa Hightow-Weidman, an expert in the use and evaluation of technology-based interventions across the HIV care continuum. Dr. Hightow-Weidman agreed to serve as her primary mentor and has been instrumental in supporting Dr. Mulawa in this work. The app being utilized in Dr. Mulawa’s K01 award is customized from Dr. Hightow-Weidman’s HealthMpowerment platform, which Dr. Mulawa notes is led by a team of researchers that also include Dr. Kathryn Muessig and Dr. José Bauermeister.
Thanks to Dr. Lisa Hightow-Weidman’s mentorship and her providing this infrastructure, I could focus on customizing and tailoring an existing platform so that it to meets the needs of our population. It just would not have been possible to start from scratch and develop such a high-quality app.
The application contains – among other features – a personal medication tracker, a peer forum, engaging articles and activities, as well as a feature to ask an expert questions about HIV and/or other health topics. The research team conducted interviews with participants who tested the app to better understand their experiences and needs from an app of this nature. While the research is still underway, Dr. Mulawa attributes the current success of her K01 award and what the team has been able to learn to the team she works with.
I cannot say enough about the importance of having amazing collaborators and an amazing team, both here at Duke and at UCT. Our Research Manager at UCT, Bulelwa Mtukushe, and our Research Assistant, Mluleki Matiwane, have been on the ground getting our participants set-up with the app and interviewing them to learn from their experience. Their work has been amazing, especially during COVID when everything has been more challenging.
She indicated that despite the effect of COVID-19 and the lockdowns in Cape Town, they have made progress:
We've been able to complete our formative research and conduct app-testing with participants. We've learned about the ways COVID has disrupted their support systems and how the need for another way to connect seems more important than ever.
Dr. Mulawa also described how adolescents in South Africa who tested the app have benefited from the app’s features including learning more about HIV care and treatment, HIV transmission, and viral suppression and U=U. She described how some participants benefited beyond the information and tools presented in the app.
One of the participants told us, “Wow, this was really good for my mental health. I sometimes feel like I'm just thinking negative thoughts and this app was positive and kept my mind busy.”
When asked to expand on the role mentorship overall has played in her research career, Dr. Mulawa pointed out that she had the opportunity to be “supported by great giants along the way” and that she is eager to mentor others. For her, the involvement of students in her research has not only afforded her an increased capacity for data analysis, but has also kept her “super motivated”. She added that serving as a mentor herself has been a fun and rewarding experience.
In addition to supporting her application process for her K01 award while completing her postdoc at the Global Health Institute, Dr. Mulawa also described the various ways the SBS Core of the Duke CFAR has impacted her career. Regarding her K01 award, she explained:
The Core helped me put together my application and organized a peer review, making it a stronger application that got funded.
She added that she also benefited from the mentorship she receives from Dr. Michael Relf, Associate Dean for Global and Community Health Affairs in the Duke University School of Nursing and a part of the SBS Core Leadership. She explained that Dr. Relf’s mentorship helped her, professionally, with her transition to her faculty position as Assistant Professor of Nursing and Global Health in the Duke University School of Nursing. She stated:
He helped guide my transition from a postdoc to a brand new faculty member and has also helped me think through my research and potential next steps for grant submissions as well.
Regarding her experience with the SBS Core overall, Dr. Mulawa went on to say that:
I think what the SBS core does nicely is connect you to others that serve as role models. I find myself now as a PI structuring my research team meetings to be similar to other successful SBS core investigators that I had the experience working with before.
Finally, when asked about the future of understanding social networks and how that ties to HIV research, Dr. Mulawa had this to say:
While we know a lot about the power of social networks and how they can be leveraged using technology to promote behavior change, I think there's still a lot more that we can learn. I see a lot of opportunity for understanding and promoting engagement in mobile apps; analyzing the data in real time to make our interventions better, and to understand how and why they're working.