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!”
—MeiMei Fox, ’94, MA ’95
