PFDD Faculty Fellows Alumni - 2010




Arachu Castro, PhD, MPH,  
Associate Professor, Samuel Z. Stone Chair of Public Health in Latin America, Tulane University School of Public Health and Tropical Medicine

Mentor: Arthur Kleinman, MD, Professor of Medical Anthropology in the Department of Social Medicine, Harvard Medical School, Professor of Psychiatry, Cambridge Health Alliance

Department Chair: Paul E. Farmer, MD, PhD, Maude and Lillian Presley Professor, Head of the Department of Global and Health and Social Medicine, Harvard Medical School

Title of Research Project: The Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis in Latin America and the Caribbean


This project is of a multidisciplinary nature, as it presents innovative health services research in the area of HIV, syphilis, and prenatal care that is based on rigorous ethnographic and epidemiological research and health policy analysis.  Its research tools have been adapted to respond to the complexities of clinical and public health programmatic conditions.  The objective of this proposal is to conduct operational research on testing and treatment of HIV and syphilis during pregnancy in seven Latin American countries (Brazil, Colombia, Dominican Republic, Nicaragua, Paraguay, Peru and Uruguay) and translate its results to pilot interventions aimed at integrating HIV and syphilis management into prenatal care, in collaboration with a consortium formed by the National AIDS Programs of these seven countries, UNICEF, and UNAIDS.  This proposal is part of the Latin American and Caribbean Initiative for the Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis (ILAP, acronym in Spanish), which I formed in 2007.  The specific objectives include: 1) to qualitatively analyze the current status of prenatal care and services to diagnose and treat HIV and syphilis; 2) to develop a national strategy for each country to improve integrated prenatal and HIV/syphilis care and pilot the intervention in several regions of each country; and, if successful, 3) to expand the strategy to nationwide coverage. 

The aim of this project is to integrate prenatal care with the diagnosis and management of HIV and syphilis and to improve PMTCT efforts among participating countries.  In addition, it will establish a model of South-South collaboration to tackle other regional challenges in the scale up of comprehensive HIV care and the provision of maternal and child health in a concerted and systemic manner.


Arachu Castro, PhD, MPH, is a former Assistant Professor of Social Medicine in the Department of Global Health and Social Medicine at Harvard Medical School, Senior Advisor for Mexico and Project Manager for Guatemala at Partners In Health, and Medical Anthropologist in the Division of Global Health Equity in the Department of Medicine at Brigham and Women’s Hospital in Boston, Massachusetts. Her major interests are how social inequalities are embodied as differential risk for pathologies common among the poor and how health policies may alter the course of epidemic disease and other pathologies afflicting populations living in poverty. As a medical anthropologist trained in public health, she works mostly in infectious disease and sexual and reproductive health in Latin America and the Caribbean. She has worked in Mexico, Argentina, Haiti, Cuba, Puerto Rico, Venezuela, Colombia, Peru, and is expanding her research to Brazil and other countries through The Latin America and Caribbean Initiative for the Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis, developed in collaboration with UNICEF, UNAIDS, the Pan American Health Organization (PAHO), and eight national AIDS programs (Brazil, Colombia, Cuba, Dominican Republic, Nicaragua, Uruguay, Paraguay, and Peru). The Initiative aims to strengthen health systems through the integration of prenatal care with the testing and treatment of HIV and syphilis in Latin America and the Caribbean and is directed by Dr. Castro.

Dr. Castro teaches social medicine at Harvard Medical School and has previously taught in Spain, Argentina, France, Mexico, Cuba, and the Dominican Republic. At the David Rockefeller Center for Latin American Studies at Harvard, she serves on its Policy Committee and is Co-Director of the Cuban Studies Program and Co-Chair of the Committee on Social Policy in Latin America.

She has been actively involved in designing several international health policy documents on tuberculosis, AIDS, and access to health care in conjunction with the World Health Organization (WHO) and the Pan American Health Organization, such as The Global Plan to Stop Tuberculosis (Geneva: World Health Organization, 2001), Scaling Up Health Systems to Respond to the Challenge of HIV/AIDS in Latin America and the Caribbean (Washington, DC: Pan American Health Organization, 2003, 100 pp.), and Barrio Adentro: Rigth to health and social inclusion in Venezuela (Pan American Health Organization, 2006) of which she was co-author and editor.

She is a member of the WHO Team on Development of Appropriate Research Strategies for Scale Up of Antiretroviral Therapy in Resource-Constrained Settings and has served on the Steering Committee on Social, Economic, and Behavioral Research at the UN Special Programme for Research and Training in Tropical Diseases (TDR), on the Scientific Working Group on Tuberculosis (TDR), and on the Public Health Watch International Advisory Board (Open Society Institute). At the Society for Medical Anthropology, Dr. Castro was the Secretary-Treasurer (2003-2006) and chair of the Critical Anthropology of Health Caucus (1998-2002). She is in the editorial boards of PLoS Medicine, PLoS ONE, and The Open Health Services & Policy Journal.