Our first Wallenberg alum is 2021 Fellow, Darius M. Moore! Darius spent his year in La Romana, Dominican Republic to complete a research project on the health care experiences and outcomes of minoritized groups in the country. This article discusses his project in detail, how it evolved over time, and his current plans now that he is back in Ann Arbor to complete his MPH at the University.

Prior to your Wallenberg Fellowship experience, what would you say were the most important experiences you had at U-M?

My most important experience at U-M has been doing research with Dr. Gary W. Harper and his research team here at the University of Michigan School of Public Health. The mentorship and guidance that I have been given during my time in this research lab have not only greatly developed by qualitative research and analytical skills, but it has also taught me so much about health equity and meaningful community engagement within public health research. These lessons have formed the foundation for the global public health practitioner that I strive to be every day: one who prioritizes the true needs of the community, one who forms meaningful and long-lasting relationships with community partners, and one who participates in capacity-sharing so that both sides benefit from the collaboration.

My contributions to Dr. Harper's research projects have solidified my passions for global public health and mitigating the impacts of stigma for racial and sexual minority men. I would like to give a special thank you to Dr. Harper for all of his guidance throughout my journey as a Wallenberg Fellow. Dr. Harper was the one who greatly pushed me to apply for the Fellowship and supported me throughout my time in the Dominican Republic. Dr. Harper has been crucial to my development as a person and future public health practitioner, and for that, I am forever grateful.

How did your Wallenberg Project evolve over time? What, if anything, was different from your original proposal?

Throughout my time as a Wallenberg Fellow, I encountered several points of challenge that altered the direction of my project in ways that I had not initially expected, but that worked to achieve a result that would better serve community members and my host institution. It was in these moments that defined for me what it meant to be a Wallenberg Fellow and the flexibility and prudence required to participate in global work. That is not to say that the solution to every problem will be straightforward, but that functioning within a community-based participatory fashion in which community feedback and needs are prioritized will help to improve the overall results and inform better approaches toward research within a given context.

The topic of my Wallenberg project centered on the impacts of intersectional stigma (i.e. the compounded effects of a person or group embodying multiple minority identities) among minoritized groups in the Dominican Republic. I accomplished my project through the sponsorship of Clínica de Familia La Romana (CFLR) which is a non-governmental organization dedicated to improving the health of all vulnerable groups and communities in the eastern region of the Dominican Republic. Given that CFLR, is one of the largest HIV clinics in the Dominican Republic, all the participants recruited for my project were individuals living with HIV. However, to ensure that the aspect of intersectionality was being captured, all participants also identified as LGBTQ+ and/or as a Haitian migrant. I decided to focus on the experiences of these communities because in the Dominican Republic, they face numerous socioeconomic disadvantages and have few, if any, legal protections against discrimination.

Originally, I wanted to focus on intersectional stigma within the context of healthcare settings and investigate how this phenomenon impacts the ability for minoritized communities within the Dominican Republic to access quality healthcare and to have equitable health outcomes. However, I had to change the focus of my project after completing half of my semi-structured interviews with participants. Given that the participants frequently came to CFLR to receive all of their HIV care and felt most comfortable within that environment, the participants almost exclusively used the clinic’s services for any health-related issue that occurred. This meant that none of the participants had negative experiences within healthcare settings and could not speak to the initial focus of my project. After coming to this conclusion, I had to pivot the focus of my project to instead center on how participants navigated Dominican society as a person with multiple minority identities and how this information could be used to pinpoint areas of improvement for the services of CFLR.

After shifting the focus of my project, the end results were incredibly impactful and provided useful insight into the perceptions of the populations included in the study. Some of the major conclusions were that participants struggled with the impacts of living in a society where racism and homophobia present major threats to their safety, community acceptance, and socioeconomic mobility. Moreover, participants' responses also indicated that they had internalized several negative perceptions about their racial and/or sexual minority status which also impacted their wellbeing. Additionally, anticipated HIV stigma was another factor that complicated some participants' of accepting their health condition and being able to seek/adhere to treatment plans. These findings were used to make recommendations on ways that CFLR could work with patients to better mitigate the mental health challenges associated with the negative experiences they had as multiple minority individuals in the Dominican Republic.

What was the most important or meaningful part of your experience?

The most meaningful part of my experience was all the wonderful people I formed relationships with throughout my journey, and being able to explore so much of the Dominican Republic. Given that CFLR has a well-developed student and volunteer program, there are typically several students working on projects in the clinic at any given time. My experience was unique in that I was the only student present for a number of weeks due to the COVID-19 pandemic. As a person who is typically introverted, these circumstances really pushed me outside my comfort zone and drove me to put in greater efforts toward making new friends and connections. I was glad to have been welcomed by so many CFLR staff and accepted into their friend groups. Moreover, I was able to make friends with other people in the community of La Romana who introduced me to so many amazing and beautiful places. These individuals have been some of the most genuine friends that I have ever had, and I greatly thank them for welcoming me into their lives and their country.

What comes next for you as you complete your fellowship experience?

After my Wallenberg Fellowship experience, I have begun my Masters of Public Health at the University of Michigan in the department of Health Behavior and Health Education. I decided to start an MPH degree program because I want to continue contributing to transformative change for communities of racial and sexual minority men through public health research and practice. In pursuing this degree, I am gaining the necessary skills, knowledge, and experiential practice to be of better service to these communities in my future career.

As you reflect back, what advice do you have for prospective applicants for the Wallenberg Fellowship?

My advice for prospective applicants is to understand that the Wallenberg Fellowship is truly a transformative experience and that there will be many points along your journey that will make you question your values, your personal and professional aspirations, and who you even believe yourself to be. Although this may seem daunting, it is important to reflect on what qualities, identities, and experiences that you are bringing into this project and how the circumstances of this opportunity may challenge and change you as a person. This process of reflection will help you to better overcome those moments of frustration when you do encounter challenges as a Wallenberg Fellow, and allow you to form deeper connections with your project and the people that you encounter along your journey.