 October 2021: Sean Arayasirikul, PhD, (they/them)
Assistant Professor
Department of Epidemiology and Biostatistics
University of California San Francisco (UCSF)
Senior Research Scientist
Trans Research Unit for Equity (TRUE)
Center for Public Health (CPHR)
San Francisco Department of Public Health (SF DPH)
Sean Arayasirikul, Ph.D. (they/them) is an Assistant Professor in the Department of Epidemiology & Biostatistics at the University of California, San Francisco (UCSF). They are also a Senior Research Scientist at the Trans Research Unit for Equity (TRUE) and the Center for Public Health Research (CPHR) at the San Francisco Department of Public Health (SF DPH). They earned a Ph.D. in Medical Sociology at UCSF and were a pre- doctoral Fellow at the Alcohol Research Group, University of California, Berkeley (UCB), a Minority Fellow of the American Sociological Association, and a Diversity Scholar of the Adolescent Medicine Trials Network for HIV/AIDS interventions (ATN). Dr. Arayasirikul is the PI or Co-PI of three current projects: 1) an NIAID DP2 New Innovator Award to develop and apply new methods and measures to characterize intersectional stigma for sexual and gender minorities of color (SGMoC) in the House and Ballroom Community (HBC) and optimize HIV prevention and care continua outcomes; 2) an NIMH R34 implementation science study to pilot a mobile screening and navigation intervention to improve utilization of substance use and mental health-related services among trans women living with HIV; and 3) an NIMH R25 training program, called SHINE Strong, to build the pipeline of HIV behavioral scientists with expertise in trans population health. Dr. Arayasirikul is a second-generation Thai American and first-generation college student who survived homelessness as a young adult. They are a member of the House and Ballroom Community and served as both the San Francisco Father of the House of Infiniti and the West Coast Father of the International Kiki House of Angels.
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Q: What are your current research interests?
A: My research portfolio is the product of years of grassroots organizing, living at the intersection of multiple, marginalized identities, and serving SGM communities of color – my communities – on the frontlines of HIV prevention, care, and research. My work can be broadly described in two areas with the first being the investigation of social determinants of SGM health, with a specific focus on the impact of intersectional forms of oppression, discrimination, stigma, and violence on SGM health and health service utilization. My second area of research is focused on the development and implementation science of systems-oriented interventions – interventions embedded in mobilizing clinics, communities, and public health departments – and stigma reduction interventions that center digital technology, homegrown approaches, and emancipatory public health. For example, I have developed a digital HIV care navigation intervention called Health eNavigation that utilizes text messaging, motivational interviewing, and ecological momentary assessments to optimize HIV care continuum outcomes among young people living with HIV.
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Q: Tell us about your career path – how did you end up where you are now?
A: My path was and still is circuitous with a number of what some might describe as “starts and stops” – nevertheless, every step taken has led me here today. I’ve spent a lot of time working on the frontlines, managing HIV testing mobile clinics, providing mobile case management to young people living with HIV, and building capacity of HIV care and substance use treatment providers to serve the SGM community. I am incredibly grateful for the opportunities I have had to serve and care for my communities. This is the foundation from which my research stems, and it pains me to see the same broken systems and intersectional stigma that I experienced when I was trying to get off the streets or get a job while homeless still exist today. This real-world experience allows me to see real problems; and only when we can see real problems, can we develop, test, and institute real solutions.
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Q: What organizational challenges have you faced?
A: Organizational challenges for SGM scholars are plentiful. There are many types of challenges that I have faced - situational, environmental, cultural, ethical, personal, and more. There are organizational challenges that I’ve encountered that I feel compelled to discuss. But first, I want to acknowledge that asking scholars who also live at the intersection of multiple, marginalized identities and may be SGM themselves about organizational/institutional challenges can be wrought with powerlessness and anticipatory vulnerability. Moreover, sharing these experiences with a large audience can be trepidatious. However, I believe it is important to discuss these topics, especially in our socio-political climate and in striving toward social and health equity and anti-oppression practices. One challenge I would like to mention is the normalized practice of “not re-inventing the wheel.” As new and future generations of SGM scholars grow to include diverse people on both the axis of gender identity, sexual orientation, and race/ethnicity, scientific training, and all that it entails – its practices, norms, systems, and beliefs – must be reinvented with equity at its center. This is the only path to disrupt the perpetuation of potential harm and oppressive practices that minority scholars are exposed to and may undoubtedly face. Thoughts like, “This is how I was trained” must be transformed to “How can I create a training experience with this scholar and these lived experiences at its center?” The repercussions of reinventing science and the practice of research can only improve how communities engage with academic, scientific, and medical institutions.
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Q: What advice do you have for trainees and researchers who want to work in this area or are interested in applying for NIH funding?
A: This applies to everyone, but trainees especially. I would urge you to think big about your mentorship team. Go beyond your own backyard – your institution, your disciplinary circles, etc. Every mentor has a role and can offer support to you in ways that may differ from the traditional academic mentorship model. Additionally, I would urge folks to build community with one another and reject the notion that only one will be able to succeed. We will need one another to move the needle on eliminating health disparities and achieving equity. On applying for NIH funding, I’d recommend early-stage investigators to conceptualize your research in phases. Often, I find myself needing to address questions that come before that one “big idea,” and this incremental lens can help you be more precise about your research approach in relation to the current state of the science. And of course, cultivate your persistence, practice self-care, and be gentle with yourself.
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Q: Do you have any specific advice for working with and involving SGM populations in research?
A: I’d like to share a thought about deepening how research values community participation. I come from the standpoint that we can always do MORE to honor and create meaningful partnerships with communities. For example, offer community members more than just snacks for attending a meeting, focus group, etc. – pay them for their time, travel, and labor. Offer opportunities to be mentored in science/research or specific skills-based training and certificate programs – better yet, employ community members not just on the frontlines, but also in coordination and management. Include community stakeholders in your dissemination plans, especially in the manuscript development process and as authors in publications. Value the decades of lived experience and expertise of community leaders over formal education and involve them as community Co-Investigators in your research proposals. This is not an exhaustive list, but a simple beginning of what I hope folks will consider in their own research practices. And for organizations and funding agencies, ask researchers to detail their community engagement – we all have a role in developing and supporting systems of accountability to the communities we serve and belong to.
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Q: Any final words of wisdom?
A: A daily mantra I remind myself in moments of struggle is: “You have made it through 100% of your most challenging days.” I find this particularly powerful because it doesn’t call for action or spark unnecessary urgency, especially when existence in and of itself is revolutionary. Instead, it helps me remember that our journeys are long, and it is a gentle reminder to start from and end with gratitude.
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