Season 2, Episode 3: Jenny Trinitapoli on HIV/AIDS and Epidemics of Uncertainty

In this episode, Joseph Harris sits down with University of Chicago sociologist Jenny Trinitapoli. They discuss her new book, An Epidemic of Uncertainty, which explores how young adults negotiate relationships, sex, and childbearing in the context of the AIDS epidemic in Malawi, one of the world's hardest hit nations. Her landmark book draws attention not only to the uncertainty young people face in relation to their HIV status (nearly 60% of the women studied reported that they did not know if they would be infected with HIV in the next two years), but the profound uncertainty they experience in their everyday lives, having to navigate challenges that include food shortages, adequate shelter, and lightning strikes.  

Transcript

Global Health Politics Podcast

Season 2, Episode 3: Jenny Trinitapoli on HIV/AIDS and Epidemics of Uncertainty

SPEAKERS

Joseph Harris, Jenny Trinitapoli

Joseph Harris  00:00

Welcome to the Global Health Politics Podcast, where we go beyond the articles and books and have real intimate conversations with people working in the field of global health today. I'm your host. Joseph Harris. Today, I'm really pleased to be here with Dr. Jenny Trinitapoli. Dr. Trinitapoli is a professor of sociology at the University of Chicago. A social demographer by training; Dr. Trinitapoli has written extensively on the role of religion in the AIDS epidemic in Sub-Saharan Africa. Her new book, An Epidemic of Uncertainty: Navigating HIV in Young Adulthood in Malawi, examines how uncertainty still haunts the everyday lives of young adults in Malawi in enduring ways, in spite of treatment that has turned a once fatal illness in HIV into a chronic disease. Dr. Trinitapoli, it's a pleasure to have you join us today for a conversation. Welcome to the podcast. 

Jenny Trinitapoli  00:41

Thanks for having me, Joe. 

Joseph Harris  00:44

So you've been working in the field of global health for some time now as a sociologist. What drew you to the study of HIV/AIDS, and what led you to focus on these issues in Malawi? 

Jenny Trinitapoli  00:53

Well, there's a personal and an intellectual answer to that question, and I'll try to share how they're kind of woven together. I first started paying a lot of attention to the AIDS epidemic in the 1990s. That's when I was growing up in the US, and in the late 1990s, I had the chance to travel to Kenya, and wherever I am, I always like to buy a local newspaper. One of the things that made an impression on me reading the local papers in Eldoret--where I was staying--was an obituary section unlike anything I had ever seen, including tons and tons of entries for young people. It was something that everyone that I met was talking about. I had just finished my undergraduate studies at the time, but it really made an impression on me, and it was something I kept thinking about for a long time. Then, after I started graduate school, I became interested in the sociology. I was interested in sociology of medicine, and also the health and demography, and I was also focused on religion. At the intersection of religion and health, the research was disproportionately focused on the United States, and I had a curiosity and an appetite for reading more work about the role of religion in some of the most acute problems in the world. It seemed like a big disconnect between the studies that were dominating the journals in terms of studies of religion and health, and what I knew about global health patterns, and so that's what led me to think about an initial approach to the study of HIV through religion in Sub-Saharan Africa--though I didn't really know where I was going to work, and there were questions of language, there were questions of networks--but I ended up focusing on these issues in Malawi because it was a place where I had conversation partners and I had senior scholars who could introduce me to the context and help me prepare intellectually to do that research, and also because it was a place that had a lot of religious diversity, and I was really interested in trying to understand the way that different religious groups were engaging with the HIV epidemic.

Joseph Harris  03:33

The discipline of sociology hasn't historically focused on global health issues a great deal. What was it like to work on these issues early on, when there were fewer of us working on these issues in countries outside the US? 

Jenny Trinitapoli  03:46

That's a really good question. I think I was really lucky to be a graduate student at the University of Texas, and that's for two reasons. First of all, that institution has a lot of emphasis on research about and research in Latin America, and so I wasn't the only person doing research outside of the United States. We also had a really good pop center there, and the demography world tends to be a little bit more quote, unquote, "international" than some other areas of sociology. Of course, I've come to resist this idea of like the "international" as being those things outside of the US, but there was something about both of those features at Texas that made it that I wasn't the only person, right? That mattered a lot, but I think specifically in sociology, because we were unusual--those of us working on questions related to health outside of the United States--we had this way of finding each other. Like, hey cool, you're working on Brazil and this is my friend who's back from field work in Nepal. At the conferences--the big conferences and at the small conferences--there was a way of getting to know other graduate students who had shared interests and supporting one another's work; specifically with this challenge of, "how am I going to convince other sociologists that reading about Malawi is important," right, that reading about Nepal is just gaining knowledge, right? It's not about the place, it's about knowledge. I think a lot of us felt that we had to clear a higher bar in order to get on the program at big conferences, or in order to find space in some of the journals, but there was something about that network and the appreciation that was really meaningful to me then. Another thing that I remember from those days and those feelings of, you know, working outside of the US, will I be able to get a job, you know, if I'm focused on a small country? I remember making a list of every paper published on a country outside of the United States in any mainstream sociology journal in the past 20 years, and it included Barbara Entwistle's paper on contraceptive uptake in Egypt, it included David Smilde's paper on Venezuelan Evangelicals and their conversion experiences, and whole bunch of other papers that I remember quite vividly, but I studied those papers in order to figure out, "how did they do it?" How did they make their research essential for sociology?

Joseph Harris  06:56

Yeah, it seems like so much of the research in sociology takes--at least implicitly--the US as sort of the reference point, and we see this sometimes in the title, sometimes in the abstract. But, you know, it would seem there's a whole lot the rest of the world has to offer.

Jenny Trinitapoli  07:16

Yeah, indeed. I think that was one thing that was very important about that camaraderie between people working--you know, on Brazil, on Chile, me in Malawi--was getting practice; giving our pitches for why this mattered. You know, to other people, we knew we were going to have to do it, and being able to do it right and efficiently was important.

Joseph Harris  07:44

You're bringing me back to learning to craft elevator pitches for jobs. So your book, Epidemic of Uncertainty: Navigating HIV and Young Adulthood in Malawi, came out this past year. It explores how young people negotiate relationships, sex and childbearing in the context of a severe AIDS epidemic. Can you share with our listeners a little bit about what the book is about and why you chose to focus on this idea of uncertainty? What is an “epidemic of uncertainty”?

Jenny Trinitapoli  08:13

Well, those are three big questions. The book, in many ways, is the portrait of a cohort: back in 2007 and 2008, I designed with my collaborator, Sarah Yeatman, a cohort study called Tsogolo La Thanzi. Our idea was to follow a cohort of young adults who were born at the time that the AIDS epidemic was established in Malawi--they never knew life before this disease--and followed them through this period of life that we described as eventful in terms of being characterized by marriages, births and new HIV infections; all taking place at basically the same time during young adulthood. We were really curious about how their lives would unfold and how they would make decisions, specifically about family relationships in this context of HIV. We followed this cohort for three years, and then got funding to follow them for even longer. Based on 10 years of data from this cohort--they were fit between the ages of 15 and 25 when we started following them--I really became convinced that this topic of uncertainty, specifically uncertainty about HIV, what people don't know about their HIV status at any given point in time, was probably the most important thing I had observed during all of these years of research. Although it was mentioned in the literature and there were citations to talk about uncertainty about HIV status, I didn't think it had been written about sufficiently, and I did think that the uncertainty was--especially around HIV status--kind of treated as a footnote rather than a major fact about social life for young adults in this context. So that's really how I chose to focus on it, and this phrase "an epidemic of uncertainty," kind of has two meanings. The first is really specifically about HIV: the fact that in this population and many populations, we often think about conditions in terms of positive and negative--presence or absence of a certain condition--but the proportion of people who don't know their status also matters a lot for what the epidemic is like socially and how it affects behavior, and that's true for HIV. It's also true for other dimensions of life, and as soon as I started kind of scratching at this question of uncertainty related to HIV, I started thinking about and discovering and hearing from our respondents how it was related to other kinds of uncertainties in their lives. That's really how this phrase, "an epidemic of uncertainty," came into my grasp.

Joseph Harris  11:26

Yeah, I think in the book, you acquaint us with a lot of the other challenges and sometimes calamities people face in their everyday life. I remember issues like lightning strikes, for example. Could you say a bit more about the other kinds of uncertainty that people face? 

Jenny Trinitapoli  11:46

Yeah, so one of the kinds of uncertainty that's really, really closely tied to HIV--because it is also tied to sexual relationships--is relationships and marriage: how people find partners, how they make decisions about love, and what happens in those relationships. So relationship uncertainty is really, really fundamental. Another kind of uncertainty that I talk about is existential uncertainty, and that relates to the demographers interest in mortality. You mentioned lightning strikes, and it's a very, very puzzling phenomenon, but Malawi experiences more deaths related to lightning strikes than any other country in the world. There are many things in Malawi that cut lives short; it's not just HIV. If you're studying HIV in Sub-Saharan Africa, and you walk around town, and you're listening for conversations related to HIV, you're going to see a lot of evidence of it. But there are also a lot of other infectious diseases, chronic diseases, and different kinds of accidents that cut people's lives short. Motor vehicle accidents are another really, really prevalent cause of death and disability, and these are things like lightning strikes that kind of come from nowhere,  and in an environment with very high and very unpredictable mortality, I argue that a lot of things about social life are fundamentally different. That's where HIV needs to be not examined as a condition on its own, but it really needs to be considered in the broader landscape of how long people can reasonably expect to live and whether they can expect anything based on what they see around them, which might include high levels of accidents, high levels of infant mortality, and also high levels of death due to HIV and AIDS. 

Joseph Harris  14:02

That's a really rich way that you broaden our understanding of uncertainty; really taking us into uncertainty in just so many different facets of our lives, but ones that are interconnected in a lot of ways. There's a moment in your book when you share survey results that suggest that a full 58% of women did not know if they would be infected with HIV in two years. The degree of uncertainty around one's HIV status, that level, just seemed shockingly high when I first read it. What was it like to discover that that level of uncertainty around HIV status existed, and how does it relate to the uncertainty of life and Malawi more generally?

Jenny Trinitapoli  14:52

Let me try to put that into context by saying that this fact that a full 58% of women said that they didn't know if they would be infected with HIV in the near-future was basically the single empirical fact that led me to write this book.

Joseph Harris  15:17

I'm glad I keyed in on it.

Jenny Trinitapoli  15:20

I knew that there was going to be prevalent uncertainty around HIV in this population, and I was thinking about uncertainty as something that exists in the present, and also is about anticipation of a future. We asked people about this on different time horizons: we asked about the likelihood of being infected with HIV right now, being infected in the near future, and then being infected ever in their lifetimes. Of course, I also knew that it would go up with thinking about now versus the near future and versus a lifetime, but I was really, really astounded by how high the uncertainty levels were. Also by how precipitously they rose in thinking about the near future, and also what it meant for decision-making, because we think probably the biggest difference in this society--in terms of people's behaviors or what they want in terms of a family--the distinction that we might want to make might be between people who know that they're living with HIV, and people who are not. But what we found was that, actually, the most crucial differences are between people who know their status and people who don't know their status, and that is something that we need to think about a little bit more seriously, and that sociologists in particular are well-positioned to study. We wouldn't really expect clinicians to be focusing on that during visits with patients, but as a person interested in the social world and interested in human behavior, this issue of uncertainty seemed like it was something that I had to explore more, and also share with others. In terms of how it relates to the uncertainty of life more broadly, I mean, we also asked people about the likelihood of other things happening in their lives, including other bad things like, for example, the likelihood of needing to borrow money to buy food in the next month or in the next year. But we also asked about good things, like getting a permanent job and having a house of one's own, and so we were really thinking about the ways that people can just think about the possibilities of their life along a host of different dimensions. What we learned about HIV, about relationships and about expectations of longevity, is that uncertainty is really the dominant category that we need to be paying attention to in order to understand how people make decisions.

Joseph Harris  18:15

Do you see this kind of enduring uncertainty haunting the lives of young people in other contexts as well, or is it particularly unique to Malawi?

Jenny Trinitapoli  18:25

Well, Malawi is a place with prevalent HIV. It's also a poor country where stable employment for young people is a really, really hard thing to achieve. But this topic of uncertainty is really, really resonant with the undergraduates that I teach at the University of Chicago. It's resonant to the conversations that I have with friends in Brazil and in Italy about decision-making around their lives. In my mind, there's something really, really universal about the way that uncertainty matters in people's lives, specifically young adults, because this is a period of the life course where a lot of things are unclear about the future, and many decisions are made in order to achieve more clarity. But perfect clarity is also a hard thing to attain in many parts of the world, whether we're talking about housing, whether we're talking about relationships, whether we're talking about job stability and economic uncertainty, I think that these specific questions of longevity and HIV are far more salient in Malawi than they are in many other parts of the world, but the questions about about work and economic security and uncertainty in these other domains of life seem to be present almost everywhere we look.

Joseph Harris  20:06

When I read your book, I couldn't help but think of its relation to another wonderful book I love to teach with in my courses, and that's Sanyu Mojola's Love, Money, and HIV. Could you share a bit about some of the issues, themes and findings from your book that connects and diverges with her work--obviously her works on Kenya--I'd love to hear you reflect on that. 

Jenny Trinitapoli  20:31

Oh, yeah. Well, I love the idea of you thinking about these books together, and potentially these books sitting together on a shelf. That's also a book that I greatly, greatly admire. I think, in terms of the issues and the themes, one of the things that Sanyu and I share is a mixed methods approach that really emphasizes demographic thinking alongside ethnographic insights. In that sense, I think that there are some really, really clear similarities there. The book Love, Money, and HIV was so successful in explaining the gender disparities in HIV prevalence in Kenya that I think a lot of us who were working on the topic of HIV after that book didn't address it very explicitly, because it had been answered so well in Love, Money, and HIV. One of the places where I think that my work diverges is that most of Sanyu's data collection, I think, took place like 2005 to 2008/2009 and that was a period in which antiretrovirals weren't widely available, and HIV mortality was extraordinarily high. I was doing work on religion and HIV in Malawi at that same period of time, but looking at the Tsogolo La Thanzi cohort, what has shifted in terms of--I mean, I'm working in a different country, in a nearby country with a HIV epidemic that's not totally dissimilar in terms of the metrics--but treatment became available, and that is something that really characterizes the cohort that we focused on in the TLT study: the fact that we followed them over a period of time in which mortality was declining, treatment was becoming more widely available, women living with HIV were having children, and having healthy children. One of the things that's distinctive about an "epidemic of uncertainty" is that it's not focused on the worst years of HIV mortality. It's following the cohort through this period of a transition to a chronic and manageable disease, but we see this persistence of uncertainty despite that. We also focused quite a bit, in the TLT study, on the intersection of fertility in particular, and HIV. That was something that I think is a little bit distinctive from Sanyu's book in terms of the way that she emphasized schooling and education. I think that that work is extremely strong in focusing on young women and girls who are focusing on their education and postponing their families. It's a small difference in terms of the time period, and also in terms of the life course period, in terms of where she focuses and where I focus. But in that sense, I think they're complimentary.

Joseph Harris  20:43

It sounds like really meaningful differences too, both in Sanyu's book. You know young women who are more educated, who might expect to have more protective effects right from that education in terms of protection from HIV. And also, I love this point you make about the time periods being so crucially different, that sounds really important. Can you say a bit about the portability of these lessons? Obviously, earlier you drew out Malawi is a particular case, right? Life is fragile in many senses, but it would seem that some. What you are finding might apply most of the world does not look like the US. Can you say a bit about that?

Jenny Trinitapoli  25:07

Yeah. One thing about that, I hope is portable, about the findings, is that this question of uncertainty about HIV status in particular, it may not necessarily be solved by testing people more and and yet provide providing more testing services and giving biomedical information as a response to that uncertainty. That was one thing that I thought my interlocutors in the United States became a lot more capable of thinking about with me as we all navigated the COVID pandemic. I mean, there was a reaction to the observation of high levels of uncertainty around HIV status that assumed that we could test people more and eliminate that uncertainty. I think one of the things that many of us who had not previously lived in epidemic circumstances learned was that tests give us some information, and they don't necessarily give us certainty about a negative status. They give us a lot of certainty when we see a positive test, but a lot less certainty when we see a negative test. Even though the HIV question is very specific—it's a specific condition—it's also, at least not yet, not a curable condition. But that is something that I think is portable across different kinds of health problems that we face in other parts of the world.

Joseph Harris  26:59

You mentioned in that answer very briefly, in passing, COVID. Obviously, a lot has transpired since AIDS hit Malawi when it did, and the struggles that it's gone through since we have had AIDS drugs that have turned it into a chronic disease, for those that have access. Can you say a bit about what you see as some of the most pressing issues in global health today?

Jenny Trinitapoli  27:26

Oh, sure. Well, in answering this question, let me make it clear that these are not questions I'm working on myself. These are the ones that I am eagerly reading other people's work about. I think the questions of climate change--and this has to do with rising temperatures, it has to do with with destruction, through storms and other kinds of climate events--I think that this is something that is closely linked to uncertainty, even though it is operating on a different level from the personal uncertainty that people might experience in their own romantic relationships, for example, which is something I really focus on in An Epidemic of Uncertainty. But I think the relationship between climate and health and how these changes are happening is probably the most pressing thing for us to be focused on. Sexual and reproductive health is another area that I think is urgent in countries with high fertility. It's also urgent in a different way in countries characterized by low fertility. It's also a domain of life in which we're seeing a lot of different changes, in terms of how people think about and form the families that they want to have, and what that means. There's an intersection there of the intimate, and the personal and also the political. That's extremely important, and I think most effectively addressed in a global health framework. I guess, another thing that's on my mind in terms of pressing issues for global health, and this might go into the "boring but important" category, if you think in such ways, is questions about the global nature of the health care workforce in the world. That's something that I've started to read about a little bit more systematically. I am by no means an expert, but I think the question of who is providing care, where are people being trained, how do migration flows relate to the health care workers? I'm not just talking about doctors and nurses, but lots and lots of different kinds of workers that constitute the medical care that people are receiving globally. I think the health care workforce and data infrastructure for global health are also things that are very, very important. I think that the last couple of years have made us realize how important infrastructure—both in terms of healthcare infrastructure, but also data infrastructure— is for answering a lot of the questions that seem important.

Joseph Harris  30:55

Is there any work by emerging scholars that's really caught your attention lately?

Jenny Trinitapoli  31:02

Yeah, you know, I've been reading about health in context of crisis and violence, and some work that stood out to me as being advanced by Orsola Torrisi and Signe Svallfors; they work on health, specifically reproductive health, in contexts characterized by violence and conflict. That's something that I've been paying very close attention to in the last year.

Joseph Harris  31:49

What about that work has really captivated you? 

Jenny Trinitapoli  31:53

Yeah, it's so hard. The questions that we ask in global health are big questions, and many of them are hard to answer, even under great circumstances where we have good conditions for collecting data and we have clarity on the environment in which we're trying to answer those questions. I think the questions of how contraception, pregnancy, abortion, are managed in contexts of crisis and violence are really, really complex, in part because the phenomena are complex, and also because the ability to observe in those settings is so difficult.

Joseph Harris  33:15

Do you see more sociological work taking place on global health in the future?

Jenny Trinitapoli  33:20

I hope that you'll be happy that I say yes to that question. I mean, I think so, for a couple of different reasons. First, I think going back to the earlier question you asked, it is probably still the case that most of US sociology is really focused on the United States, but I have been heartened to see far more interest from students in topics that are international, global, transnational, and I think that's becoming a dominant disposition among graduate students in particular. I'm also finding more and more interlocutors at different sub-fields and in different departments that are approaching sociology in that way. So absolutely, I think sociology is becoming more and more open to that. I also think that questions of health and aging are becoming more important to sociologists, and so in both directions, I think that there's a lot of good work.

Joseph Harris  35:04

The next few questions I'll ask you are aimed at helping the listener to understand more about how you think about the research process. What would you say are the most meaningful parts of the research process to you? Are there any parts of the research process that you feel just don't get enough attention, or that we don't talk about?

Jenny Trinitapoli  35:25

Well, one of the great things about the research process is that it's just really so varied, and I find a lot of joy in the different aspects of it, right? Whether it's reading, formatting references, the most fun is the process of discovery, right, and finding the new question and starting to pursue it. But I find I get a lot of gratification from formatting references, and making tables and revising figures and all of those kinds of things. So I really think--and those different pieces of the process are so different from one another--I really enjoy being able to turn to one for comfort when the other is not going especially well on a particular day. So that's one thing I would say about the about the research process as a whole. The most meaningful parts of the research process--I'm probably extremely intellectually extroverted-- and so I would really point to collaborations when it comes to the most meaningful parts of the research process. I mean that in a formal way, when you're writing with a person, exchanging ideas, arguing over the theories that should be emphasized, or line editing one another's work, right? I really, really love that part of the research process. I also really, really appreciate the back and forth that we get through workshops and exchange, right, the supportive stuff and the critical stuff. I think all of that really keeps me going in the research process. I mean, without conversation partners, I don't know if I would have finished one article, let alone many articles and two books, but for me, I think that the collaborative part is extremely important.

Joseph Harris  37:52

It really doesn't occur in isolation, does it?

Jenny Trinitapoli  37:54

No, not at all. I mean, not from data. I mean, not from the perspective of data collection, and also not from the perspective of writing at all. Yeah.

Joseph Harris  38:10

It's so weird because, on the one hand, I think about the journey to get a PhD, and it really is solitary, right? I mean, there is, you know, frankly, a lot of isolation involved. You know, at the end of the day, it is about getting your dissertation done. You got to do it, and yet, at the same time, I love your idea of intellectual extroversion. I'm just gonna keep that with me. I think it's wonderful, and bold and fun, and describes well, I think, those moments when, you know, we do get to learn from others and put ourselves out there, and the best parts of the research process.

Jenny Trinitapoli  38:53

Yeah, I think, you know, writing your dissertation is a solitary endeavor. But I think one thing about the purpose of being at a university, and the reason that we're not independent scholars, right, is that we're not alone, and that bumping into other people while getting coffee or coming into the building, or running to the library to check out a book; all of those things really matter. It's hard to quantify, and it's hard to plan for those kinds of injections of ideas in our research, but just informal interactions with other people who care about ideas are consequential. I'm convinced that they're consequential. 

Joseph Harris  40:03

Yeah, I really love that. I mean, it's maybe in some ways less systematic than we're, you know, trained or told it will be, because you do have those moments where you have a major step forward because of someone you happen to talk to, but it certainly doesn't happen in a linear fashion.

Jenny Trinitapoli  40:28

Have you had any informal interactions recently that influenced your work or gave you a phrase for something you were thinking about, or--

Joseph Harris  40:39

I think this one you just mentioned, intellectual extroversion, I'm going to be thinking about for a while. It was one recently; I'm struggling to recall exactly what it was, but I'm sure in the middle of asking you, my next question will come up. Who are some of your biggest influences in writing and research?

Jenny Trinitapoli  41:05

Okay, well, hands down, without a doubt, in a league of her own in terms of influences on me, is Susan Watkins. And Susan died very recently, and I miss her a lot. She was the person who first opened the door for me to go to Malawi and created a environment in which I met people who became my collaborators--now, going on decades--and friends and collaborators. Susan's influence on my writing is tremendous. She had very high standards, and she gave a lot of feedback. Some of it was very funny. It didn't always feel great to read in the exact moment, but, you know, marked up pages from Susan made you feel attended to and loved rather than criticized, even though there was a lot of criticism on those pages. I mean, it really was an investment and it was a gift, and it made me a better editor of my own work through the process of interacting with her. Other influences in terms of writing and research--I read a book at just the right time called Write No Matter What by Joli Jensen, and that was an extremely helpful book for me as I was turning to the solitary part of the dissertation process in terms of thinking about writing, thinking about motivation and thinking about different types of writing. Those are both really big influences for me.

Joseph Harris  43:14

I thought of an answer to the question earlier about, sort of, ideas that we come across through conversations that change the course of the way we think of things. I recently had the occasion to hear from a scholar who's doing some really interesting work at University of Wisconsin-Madison on what she calls "class keeping," and there's this industry that's arisen around the rich to be attended to. It includes all kinds of different occupational categories, but different kinds of professionals, right? You can imagine this, right, and the way in which those service occupations carry a status that's beyond the one that we may have envisioned in sort of earlier times, where there's such a hierarchy between a butler, for example, and then the person they serve, and today, in which those professions themselves may sort of gain status from being close to those in the upper income strata, but also pointing at the way in which it is the middle class themselves, these professionals who are intimately involved in the reproduction of the elite. There's a relational aspect between those middle class professionals and the elite themselves, and in many ways, their lives are made possible, right? I have to say that that those ideas really set my head spinning.

Jenny Trinitapoli  44:58

Interesting. Yeah, fascinating. That sounds great.

Joseph Harris  45:05

Are there any practices or habits that you found indispensable in helping you in the process of conducting research and writing? I know that you made so many wonderful contributions. A lot of our listeners would be interested to know, what can we learn from Jenny?

Jenny Trinitapoli  45:22

Well, I already said I'm extroverted, so, you know, I mean, I inflict in- progress work, short pieces of it, on people in my life, on my collaborators, even if we're not collaborating together on a particular piece of research. I've got a great network of people who read two orthree pages at a time and give a quick reaction. My students do that for me as well; so do my colleagues at Chicago. So that's, I mean, sharing bits often and in formal ways, is something that I do a lot. I also do a lot of walking when I'm working on projects and trying to figure out puzzles that I don't have the answers to. I mean, I think a lot of people do this. It's sort of recommended by a lot of different creative types and a lot of different kinds of books. But if I think that being in motion is helpful for thinking in some ways, I mean, no headphones; I don't even carry my phone if I really, really want to think about a problem, but a really, really long walk, actually, with a deliberate intention of trying to puzzle through something is useful, has always been one of the best things I can do. I mean, sometimes we do find answers to the things that we're thinking about by reading more, but sometimes we've read a lot and we just haven't found ways--our brains haven't found ways--to put it together. So I think that being in motion is helpful for me when I'm in those stuck phases.

Joseph Harris  47:19

I love that. Yeah, it's like things fall into place. That's great. If you could give first-year PhD students doing work on global health one piece of advice, what would it be?

Jenny Trinitapoli  47:35

So, in global health, I think that we have this emphasis on reading  cutting edge work, being current, and building technical skills. These are things that are really, really highly valued, to be able to publish a lot and respond to the topics that are important. This makes a lot of sense to me, because global health is a field that moves really, really fast, and when you're a first-year PhD student, you're just trying to find your feet, let alone keep up with the journals. There are just so many of them. It's really, really hard. But I think the piece of advice that I might give would be not to neglect the classics, like, not to forget to read good history about the place that you are working in, or might want to be working in the future, or the literature from the setting that you're working in. I think that they might seem like luxury investments when you just need to get your course paper done, and can you really prioritize that? But I think that many of the questions and puzzles that keep coming up in global health are coming up because they are enduring, right, and that having strong foundations in, for example, the history and the literature of the settings that we're working in can be something that we really rely on.

Joseph Harris  49:29

I love that because it seems to me, when I first meet students and we talk about the projects, and they're trying to figure out if I should be their advisor, or I'm trying to learn more about them, one of the things that we talk about is, you know, how are you going to anchor your work? What are the big works you're going to think about in relation to it? I think about what you said in light of that, you know, and "what the classics offer," as you said, so I really love that. And before we end, I want to go back to something you said in the earlier question aboutputting your work out there, and you know, you have this constant stream of companions that you're very kind about sharing your work with and offering feedback, even quick feedback. Would you say you have a thick skin, because you know this enterprise that we're involved in, it involves criticism, right? And you seem, as someone, as you say, very extroverted; very comfortable sharing these bits of yourself, right? You know, for I think many graduate students, it's so difficult, right? We're invested, you know, so much in our ideas. What would you say to those people who maybe have a hard time doing that? How did you develop that ease?

Jenny Trinitapoli  50:59

Gosh, I mean, I don't want to go too deep, you know, we can talk about our natal families and our extracurricular activities as a kid. I mean, I did a lot of sports as a kid, and I think one of the things that you learn from your teammates and from your coaches is that everyone's giving you corrections and pushing you--there's always something that you can be doing better, right? I think that people who do music as a kid probably get that kind of feedback, or in theater too, right? I don't know; I never did theater, but a director is giving notes constantly, right? I think I probably do have thick skin, and it's important for me to keep in mind in when I interact with others that  some people are more tender, and they're also younger than me, right, so they haven't been through as many iterations. But I think that, you know, hey, Joe, if I gave you three pages that I was working on, and you gave them back to me, and you said, "Oh, Jenny, like, I think this is good," I wouldn't think that you had read it, and we wouldn't be engaged in an ongoing conversation that lasted for you. You know, we wouldn't be meeting up at ASA and, you know, finding other opportunities to engage if you gave me a gold star and told me this was really nice, right? So I think that the ability to see engagement and genuine curiosity alongside criticism, right? Sometimes something feels like criticism, but it's curiosity. It's a desire to know and understand better. We can always improve in terms of giving better explanations, clearer examples and those kinds of things. So yeah, I probably do have thick skin.

Joseph Harris  53:13

But I love this, because it's about, in some way, criticism as support, right? And I think that some of the best criticism is just that.

Jenny Trinitapoli  53:27

Engagement, yeah.

Joseph Harris  53:28

I promise to never give you a gold star.

Jenny Trinitapoli  53:31

Thank you. That means we're actually friends.

Joseph Harris  53:36

We've been here talking with, in this wonderful conversation, Dr. Jenny Trinitapoli. She's a professor of sociology at University of Chicago. Her recent book is An Epidemic of Uncertainty: Navigating HIV and Young Adulthood in Malawi. If you haven't read it, go out and get it. It's a wonderful book, and it's filled with wonderful figures and tables. Those of you who are demographers, you'll love to see that, and those of you who aren't, you will love it as well. So, thank you so much for joining us today.

Jenny Trinitapoli  54:08

Thanks so much for having me and for this very fun conversation; I've loved it.

This podcast was produced with the assistance of Mayuri Koka-Johnson.