There are not many couples in which both husband and wife are first authors on a paper in the prestigious New England Journal of Medicine, but Drs.Roger Shapiro and Shahin Lockman are one of them. In addition to being researchers for the Harvard AIDS Initiative, both are also physicians specializing in infectious diseases. Together they have three sons, ages three, six and nine. And in spite of constant demands on their schedules, Shapiro and Lockman spend a significant amount of time mentoring young HIV/AIDS researchers.
Roger Shapiro was born in Hartford, Connecticut. His father, a cardiologist, and his mother, a career counselor, met on a blind date. Shapiro was a magna cum laude history major at Yale who then went to medical school at New York University.
Shahin Lockman was born in Columbus, Ohio. Her mother was a physician born in India to a Bahá’í mother and a Zoroastrian father. Lockman’s parents met in Heidelberg where her father, a chemist, was playing clarinet in a U.S. military band. As a child, Lockman moved with her family to Scotland and then to England and Germany. She returned to the U.S. for college and medical school at Northwestern University.
Lockman and Shapiro met in CPR class on the first day of residency at Beth Israel Hospital in Boston and began dating a year later. After residency they moved together to Atlanta to begin the Epidemic Intelligence Service, a two-year program at the Centers for Disease Control and Prevention (CDC). The couple spent a fair amount of time driving each other to the airport. Shapiro worked on food-borne and diarrheal outbreaks in Argentina and Kenya. Lockman worked on tuberculosis in Botswana. On her first visit there in1996, another disease caught her attention. “At that point it became incredibly clear that HIV/AIDS was the fire burning down the house in southern Africa,” said Lockman, “but it wasn’t yet on the radar screen internationally how severe the epidemic was.”
Shapiro’s marriage proposal, like the rest of their lives at the time, involved a great deal of travel. Lockman flew from Botswana to meet Shapiro in Nairobi, Kenya. Together they flew to Entebbe, Uganda, took a bus to Kampala, and then another all-day bus to the far west of Uganda, stopping to help to shovel out a landslide that blocked the road. As the day was ending, they took a taxi to a pier and then a boat to an island on a deepwater lake where they were the only travelers at a tent camp. At sunset Shapiro proposed.
They got married three months later. A few days after that they started fellowships at the Partners Program for Infectious Disease in Boston and began looking for a research project. Both wanted to return to Africa to work on HIV/AIDS-related issues. They knocked on Dr. Max Essex’s door in the fall of 1998. Their timing couldn’t have been better.
Essex, Chair of the Harvard AIDS Initiative, was establishing the Botswana–Harvard AIDS Institute Partnership (BHP). Preparations were underway for the Mashi Study, the BHP’s first clinical trial in prevention of mother-to-child transmission of HIV. Shapiro and Lockman signed on. In 1999 they moved to the Botswana village of Molepolole for a year to work on the project. “For me it was a tremendous stroke of good luck,” said Essex. “In retrospect I don’t know what I would have done without them.”
Returning to Boston in 2000, the couple continued with their research. In addition, Shapiro treated patients in the infectious disease clinic at Beth Israel Deaconess Medical Center and began working towards an M.P.H. in International Health from the Harvard School of Public Health (HSPH). Lockman treated patients at Brigham and Women’s Hospital and began working towards her M.Sc. in Epidemiology from HSPH. Their first son was born in 2001. They both earned degrees from HSPH in 2003. Their second son was born in 2004. Until 2005 they continued to spend three months a year in Botswana with their children.
In 2007 the Mashi team published key results on the study, demonstrating a way for women to avert the dangerous drug resistance that often occurs when they take antiretroviral drugs (ARVs) to prevent their infants from becoming infected with HIV. Lockman was the first author on the paper that appeared in The New England Journal of Medicine. She gave birth to her third son that same year. Shapiro was the first author of HAI’s most recent paper that appeared in NEJM on the results from the Mma Bana Trial. (See main article).
When asked how they manage, Shapiro and Lockman both acknowledge the importance of their full-time nanny and say that setting priorities is crucial. Although there are always competing demands on their time, family is their number one priority. “We work well together,” said Shapiro. “Shahin is my closest colleague. We have different strengths and weaknesses, so we try to take advantage of that.” Both admit that being married to one’s research collaborator means there is no clear line between work and home life. “We are as blurred as blurred can be” said Shapiro. “We will put the kids to bed and then start talking about a study that we’re working on.” Lockman added, “We feel very fortunate to do work that we love and to do it together.”
One of the studies is a new clinical trial on which Shapiro and Lockman are co-principal investigators that looks at survival among HIV-exposed infants. They also work independently. Lockman is looking at health outcomes and neurodevelopment in infants exposed to ARVs and HIV. Shapiro is taking the lead on an analysis of the risk factors for stillbirth and neonatal mortality among HIV-infected and uninfected women.
Just as Shapiro and Lockman were mentored by Max Essex at the start of their careers, they are now mentoring the next generation of HIV researchers. Dr. Scott Peterson said that Lockman’s mentoring was invaluable to him in setting up a clinical trial that examines ways to improve the health outcomes of HIV-exposed infants. “She assisted with development of the project, securing funding, and obtaining ethical approvals,” said Peterson. “She has tirelessly led me through the logistical and regulatory webs of initiating a clinical trial.” Lockman’s mentoring to Peterson included weekly hour-long calls to discuss progress and over 1000 emails.
When advising young researchers like Peterson, Shapiro and Lockman stress the importance of understanding the culture that they’re working in. “We’ve spent about four years total in Botswana over the years,” said Lockman. “It’s important to put in a lot of time on the ground early on, to really understand what the issues and problems are and to build relationships and trust. It’s helpful to do this before family issues become more complicated.”
As co-investigators and co-parents, Shapiro and Lockman returned to Botswana for six weeks this summer with their three boys. Although the logistics aren’t always easy, they see spending time in Africa as a valuable experience for their children. “The exposure to what people’s lives are like in Botswana and the rest of the world has already had an impact on them,” said Lockman.