Expansion of research and mentoring opportunities to reduce the burden of maternal and pediatric HIV in Botswana

摘要/摘要

Summary / Abstract I am applying for a K24 renewal with the goal of expanding the scope of my NIH-funded research and expanding mentorship opportunities at the Botswana-Harvard AIDS Institute Partnership in Botswana. In the past 23 years, I have built a successful research program in Botswana with a recent focus on adverse birth outcomes surveillance and novel treatment strategies for children with HIV. I have successfully mentored or co-mentored nearly 50 young investigators in my career, and my current K24 has been essential for my recent mentoring activities. Despite the challenges of COVID-19, my K24 research and mentoring aims have been achieved – and often expanded – over the past 5 years. With re-funding, my K24-supported research will have the following mentored research aims, which span all of my funded research activities: (1) to evaluate uptake of 6-week HIV DNA PCR testing, risk factors for lack of testing, and risk factors for HIV vertical transmission in the Botswana national treatment program; (2) to evaluate the uptake of cabotegravir-LA pre-exposure prophylaxis (PrEP) offered in pregnancy through the Botswana national program; (3) to determine the incidence of maternal morbidity and mortality associated with cesarean section at Princess Marina Hospital (by HIV status), and develop interventions to standardize medical indications for caesarean section, while training my current mentee to become a mentor; and (4) to perform specialized diagnostics and qualitative interviews to optimize a strategy for a future analytic treatment interruption (ATI) among highly selected children and adolescents living with HIV, while fostering research independence in a Botswana-based laboratory mentee. My training plan will specifically expand my expertise in maternal-fetal medicine and HIV cure strategies, and my mentoring plan will involve a team approach with co-mentors in Boston and Botswana to efficiently utilize opportunities within a new Program Award, ongoing clinical trials, and existing datasets and specimens. The ultimate goal of my K24 renewal application is to expand capacity to conduct high-impact patient-oriented research in Botswana by the next generation of global health leaders from Africa and the United States.