Sexually transmitted infections (STIs) are one of the world’s most serious and widespread public health challenges. More than 1 million STIs are acquired every day, according to the World Health Organization. In 2020 alone, an estimated 37.6 million people worldwide were living with HIV and 1.5 million individuals became newly infected.
Faculty and student researchers from the Department of Global Health are committed to reducing the global burden of HIV/AIDs and other STIs through innovative research, impactful partnerships, and novel interventions. Below, we’re highlighting a selection of recent efforts by the DGH community to address this global health epidemic.
Prevention & Treatment of HIV/AIDS
HIV in Women, Adolescents, and Children:
- Children living with HIV experience gaps in HIV testing globally. Scaling up evidence-based testing strategies is critical for preventing HIV-related mortality. In a recent study, a team of researchers, including UW acting assistant professor of global health Dr. Kristin Beima-Sofie, evaluated considerations for the use of financial incentives to increase pediatric testing in Kenya. Read the full study published in AIDS and Behavior: Financial Incentives for Pediatric HIV Testing (FIT): Caregiver Insights on Incentive Mechanisms, Focus Populations, and Acceptability for Programmatic Scale Up.
- Pregnancy is a high-risk time for HIV acquisition in both mothers and infants. Dr. Anjuli Wagner, UW assistant professor of global health, is leading an implementation science K01 research and training grant from the National Institutes of Health (NIH), now in its third of five years, to test strategies to improve delivery of pre-exposure prophylaxis (PrEP) for pregnant and postpartum women in Kenya. The project team has innovated to conduct careful and thoughtful research during the COVID period, gearing up to test health care worker generated ideas for how to more efficiently delivery PrEP.
- There is emerging evidence that fetal exposure to maternal HIV infections and medications may have adverse long-term health effects. Dr. Grace John-Stewart, UW professor of global health, and colleagues Dr. Irene Njuguna, UW affiliate professor of global health and research scientist at Kenyatta National Hospital in Kenya, and Dr. Dalton Wamalwa, a lecturer in the Department of Pediatrics at the University of Nairobi, received an NIH grant to systematically conduct neurodevelopmental and mental health assessments to comprehensively understand burden, mechanism and outcomes in children and adolescents who were HIV-exposed but uninfected in sub-Saharan Africa.
Comorbidities in Persons Living with HIV
- Dr. Tecla Temu, UW clinical assistant professor of global health, has received a K01 research and training grant form the NIH to support the design and implementation of studies related to gut microbiota, inflammation, and cardiovascular disease in persons living with HIV. Dr. Carey Farquhar, UW professor of global health, is a co-mentor for this program, along with UW associate professors of global health Dr. Alison Roxby and Dr. Heather Jaspan, and UW professor of biostatistics Dr. James Hughes.
Technological Innovations and Health Systems Strengthening in HIV Treatment and Care
- Approximately 67% of HIV-infected individuals in sub-Saharan Africa are retained on antiretroviral therapy (ART), leaving a large proportion of patients at risk of poor outcomes. Cost-effective, mobile health innovations (such as two-way texting) that may significantly increase retention among patients on ART are urgently needed. Caryl Feldacker, UW assistant professor of global health, recently received an NIH grant to test, optimize, and evaluate a low-cost, two-way texting system to increase retention in a public, high-volume, routine ART clinic in Malawi, aiming to help fill a clear gap in patient care.
- The International Training and Education Center for Health (I-TECH) has received three new awards from both the CDC and HRSA to support local partners in the development, expansion, and strengthening of HIV treatment and care programs. Projects include providing technical assistance to the Mozambique Ministry of Health to expand pediatric advanced HIV disease services; building sustainable health systems in Botswana, Caribbean, India, Mozambique, and Ukraine to improve health outcomes for people living with HIV; and implementing three continuous quality improvement collaboratives in Tanzania to improve HIV care and treatment.
Student-Led HIV Research Projects
- Intimate partner violence (IPV) and HIV represent complex and interconnected threats to global health. Dorothy Thomas, a UW Implementation Science PhD student in the Department of Global Health, has received an NIH grant to evaluate the relationship between experiences of IPV and HIV-related outcomes in Kampala, Uganda. This project will inform the development of optimized implementation strategies to concurrently address challenges of IPV and improve HIV treatment and prevention outcomes in settings like Uganda. Thomas will be mentored on this project by Renee Heffron, UW Associate Professor of Global Health.
- In cooperation with the UW/Fred Hutch Center for AIDS Research (CFAR), The Joint United Nations Programme on HIV and AIDS (UNAIDS) is providing remote data analysis opportunities to six UW graduate students to contribute to important short-term HIV-related research projects. These students will benefit from UNAIDS and UW mentorship and training, build international networks, and develop transferable skills that will help them to make a difference in the fight against HIV/AIDS.
Prevention and Treatment of Other STIs
- HIV infected children remain at increased risk of human papillomavirus (HPV) associated malignancies as they initiate sexual activity. A study led by UW research associate professor of global health Nelly Mugo in Kenya determined that children with HIV infection may retain long term antibody response following HPV immunization. Read the full study published in Vaccine: Antibody responses to prophylactic quadrivalent human papillomavirus vaccine at 48 months among HIV-infected girls and boys ages 9-14 in Kenya, Africa
- A team of Seattle-based researchers, including UW adjunct associate professor of global health Lorenzo Giacani, have demonstrated that the genetic manipulation of T. pallidum, the causative agent of syphilis, is attainable. This discovery will allow the application of functional genetics techniques to study syphilis pathogenesis and improve syphilis vaccine development. Read the full study published in PLOS Pathogens: Genetic engineering of Treponema pallidum subsp. pallidum, the Syphilis Spirochete.
- Rates of STIs are increasing in the US, especially amongst HIV-infected men who have sex with men (MSM) and transgender women (TGW), and HIV-uninfected MSM and TGW who are on PrEP. Dr. Connie Celum, UW professor of global health and medicine, is co-Principal Investigator with Dr. Annie Luetkemeyer from the University of California, San Francisco on a NIH grant to evaluate the use of doxycycline post-exposure prophylaxis (PEP) among HIV-infected and HIV-uninfected MSM and TGW on PrEP in San Francisco and Seattle. The primary objectives are to evaluate the effectiveness of doxycycline PEP on the incidence of syphilis, chlamydia and gonorrhea and secondary objectives are to assess safety, acceptability, and antimicrobial resistance.
For a complete list of recent global health publications by UW faculty and researchers, visit the global health research highlights page.
By Amy Frances Goldstein