UNC OB-GYN receives four new NIH grants to study HIV and women’s health

The Division of Global Women's Health will lead the group of studies in Malawi and Zambia.

The Global Women's Health Division of the UNC Department of Obstetrics and Gynecology has received new grant funding from the National Institutes of Health (NIH) for a collection of studies to be conducted in the African nations of Malawi and Zambia, where UNC has large ongoing research programs.

The awards, which total nearly $8 million in aggregate, are aimed at improving outcomes for women who are infected with – or at risk for – the HIV virus.

Two of the new grants will support clinical trials of the drug progesterone to prevent preterm birth among HIV-positive pregnant women.

"Pregnant women who are infected with HIV – whether they are talking anti-AIDS medication or not – have a high risk of delivering a premature baby," said Dr. Jeffrey Stringer, chief of the division and professor of obstetrics and gynecology at UNC OB-GYN. "Our group has contributed for years to the successful global effort to prevent mothers from passing HIV to their children. The next great challenge is to ensure these babies are born healthy and full-term."

A total of 920 women will participate in the trials, which will investigate two preparations of the drug progesterone.

"If our primary hypothesis is confirmed, we will have identified an intervention that could prevent as many as 70,000 preterm births per year worldwide," said Dr. Stringer.

A third study will attempt to determine the best birth control methods for HIV-positive women who are taking the anti-AIDS drug Efavirenz (EFV). EFV has been found to cause some birth control methods to be less effective. In a four-year study to be carried out in Lilongwe, Malawi, UNC investigators will recruit 1420 women who are taking EFV and compare their pregnancy rates when using the Jadelle® birth control implant versus an injectable contraception called DepoProvera®.

According to Dr. Jennifer Tang, assistant professor at UNC Global Women's Health who will lead the study, "Understanding these pregnancy rates will help HIV-positive women to make the best birth control choices for themselves and help to decrease Sub-Saharan Africa's high rates of unintended pregnancies, maternal mortality and perinatal HIV."

A fourth award will focus on the study of HIV prevention in pregnancy and breastfeeding. In sub-Saharan Africa, numerous studies have shown elevated risk of HIV infection during this window, likely due to a variety of biological and behavioral factors.

Funded as part of the NIH's Methods for Prevention Packages Program (MP3), this project seeks to design and evaluate a combination HIV-prevention package for pregnant women and their partners, based on evidence-based interventions. Led by Dr. Ben Chi, a professor at UNC Global Women's Health, and Dr. Wilbroad Mutale at the University of Zambia, the study will be implemented at UNC-supported sites in Zambia and Malawi.

For more information on the work of the Global Women's Health division, click here.