NIH Funds Global Women’s Health

Jeff Stringer, MD

Jeff Stringer, MD

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 (R01-HD087119 and R21-HD090987) will support clinical trials of the drug progesterone to prevent preterm birth among HIV+ pregnant women. “Pregnant women who are infected with HIV – whether talking anti-AIDS medication or not – have a high risk of delivering a premature baby,” said Jeffrey Stringer, M.D., chief of the division and professor of obstetrics and gynecology at UNC OB-GYN and associate director of research for the UNC Institute for Global Health & Infectious Diseases. “UNC IGHID 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 (R01-HD088279) will investigate the best birth control methods for HIV+ 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 4-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 UNC Assistant Professor, Dr. Jennifer Tang, who will lead the study, “Understanding these pregnancy rates will help HIV+ 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 NIH grant (R01-AI131060) will focus on preventing new HIV infections during 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 will design, implement, and evaluate a combination HIV prevention package for pregnant women and their partners, based on evidence-based interventions. Led by Dr. Ben Chi (UNC) and Dr. Wilbroad Mutale (University of Zambia), the study will be implemented at UNC-supported sites in Zambia and Malawi.