About

Years: 2019-2020

Training Site: UNC Project-Malawi

Country: Malawi

Mentors: Mina Hosseinipour, MD, MPH; Dr. Benjamin Chi, MD, MSc; Jennifer Tang, MD, MSCR

Title: Changes in the vaginal microbiota among pregnant women on antiretroviral drugs for HIV prevention or treatment

Program Objectives: Changes in the vaginal microbiota have been linked to numerous adverse birth outcomes, including preterm birth. However, the effect of antiretroviral therapy (ART) on vaginal microbial community composition and structure during pregnancy remains unclear. We propose a descriptive pilot study to understand whether antiretroviral (ARV) drugs lead to changes in the vaginal microbiota in the context of HIV treatment (for HIV-infected women) and pre-exposure prophylaxis (PrEP, for high-risk HIV-uninfected women) during pregnancy. If we find differences in the composition and structure of the vaginal microbiota, we will leverage these findings to perform larger studies to further evaluate the effect of these differences on obstetric outcomes.

Aim 1: To characterize differences in vaginal microbiota composition and structure between HIV+ and HIV- pregnant women prior to initiation of ART for HIV treatment or prevention.

Aim 2: To compare changes in vaginal microbiota composition and structure between HIV- women on PrEP and HIV+ women on ART, after they initiate their ARV drugs.

Aim 3: To explore whether specific vaginal microbiota are associated with preterm birth amongst women on PrEP or ART.

NIH Support: Fogarty fellow postdoctoral training award