December 5, 2025
Researchers receive major grant to study impact of HIV/ART exposure on child neurodevelopment
Multiple Principal Investigators Dr. Grace John-Stewart, Prof. Dalton Wamalwa, Dr. Kathleen Powis, and Prof. Andrew Prendergast leading the newly awarded U19 RISE Project
An international research team with Global WACh and partners in the U.S., Kenya, Zimbabwe, and Botswana received a five-year long $36 million dollar grant from the National Institute of Health to better understand how HIV or antiretroviral (ART) exposure in utero influences child health outcomes, including neurodevelopment.
“Researching Interventions and Implementation Strategies to Evaluate the Health and Development of Children Affected by HIV (RISE)” is a large NIH-funded U19 Program to evaluate tools for screening children for neurodevelopmental delays and to identify interventions to optimize neurodevelopment among children with and without in utero HIV/ART exposure. The RISE Program includes three distinct research Projects and three Cores that provide shared resources, focusing on scientific administrative support, data management and analysis, and dissemination and stakeholder engagement, to facilitate the Projects.
The Projects include a multi-country randomized trial evaluating an intervention to optimize child neurodevelopment, implementation science studies to optimize integration of neurodevelopmental assessment in busy clinics, and novel imaging studies with MRI to understand impact of HIV/ART exposure and interventions on brain structure. These findings will be helpful to understand neurodevelopment of children worldwide.
RISE will be conducted in Kenya, Zimbabwe and Botswana – regions with a large population of children exposed to peripartum HIV/ART (CHEU). There will be active engagement with community members, Ministries of Health, study participants, and clinical providers. The geographic span and on-the-ground support enables these well-powered studies to assess neurodevelopment in CHEU and interventions, implementation strategies, and surveillance.
RISE researchers will identify interventions administered during pregnancy and the first two years that could improve neurodevelopment of children. The study will also identify new screening approaches that could feasibly be integrated within public health clinics to find children who may be at risk for poorer neurodevelopment and could benefit from interventions. The investigators will engage with Ministries of Health and Education to facilitate processes to monitor impacts of pregnancy exposures at population-level and to disseminate and engage communities on how to prioritize neurodevelopment of children during the first two years of life. The results have potential for major public health impact globally and improve the lives of children and their families.
The study is led by multiple principal investigators (MPIs) each with extensive research expertise leading large clinical trials, observational studies, implementation science projects, and data cores, with demonstrated success in stakeholder engagement and dissemination in Botswana, Kenya, and Zimbabwe. The MPIs, Dr. Grace John-Stewart (University of Washington), Prof. Dalton Wamalwa (University of Nairobi), Dr. Kathleen Powis (Botswana Harvard Partnership, Mass General Hospital), and Prof. Andrew Prendergast (Queen Mary University of London) prioritize building research capacity and elevating the scholarly contributions of early-career researchers. Investing in the mentorship and training of emerging scientists is essential to continue addressing global health challenges and driving new scientific directions that lead to meaningful solutions.
Investigators come from partner institutions in Kenya (University of Nairobi, Kenyatta National Hospital, UW-Kenya, Kenya Medical Research Institute), Zimbabwe (Zvitambo, Queen Mary University, London), Botswana (Botswana Harvard Partnership, Mass General Hospital), Mayo Clinic, Seattle Children’s Hospital, University of California, San Diego (UCSD), Emory University, and Indiana University.
We look forward to sharing updates as the study progresses.