News
August 3, 2017
Global WACh goes to Paris to share research findings at the annual International Aids Society (IAS) Conference
Categories: Uncategorized
Last week, Global WACh researchers shared their study results with HIV/AIDS experts across the globe at the International AIDS Society Conference in Paris, France. Check out highlights from Global WACh studies on family planning misconceptions among postpartum adolescents, low retention of women enrolled in Option B+ in Mozambique, financial incentivization for pediatric HIV testing, and a cost analysis for young adults seeking free HIV testing services below. Their studies contribute to HIV science and the global effort to eliminate HIV/AIDS worldwide.
Drs. Irene Njuguna (right) and Anjuli Wagner (left) visit the Eiffel Tower in between sessions at the IAS Conference 2017
Invited Talks from Global WACh Members
Dr. Alison Drake was an invited plenary speaker at the 9th Annual Pediatric HIV Workshop. She gave a presentation entitled “A Last Barrier to eMTCT: Acute HIV Infection in Pregnancy and Breastfeeding.”
Dr. Anjuli Wagner was an invited panelist at a CIPHER satellite session in a discussion on “The role of implementation science in pediatric and adolescent HIV”.
Dr. Grace John-Stewart gave a talk on “mHealth interventions for ensuring effective Prevention of Mother to Child Transmission” at the IAS mHealth and Global HIV Response Workshop.
Poster Presentations from Global WACh Scholars and Researchers:
Dr. Alison Drake: “Desire to prove fertility and contraceptive misconceptions delay family planning and condom use until after pregnancy among Kenyan adolescents”
Adolescent women in Kenya are experiencing a high risk of unintended pregnancies and HIV infection. Dr. Alison Drake and her team hoped to better understand these misconceptions, and reveal their impact on HIV prevention and family planning decisions. The team surveyed postpartum HIV-free adolescents at two maternal-child health clinics in Western Kenya. Despite familiarity with contraception methods, many adolescents held misconceptions on the social acceptability of using them. Many believed that long-term methods increased the risk of HIV infection and transmission. Should they become HIV-positive, some feared harmful side-effects by combining medication with the birth control hormones. Family Planning Health Care Workers (FP HCW) were also surveyed on their perception of contraception effects and benefits. FP HCW did not feel supported in training and experience, and lack of staff to manage more patients. Overall, the team found that adolescent’s perception of contraception is shaped by social norms and misinformation from their community. The study suggests the need for innovative strategies to encourage dual method use (condom and another method), utilize of mobile health tools, improve HCW training and experience, and integrate family planning in prenatal care.
Dr. Irene Njuguna, “Financial incentives to increase pediatric HIV testing in Kenya (FIT STUDY): A randomized trial
Children with HIV infection have a high risk of dying if they are not diagnosed and treated early. Finding older children with HIV is challenging because there aren’t built-in health systems for systematic HIV testing of exposed children once PMTCT is completed. Reasons why parents don’t have their children tested include fear or denial that their children may be infected and financial burdens. The FIT Study will determine whether small cash incentives can motivate HIV-infected parents to test their children for HIV. Irene Njuguna, PhD Epidemiology student, presented FIT’s pilot research poster at the conference. The pilot study recruited 60 HIV-infected mothers with children of unknown HIV status, who were randomly assigned a cash incentive valued at $5, $10, or $15USD. 72% of women completed HIV testing for their children, which was significantly higher than unincentivized testing rates in a previous study in the same region (14%). Dr. Njuguna is now leading a trial evaluating incentive efficacy, which is enrolling 800 HIV-infected caregivers and will compare testing rates between no incentive and $1.25, $2.50, $5 or $10.
Anjuli Wagner, “Can Adolescents and Youth in Kenya Afford Free HIV Testing Services? A Cost Analysis”
Although free HIV testing services may be available to adolescents and young adults (AYA), non-medical costs related to travel and time off school or work may pose as barriers for AYA to actually access such services. Anjuli Wagner, post-doctoral fellow worked with a team from the University of Washington, University of Nairobi, and Kenyatta National Hospital to identify those costs and the possible burden they cause to AYA. The study interviewed 189 AYA aged 14-24 who completed free HIV counseling and testing at Kenyatta National Hospital. The team discovered 62% of AYA paid for non-medical costs, such as transportation and meals during their HIV test visit. Most AYA are students and unemployed, and 42% reported missing at least half a day of school to accommodate travel time and HIV testing services. The results suggest achieving universal HIV testing among AYA may require interventions to reduce their burden of indirect costs.
Keshet Ronen, “SMS messaging to improve adherence to PMTCT/ART: perspectives on HIV-related content among peripartum HIV-infected women in Kenya”
Keshet Ronen, PhD, research scientist, presented data on SMS messaging preferences among pregnant and postpartum women with HIV. There is growing evidence that SMS can be used to improve HIV treatment adherence and retention in care, but there has been concern about risks of HIV status disclosure through phone messages. In formative work for an ongoing clinical trial that evaluates the impact of SMS messaging on HIV treatment and prevention of mother-to-child transmission, Mobile WACh-X, 10 focus group discussions were conducted with 87 peri-partum women to explore their preferences regarding SMS containing overt HIV-related language or language that may bring attending to the recipient’s HIV status (e.g. ‘HIV’, ‘ART’, ‘infection’, ‘medication’). Some women desired overt messages regarding their HIV medications and the option to ask overt questions using the mHealth system, while some women, especially those who had not disclosed their status or shared their phone, preferred to receive and send only covert messages. Based on these findings, the Mobile WACh-X system was designed to provide all three options and allow women to choose. In the ongoing trial, most participants who have disclosed their status or own their own phone chose either overtly HIV-related SMS (65% of participants) or the option to send overt messages to the system (10% of participants).
March 16, 2017
Study achieving optimal neurodevelopmental outcomes in HIV-Infected Infants
Categories: Research
Tags: ART, growth, HIV, neurodevelopment, Pediatrics
HIV infection can result in neurodevelopmental impairment in children. We do not yet understand the extent to which effective antiretroviral therapy (ART) prevents these delays, but Global WACh researcher Dr. Sarah Benki-Nugent’s recent study, conducted in collaboration with researchers at the University of Nairobi, has provided insight to help answer this question. Their study focused on HIV-infected infants in Nairobi Kenya who received ART from the time of infancy and compared their developmental milestone attainment to HIV-unexposed infants.
Sarah Benki-Nugent, MS, PhD, is the study’s lead investigator and Acting Assistant Professor at University of Washington Department of Global Health
Most HIV-infected infants in their study were extremely ill at the time of HIV diagnosis and many were first identified in the hospital. Unfortunately, late diagnosis continues to be common in Africa and UNAIDS has recently estimated that only about half of HIV-infected children are receiving treatment.
The study found that overall, HIV-infected infants had later age at attainment of milestones compared to unexposed infants. However, infants who had better responses to treatment had better developmental outcomes. Benki-Nugent and Kenyan research collaborator Dalton Wamalwa say, “We still don’t’ know how children will do in the long-term; however, this data suggests that effective response to ART provided some benefit, even in a group of infants who were very sick when first diagnosed.”
The study suggests that early HIV diagnosis and successful treatment are likely key factors in retaining cognitive and motor neurodevelopment in HIV-infected children. It is also likely critical, Dr. Benki-Nugent says, to provide additional strategies, such as parenting support for early childhood development alongside HIV treatment to help children reach their full potential.
Click here to read more about the researcher’s work recently featured in Infectious Disease Advisor.
March 9, 2017
Certificate capstone brings together experts in adolescent health to understand early gender socialization
Categories: Research, students
Tags: adolescent health, Certificate Program
In fulfillment of her Global WACh Certificate Capstone, Marina Plesons worked with a team of adolescent, sexual, and reproductive health professionals from the WHO, USAID, Gates Foundation, and the David & Lucille Packard Foundation to write a commentary for the Journal of Adolescent Health. The paper considers the implications for action and research of the Global Early Adolescent Study’s formative qualitative research on gender socialization.
The Global Early Adolescent Study (GEAS) aims to understand the factors in early adolescence that predispose young people to subsequent sexual health risks, and conversely promote sexual and reproductive health and well-being. In her capstone presentation last week, Marina commented on the fact that ages 10-14 are among the most critical for human development, but are a comparatively poorly understood life stage. This work thus serves to investigate the social processes that shape young people’s health and development, especially as this relates to gender norms informing adolescent sexuality.
Gender inequities are a key underlying determinant of the sex-specific differentials in morbidity and mortality of adults, and adolescents. Gender inequities manifest in different ways, such as discriminatory laws, policies, and socio-cultural practices or unequal power, access, and control over resources. At the root of inequities are gender norms and attitudes, which prescribe different status, power, access, and behaviors (including in relationships) according to culturally appropriate expectations for males and females. If we understand how gender norms for young adolescents are enforced, reinforced, challenged, and accepted, then we can be better address these in programs and interventions to improve adolescent and adult health.
Marina’s contributions to the paper included key themes in which gender norms and attitudes manifest in the lives of young adolescents, their peers, and their families in a number of countries. The team then extrapolated seven key programmatic and policy recommendations for ways that the global community can promote gender equitable norms and attitudes in early adolescence.
We can expect the paper to be included as part of a Journal of Adolescent Health special supplement this year, featuring the results from Marina’s work. We look forward to sharing when it is released!
Through
out her capstone and internship with the WHO, Marina also worked closely with her faculty advisor, Dr. Donna Denno.
Marina Plesons is an MPH candidate in the department of Global Health, and President and Co-founder of Health Advocacy Innovations, Inc.
March 3, 2017
Global WACh Seed Grant recipient publishes at PLOS One
Tags: adolescent health, Seed grants, STIs
As part of our commitment to meaningful research collaborations, Global WACh offers Integrated Health Seed Grants: one-year of seed funding for pioneering research to improve the health of women, adolescents, and children. The proposals we award recognize a global focus on community advocacy and innovative exploration.
Dr. Linnet Masese is a Postdoctoral Fellow at the University of Washington Department of Medicine
In 2011 we awarded the seed grant to Dr. Linnet Masese, who at the time was a doctoral student at the UW Department of Epidemiology, and Clinic Section Head at the UW/University of Nairobi Research Site in Mombasa. Her original proposal was to explore the feasibility of Chlamydia trachomatis screening among adolescents and young women in Kenya. However, with nucleic acid amplification testing locally available at the UW Research Laboratory in Mombasa, she expanded the study to include screening for Neisseria gonorrhoeae and Trichomonas vaginalis. We are thrilled to report that the first of three papers from this study titled “Barriers and Facilitators of Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya” was recently published in PLOS One.
Dr. Masese’s work centers around one of the earliest reproductive health challenges faced by young women as they become sexually active: the risk of sexually transmitted infections (STIs). Young women bear the greatest burden of STIs as they face significant barriers to STI screening. Through focus group discussions and in-depth interviews, Dr. Masese and her study team identified the barriers to STI screening among adolescent girls and young women in Mombasa, Kenya (PLoS One paper). Based on findings from this qualitative study, they developed a screening intervention for adolescent girls and young women in Mombasa (manuscript submitted to STD).
As a center dedicated to fostering new discovery and career development, we couldn’t be happier to support this research achievement in Mombasa and we look forward to following the improvements in sexual health education and STI screening as a result of your work.
February 23, 2017
WACh Priority Areas in Focus: Family Planning Decision Support
Categories: Research
Tags: Family Planning Decision Support, Scientific Priority Areas
Our third and final Scientific Priority Area hones in on the life-saving ability of family planning services. Women face significant barriers to finding a contraception method that fits their unique needs, or gaining access to support to make informed reproductive decisions.
By providing new support and data collection tools, we can bring the health care system closer to women and their families, bring their health concerns to the attention of decision makers, and reduce the unmet need for family planning.
We can provide Family Planning Decision Support.
February 17, 2017
WACh Priority Areas in Focus: Gut Health and Child Survival
Categories: Research
Tags: Gut Health and Child Survival, Scientific Priority Areas
Global WACh Scientific Priorities develop a deeper focus on our research efforts to decrease morbidity and mortality among women, adolescents, and children. Gut Health and Child Survival is vital to understanding and improving this inter-generational health and well-being.
When we asked this scientific priority’s co-lead, Dr. Patricia Pavlinac, what the greatest challenge is to developing interventions for enteric and diarrheal disease, she says, “Even among children who survive diarrhea, multiple episodes of the disease and the underlying enteric infections can lead to chronic malnutrition, increased risk of lower respiratory tract infections, cognitive disabilities, and poor school performance. These consequences hold extreme economic and societal implications.”
Gut Health and Child Survival is our response to the unmet need for programs to treat and prevent the adverse effects of enteric and diarrheal disease. We strive to ensure children survive and reach their developmental potential.
February 16, 2017
WACh Priority Areas in Focus: HIV Through the Lifecycle
Categories: Research
Tags: HIV Through the Lifecycle, Scientific Priority Areas
Today we introduce our Scientific Priority Area of HIV through the Lifecycle.
Our center has cultivated expertise in HIV/AIDS since its inception, and our focus has always been on the intersection of three key populations: women, children and adolescents. While AIDS-related deaths are decreasing in children and adults, they are increasing in adolescents, which is why strategies for prevention and treatment of adolescents is a major focus of our priority area. By focusing on interventions during critical life stages for pregnant women, infants, and adolescents, we can prevent HIV from persisting throughout the duration of a person’s life and into the next generation.
This is how we will transform HIV testing and treatment approaches and achieve an AIDS free generation.
This is HIV Through the Lifecycle.
February 13, 2017
Global WACh reaffirms research commitments; launches new Scientific Priority Areas
Categories: Research
Tags: Family Planning Decision Support, Gut Health and Child Survival, HIV Through the Lifecycle, Scientific Priority Areas
When Global WACh completed its fifth year in June, we took a look back at the vision and goals that catalyzed the creation of our Center in 2011. The Global Center for Woman, Adolescent, and Child health was established to pursue scientific discovery and leadership development by breaking down traditional silos that separate disciplines. In doing so, we foster collaborative approaches that emphasize the interdependent nature of woman, adolescent and child health. We shaped our Center’s approach to research using a lifecycle perspective- one that views women, children and adolescents as interconnected populations that move along a shared life course.
It is from this this perspective that we introduce three newly articulated scientific priority areas to guide Global WACh in our mission to make scientific discoveries, cultivate leaders, and bridge disciplines to advance the tightly connected health and well-being of women, adolescents and children.
Our Scientific Priorities:
- HIV Through the Lifecycle
- Gut Health and Child Survival
- Family Planning Decision Support
We’ve refined our Core identities into three Scientific Priority Areas to clearly convey how Global WACh contributes to research that accelerates health improvements and decreases unnecessary deaths of women, adolescent and children. We hope this deeper focus will enrich our collaborations and expand our capacity to contribute and implement research with meaningful effects on the health of women, adolescents, and children.
Throughout the coming weeks, we will share a post about these three Scientific Priority Areas: what their specific response to global health challenges will be, their missions and focus areas, and what their leadership is most excited about moving forward.
We look forward to sharing our continued commitment to WACh research with you!
February 10, 2017
Celebrating International Day of Women and Girls in Science
Categories: Education, students
Tags: Certificate Program, Women in Science
Over the past 15 years, the global community has made concerted efforts to inspire and engage women and girls in science. According to a study conducted in 14 countries, the probability of a female student graduating with a Bachelor’s degree, Master’s degree and Doctor’s degree in a science-related field are 18%, 8% and 2% respectively, while the percentages of male students are 37%, 18% and 6%.
The UN General Assembly recognizes that full and equal access to and participation in science, technology, and innovation is imperative for empowering women and girls of all ages. As a response, one year ago the General Assembly declared February 11th as the International Day of Women and Girls in Science.
This weekend we celebrate the Day in recognition of the critical role women and girls play in science and technology communities—including education, training, and research activities at all levels. To observe International Day of Women and Girls in Science, we are highlighting three members of our Graduate Certificate program. These three students are each making meaningful contributions to their respective scientific fields, and, they are also women.
Hannah Frizzell is a third year PhD student in the Department of Bioengineering. She received her Bachelor of Science in Biomedical Engineering and is currently a graduate research fellow working on mucosal immunoengineering, vaccines, drug delivery, and how these relate to women’s and children’s health on a global scale. Hannah is the Vice President of Funding at UW’s Bioengineers without Borders, which develops medical devices for resource-limited areas. She mentors a team focused on a low-cost device for diagnosis of pre-eclampsia in pregnant women. Hannah is also a National Science Foundation Graduate Research Fellow and a Roche/Achievement Awards for College Scientists (ARCS) scholar. As she progresses in her field, she hopes to apply both her technical background and experience from the Global WACh program to create and integrate medical technologies into communities to improve their accessibility and thus ultimate effectiveness in improving health globally.
Ke Pan is an MPH student in the Department of Global Health, having received her BA in Public Health with a concentration in Maternal and Child Health from Huazhong University of Science and Technology (HUST) and Masters Degree in Medicine from Third Military Medical University in China. Prior to coming to UW, she worked as a resident in the Department of Obstetrics and Gynecology for three years and conducted research about the quality of women’s life after surgery for Pelvic Organ Prolapse. She also conducted a research regarding the prevalence of hypertension and obesity in adolescents. Ke Pan is deeply interested in improving global health disparities of women, adolescents and children through education, awareness, and access to healthcare.
Molly Feder is an MPH student in the Department of Epidemiology with a concentration in Maternal and Child Health. She received her BA in International Affairs concentrating in Global Health from the Elliott School of International Affairs at the George Washington University. Prior to attending UW, Molly worked as a Government Relations Associate and Database Administrator at the Council for Responsible Nutrition in Washington, DC where she advocated for enhanced FDA oversight of the vitamin and supplement industry. As an MPH student, Molly is a Maternal and Child Health Trainee and is interested in research pertaining to family planning and reproductive health.
We’re proud of the interdisciplinary commitment these three students have made to advance health care globally within the fields of women, adolescent, and child health. Please click here to learn about each of our fantastic certificate students and the impact they are making in their fields.
On the International Day of Women and Girls in Science, we also hear from Chief Information Technology Officer of the United Nations, Atefah “Atti” Riazi, who urges all girls to aspire to be ‘geeks.’ Click here to read.
January 12, 2017
Building evidence for HIV risk with contraceptive methods
Categories: Research
Tags: Contraception, Family Planning, HIV
Renee Heffron is the grant’s primary investigator.
Dr. Renee Heffron, co-director of our Global WACh Family Planning Working Group, has received new funding from the NIH to tie into the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Study. ECHO enrolls participants in sub-Saharan Africa for a randomized trial of three equally safe and effective contraceptive methods: the copper T intrauterine device (IUD); injectable depo-medroxyprogesterone acetate (DMPA), also known as the Depo shot; and the Jadelle implant.
For sub-Saharan African women at risk for becoming infected with HIV, it is important to build knowledge around potential associations of specific contraceptives with HIV acquisition. A number of observational studies have examined whether or not use of hormonal methods affects the risk of HIV acquisition. Some of these studies suggest that injectable methods—particularly the Depo shot—might increase a woman’s risk of acquiring HIV infection, while other studies show no association. The World Health Organization continuously reviews the information about contraceptives and, thus far, has determined that all of the contraceptives that will be used in the ECHO Study are safe for women at risk of HIV risk infection, but that more research is needed.
Photo by echo-consortium.com
With this additional funding, ECHO will now begin to measure biological markers periodically over the three-year trial period associated with the Depo shot, the Jadelle implant, and the copper IUD. These markers include vaginal microbiome, markers of inflammation, HIV target cells, protein signatures, and transcriptome to identify differences between women using the different contraceptives.
Read the full story from ASPPH here.
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