Assistant Professor of Medicine
Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center
Lowry Building- Suite GB
110 Francis Street
Boston MA 02215
Harvard T.H. Chan School of Public Health
Immunology and Infectious Diseases
Available: 12/05/18, Expires: 12/05/20
Since 2013, I have been working with the Botswana Harvard AIDS Institute Partnership (BHP) in Botswana. BHP is a research organization that was founded more than 20 years ago by Dr. Max Essex as a collaboration between Harvard University and the Botswana Ministry of Health. The focus of BHP has been to conduct high quality, public-health driven research and build research capacity in Botswana to address the HIV epidemic and other emerging public health challenges. As one of the leading research institutions in Africa, research areas include virology, immunology, molecular biology, epidemiology, socio/behavior and clinical trials.
My work within BHP has been focused on HIV in pregnancy. Some of the earliest clinical trials showing that antiretroviral therapy (ART) could be used successfully to prevent mother-to-child transmission of HIV were done at BHP. Improvements in access to ART among pregnant women around the world resulted in huge declines in pediatric HIV infections and this has been one of the biggest public health successes of the last decade. However, women with HIV continue to have more infants with poor outcomes like stillbirth, preterm delivery and low birthweight compared to HIV-uninfected women. Our research in Botswana has shown that this increased risk in adverse birth outcomes occurs even among women on ART with well-controlled HIV good immune systems—and that some of the increased risk of poor outcomes may be related to the ART itself. Our findings have also highlighted the lack of research into the safety of medications in pregnancy, particularly in low and middle income countries. Current research projects aim to understand the risk factors and mechanisms for adverse pregnancy outcomes among HIV-infected women on ART in order to figure out interventions to improve birth outcomes and decrease childhood morbidity and mortality. Additionally, our research focuses methodologically on how to collect high-quality data on medication safety in pregnancy and birth defects in resource limited settings.
We are seeking students who are hard-working, team-players and able to work well with people from a variety of backgrounds and cultures and can spend a minimum of 2 months in country. We can also mentor students who want to take a 5th year to complete a more in-depth, comprehensive project. Our current research opportunities broadly include projects within our ongoing studies:
1. A large Birth Surveillance Study with information on >50% of all birth in Botswana. Data collected is broad and includes almost all information available in the maternal antenatal medical record as well as information on the birth and outcome of the baby.
2. Birth Defects information data collected from ~50% of all births in Botswana since 2014 and development of training for health care professionals in Botswana around birth defects
3. A cohort of pregnant women followed prospectively during pregnancy to evaluate the role of hypertension, endothelial dysfunction and chronic inflammation on pregnancy and birth outcomes
4. A study of the placentas (histology and stereology) of HIV-infected and HIV-uninfected women
5. A project to evaluate how best to communicate research findings on adverse effects of ART in pregnancy to healthcare professionals and people living with HIV in Botswana
6. A pilot project to evaluate feasibility of patient-centered decision making around ART regimen and contraception in the Botswana setting
If you are interested, please contact Rebecca Zash and submit your resume with a brief description of your interests.
The research activities and funding listed below are automatically derived from
NIH ExPORTER and other sources, which might result in incorrect or missing items.
to make corrections and additions.
(ZASH, REBECCA MARIE)
Jul 1, 2017 - Jun 30, 2022
Decreasing Adverse Birth Outcomes among HIV-infected Women on Antiretroviral Therapy
Role: Principal Investigator
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