# Modeling the Effects of HIV, Chlamydia, and Gonorrhea in Mother-Infant Pairs in Botswana.

> **NIH NIH K08** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $172,237

## Abstract

Project Summary
HIV-exposed infants experience high rates of adverse birth outcomes, including stillbirth, preterm birth, small
for gestational age, and neonatal death. These birth outcomes carry substantial morbidity and mortality in sub-
Saharan Africa (SSA) where access to neonatal intensive care services is limited. Chlamydia and gonorrhea
are sexually transmitted infections (STIs) that are highly prevalent among women with HIV in SSA. These STIs
are associated with increased risks of adverse birth outcomes if untreated in pregnancy. While antenatal
screening for chlamydia and gonorrhea is recommended in pregnancy in some high-income settings, including
the US, it is not yet a part of routine care in SSA. Syndromic management, the current standard of care in SSA,
consists of empiric, symptom-driven treatment of STIs. However, this approach misses up to 70% of STIs,
while exposing 75% of symptomatic pregnant women to inappropriate treatment and promoting antibiotic
resistance. The clinical impact and cost-effectiveness of antenatal chlamydia and gonorrhea screening among
pregnant women with HIV has not been well-studied in resource-limited settings. I am an infectious disease
physician and clinician-investigator with experience in simulation modeling and cost-effectiveness research. I
am committed to using model-based research to improve the health of women and children in resource-limited
settings. To become an independent investigator, I require further training and mentorship in: 1) advanced
modeling techniques, 2) costing and model input derivation, and 3) principles of implementing maternal, child,
and reproductive health interventions. I have outlined a didactic plan, assembled a multidisciplinary mentorship
team, and established a new collaboration with investigators focused on maternal-child health in Botswana. My
primary mentor is Dr. Andrea Ciaranello, an expert in modeling and cost-effectiveness analysis related to
maternal-child health. My mentorship team additionally includes experts in advanced modeling methods (Dr.
David Paltiel), adverse birth outcomes among children in Botswana (Dr. Roger Shapiro), and obstetrical care in
sub-Saharan Africa (Dr. Blair Wylie). With their guidance, I will address two Specific Aims:
 1. To develop a detailed microsimulation model of women with HIV and their infants through
 pregnancy, delivery, and the postpartum period that incorporates clinical and economic details of
 maternal and infant HIV, chlamydia, and gonorrhea infection, as well as adverse birth outcomes
 2. To evaluate the clinical impact, cost, and cost-effectiveness of chlamydia and gonorrhea
 screening strategies in pregnancy, incorporating outcomes for women with HIV and their infants
 in Botswana
The proposed training and research aims will inform efforts to improve maternal-child health outcomes in
Botswana and will provide a foundation for a career as an independent investigator who can apply modeling to
address critical questio...

## Key facts

- **NIH application ID:** 10116440
- **Project number:** 5K08HD101342-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Caitlin Dugdale
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $172,237
- **Award type:** 5
- **Project period:** 2020-03-02 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10116440

## Citation

> US National Institutes of Health, RePORTER application 10116440, Modeling the Effects of HIV, Chlamydia, and Gonorrhea in Mother-Infant Pairs in Botswana. (5K08HD101342-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10116440. Licensed CC0.

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