# Implementing a risk score to facilitate enhanced adherence support for pregnant and postpartum women at risk of viremia

> **NIH NIH K01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $184,588

## Abstract

PROJECT SUMMARY/ABSTRACT
The overall goal of this K01 proposal is to support Dr. Pamela Murnane’s research training to develop into an
independently funded epidemiologist with expertise in implementation science and decision support to improve
maternal health and HIV outcomes globally. Career development and training plan: Together with a dedicated,
interdisciplinary, internationally recognized mentorship team, the candidate has developed a career
development and training plan including structured mentorship, coursework, conferences, seminars, and
applied research experience. The training goals of this K01 proposal are: 1) to gain expertise in risk score
development to design decision support tools which can facilitate targeted HIV service delivery to vulnerable
populations; 2) to develop skills in qualitative research methods to inform optimal approaches to
implementation of novel models of HIV care; 3) to acquire expertise in implementation science methodology to
inform optimal and sustainable scale-up of services to improve maternal health and HIV care outcomes.
Research plan: Recent data from several cohorts across sub-Saharan Africa indicate that over a quarter of
pregnant and postpartum women living with HIV on effective antiretroviral treatment (ART) have inadequate
adherence and experience viremia. Viral suppression is essential for both maternal health and prevention of
sexual and perinatal transmission. To optimize targeted delivery of evidence-based approaches to adherence
support, the candidate proposes to develop a widely usable risk score to identify pregnant and postpartum
women living with HIV most at risk of viremia, and to evaluate its implementation in a routine care setting in
western Kenya. The specific aims are: 1) to develop and externally validate a risk score to predict viremia in
pregnant and postpartum women living with HIV and on ART in sub-Saharan Africa; 2) to explore preferences,
facilitators and barriers to risk score implementation within a busy clinical setting in western Kenya, through
qualitative interviews and focus groups with care providers; 3) to conduct a mixed-methods pilot study to
evaluate the implementation and potential impact of a risk score to facilitate targeted, evidence-based
adherence support to pregnant and postpartum women at risk of viremia in western Kenya. Aims 2 and 3 will
be conducted at Family AIDS Care and Education Services (FACES) clinics in Kisumu County, Kenya. FACES
is a collaboration between the University of California San Francisco and the Kenya Medical Research
Institute, and is led by the candidate’s primary mentor and co-mentor. This integrated training and research
plan will prepare Dr. Murnane to launch an independent research career with a R01 application designed to
test the hypothesis that implementing a risk score to facilitate targeted adherence support can reduce the risk
of viremia and improve maternal and infant health outcomes.

## Key facts

- **NIH application ID:** 10449213
- **Project number:** 5K01MH119910-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Pamela Mae Murnane
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $184,588
- **Award type:** 5
- **Project period:** 2019-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10449213

## Citation

> US National Institutes of Health, RePORTER application 10449213, Implementing a risk score to facilitate enhanced adherence support for pregnant and postpartum women at risk of viremia (5K01MH119910-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10449213. Licensed CC0.

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