# Administrative Supplement - In Utero HIV Exposure and Metabolic Disease Risk in HIV-Uninfected Young Adults

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $25,200

## Abstract

Project Summary/Abstract
With the global implementation of prenatal antiretroviral therapy (ART), over 18 million individuals born to
mothers with HIV have been HIV-exposed but uninfected (HEU). While infants and children with HEU are known
to be at increased risk of adverse health outcomes, the long-term implications of in utero HIV/ART exposure into
adulthood have not been well explored. The candidate has generated novel preliminary data to show an
increased prevalence of obesity in adolescents and young adults with HEU versus well-matched controls. These
findings convey the compelling need to characterize the extent of metabolic and immune dysregulation among
young adults with HEU, and to delineate molecular pathways that may underlie this phenotype. Candidate: Dr.
Fourman is an endocrinologist and clinical investigator at Harvard Medical School dedicated to identifying novel
mechanisms and treatment strategies for metabolic disease. Her overarching career goal is to become an
independent R01-funded clinical investigator committed to preventing and treating obesity and metabolic disease
in the rapidly growing HEU population, as well as in other groups exposed to abnormal intrauterine environments.
Training: To achieve this goal, Dr. Fourman has developed a career development plan that provides targeted
training in developmental origins of health and disease (DOHaD), immunologic aspects of metabolic disease,
design and interpretation of epigenetic studies, and social and behavioral determinants of health. Mentors: The
candidate’s career development and research plans are overseen by her primary mentor, Dr. Steven Grinspoon,
who is an internationally recognized leader in metabolic disease research in HIV. The applicant also is supported
by a highly invested team of co-mentors and advisors with expertise in DOHaD, epigenetics, immunology,
infectious diseases, epidemiology, and biostatistics. Research: Dr. Fourman is leveraging her background in
endocrinology and HIV to test the innovative hypothesis that the HIV intrauterine environment influences fetal
development to confer an increased susceptibility to metabolic and immune dysregulation later in life.
Specifically, she will conduct the first prospective study that compares long-term health outcomes in young adults
with HEU versus well-matched controls without HIV exposure or infection. In Aims 1-2, Dr. Fourman will delineate
the downstream metabolic and immune sequelae of in utero HIV/ART exposure among young adults with HEU.
In Aim 3, she will investigate the contribution of epigenetic modifications to the HEU phenotype. This project
stands to establish in utero HIV/ART exposure as a previously unrecognized risk factor for metabolic disease.
Only by defining long-term metabolic and immune perturbations among the HEU population can screening and
prevention strategies be tailored toward this group. Funding from this administrative supplement will accelerate
the candidate’s completion of her K23...

## Key facts

- **NIH application ID:** 10938191
- **Project number:** 3K23HD100266-04S1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Lindsay Tara Fourman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $25,200
- **Award type:** 3
- **Project period:** 2020-04-14 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10938191

## Citation

> US National Institutes of Health, RePORTER application 10938191, Administrative Supplement - In Utero HIV Exposure and Metabolic Disease Risk in HIV-Uninfected Young Adults (3K23HD100266-04S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10938191. Licensed CC0.

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