Success Stories Fall 2020

Ushma Upadhyay, PhD, MPH
SOM: Department of Obstetrics, Gynecology, & Reproductive Sciences
Pilot for Established Investigators in Basic and Clinical/Translational Sciences
Misoprostol-Alone as a ‘Missed Period Pill’: A Study to Evaluate Proof of Concept

As the number of state laws restricting access to abortion increases across the country and with legal access to abortion under threat, more creative methods are needed to support individuals to achieve their reproductive goals.  Menstrual regulation is a potential new fertility control intervention to be utilized before a person confirms they are pregnant. Misoprostol is an ideal medication for use as a “missed period pill.” It is safe, effective, well-researched, and available by prescription at most pharmacies including in rural areas throughout the U.S.. This RAP award will support a feasibility study to test a traditional but underutilized framework of menstrual regulation, to “bring back” a period when it is late. This study fits into my larger portfolio of research that collectively aims to improve women's reproductive autonomy and access to reproductive health services. If feasibility is demonstrated, the preliminary data collected will enable me to pursue private foundation funding for a larger multi-center trial of the missed period pill.

Orlando Harris, PhD, RN, FNP, MPH
SON: Department of Community Health Systems
Pilot for Under-Represented Faculty & Senior Fellows in Clinical and Translational Research Awards
“Our Lives Matter”: Exploring the Impact of COVID-19 on Black/African American and Latino Sexual Minority Men’s Access to HIV Prevention and Treatment Services, and Vaccination Acceptance and Uptake”

There is an urgent convergence of two pandemics that is disproportionately affecting marginalized Black/African American and Latino sexual minority men, HIV and SARS-CoV-2 (COVID-19). The current COVID-19 pandemic has disrupted HIV treatment and prevention services globally, with the full impact of that disruption still unknown. Additionally, as the race for a safe and effective vaccine against COVID-19 continues, there is growing skepticism and fear regarding the vaccines’ safety, effectiveness, and impact on communities of color. Moreover, given the history of medical experimentation on African Americans and Latinx individuals (i.e., Tuskegee Study of Untreated Syphilis in the Negro Male and forced sterilization in California), a history of structural and institutional racism, medical distrust, and other contextual factors, there is a dire need for studies that explore these historical issues among vulnerable individuals such as those represented in this research proposal. The overarching goal of this project is to assess COVID-19 related barriers and facilitators to accessing HIV prevention and treatment services during the pandemic, multi-level factors affecting vaccination acceptance and uptake, and overall wellbeing of Black/African American and Latino sexual minority men. We will also identify individual and community assets that can be leveraged among this community to increase COVID-19 vaccination uptake. This proposal has the potential to make a significant contribution in improving our understanding of the impact of these two overlapping pandemic on the lives of Black/African American and Latino sexual minority men. With the data from this study, we will leverage funding to develop interventions strategies that improves access to HIV care and COVID-19 vaccination uptake among marginalized sexual minority men of color. From a personal standpoint, this award will enable me to develop key skills in vaccine hesitancy research, cultivate productive collaborations with world-leading researchers in the area of vaccine research, and continued community engagement activities, all of which will be invaluable to my career development.  

Frank Mulindwa, MD
SOM: Medicine (Infectious Diseases Institute, Makerere University, Uganda)
International Mentored Scientist Award Program in HIV/AIDS
Changes in insulin kinetics in HIV infected patients diagnosed with dolutegravir associated diabetes in Uganda

The burden of non-communicable diseases is on the rise in people living with HIV (PLHIV). This has been attributed to HIV itself as well as HIV pharmacotherapy. The World Health Organization (WHO) included dolutegravir (DTG) as an alternative first- and second-line HIV drug after multiple studies demonstrated it was very efficacious, had a higher genetic barrier to resistance, a good side effect profile and less drug- drug interactions. Despite the good side effect profile, DTG has been linked with incident diabetes and worsening hyperglycemia in patients with diabetes. It is still unclear whether insulin resistance or pancreatic beta cell dysfunction or both drive the onset of diabetes in this group of patients. This RAP will help me compare insulin production, sensitivity and clearance over time in patients who develop diabetes with those that do not in a prospective cohort of HIV patients on dolutegravir. This will help generate more understanding of the processes that precede the onset of diabetes in this group of patients as well as generate hypotheses for future studies. This is an opportunity for me to kickstart my journey as an independent researcher with special interest in studying diabetes in HIV patients.

Emma Bainbridge, MD, MPH
SOM: Medicine
Mentored Scientist Award Program in HIV/AIDS
Urogenital and rectal Mycoplasma genitalium in men who have sex with men and transgender women at high risk for STIs: a pilot study of prevalence and antibiotic resistance

M. genitalium is an under-recognized contributor to the growing STI epidemic, and the high prevalence of antibiotic resistance has made M. genitalium challenging to treat. M. genitalium causes nongonococcal urethritis (NGU) in men as well as cervicitis and PID in women, and has been associated with an increased risk of HIV acquisition. Asymptomatic M. genitalium carriage may serve as a reservoir for future infection and drive the development of drug resistance when antibiotics are administered for other indications. Studies outside of the U.S. have demonstrated a substantial burden of asymptomatic M. genitalium in men who have sex with men (MSM), but U.S. data on asymptomatic prevalence are limited. This RAP award will support a pilot study that aims to estimate the prevalence of M. genitalium infection and antibiotic resistance in a cohort of high risk MSM and transgender women (TGW) who have HIV or use PrEP and are enrolled in an ongoing clinical trial of doxycycline post-exposure prophylaxis for STI reduction. Reliable estimates of M. genitalium infection and resistance are essential to understanding the clinical significance of M. genitalium and rationale approach to effective treatment