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Principal Investigator: Jana Jarolimova
Organization: MASSACHUSETTS GENERAL HOSPITAL
Fiscal Year: 2024
Award: $195,569
Funding agency: National Institute of Allergy and Infectious Diseases
PROJECT SUMMARY
Curable sexually transmitted infections (STIs) are highly prevalent among adolescents and young adults in
sub-Saharan Africa, who are also at the highest risk of acquiring HIV. Untreated STIs, such as gonorrhea,
chlamydia, and trichomoniasis, increase HIV acquisition and transmission risks and can lead to significant
morbidity for women, including pelvic inflammatory disease, tubal infertility, and pregnancy complications.
Faced by constraints in diagnostic capacity, many countries rely on syndromic management, which has poor
sensitivity and specificity, particularly because the majority of curable STIs are asymptomatic. As accurate
diagnostic tests for STIs are developed, effective screening strategies to reach populations at high risk for STIs
and HIV, such as adolescents and young adults in rural South Africa, need to be rigorously evaluated to inform
the future implementation of STI screening programs. I am an Infectious Disease physician with a background
in clinical epidemiology and an interest in decreasing the burden of STIs and their contribution to HIV
transmission in sub-Saharan Africa. I am motivated to pursue training to apply new methods to the design and
evaluation of STI screening strategies in rural South Africa. The NIH K23 Mentored Research Career
Development Award will afford me the opportunity to gain the necessary skills to become an independent
clinician investigator. I will pursue training in (1) qualitative research methods, (2) discrete choice analysis and
clinical trial design, and (3) implementation science methods and frameworks. I have designed a didactic
curriculum to address each of these training aims and assembled a multidisciplinary mentorship team. My
primary mentor is Dr. Ingrid Bassett, an expert in cohort studies and implementation research to evaluate HIV
and tuberculosis linkage to care in South Africa. My mentorship team additionally includes experts in
community-based, peer-led interventions for sexual health and HIV prevention in South Africa (Dr. Maryam
Shahmanesh), qualitative research (Dr. Christina Psaros), and biostatistics (Dr. Robert Parker). With their
guidance, I will assess young people’s preferences for STI screening and design and evaluate a community-
based STI screening strategy in rural South Africa through the following specific aims: 1) Evaluate motivation
and preferences for STI screening among adolescents and young adults using qualitative methods, 2) Conduct
a Discrete Choice Experiment to quantify young people’s preferences for community-based STI screening, and
3) Evaluate the implementation of a new community-based STI screening strategy among adolescents and
young adults. I will deepen an existing collaboration with the Africa Health Research Institute (AHRI),
leveraging the infrastructure of a funded clinical trial. The proposed training and research aims will inform
future efforts to expand STI screening in South Africa, and will provide a strong foundation for my career as an
independent clinician investigator focused at the intersection of STIs and HIV prevention.
Terms: <AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV test><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Address><Adolescent and Young Adult><Adoption><Affect><Africa><Africa South of the Sahara><African><Assess implementation><Biometrics><Biometry><Biostatistical Methods><Biostatistics><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Caring><Causality><Chlamydia><Clinic><Clinical><Clinical Investigator><Clinical Trials><Clinical Trials Design><Cohort Studies><Collaborations><Communicable Diseases><Communities><Concurrent Studies><Country><Data><Diagnostic><Diagnostic tests><Economic Income><Economical Income><Effectiveness><Enrollment><Epidemiology><Etiology><Evaluation><Face><Foundations><Funding><Future><Goals><Gonococcal Infection><Gonorrhea><Guidelines><HIV><HIV Infections><HIV Prevention><HIV test><HIV-1 test><HIV-2 test><HIV/AIDS prevention><HIV/Mtb><HIV/TB><HIV/mycobacterium tuberculosis><HIV/tuberculosis><HTLV-III Infections><HTLV-III-LAV Infections><Health><Health Services><Heterogeneity><Home><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Human immunodeficiency virus test><Implementation assessment><Incidence><Income><Individual><Infectious Disease Pathway><Infectious Diseases><Infectious Disorder><Infrastructure><Interview><Investigators><K-Awards><K-Series Research Career Programs><LAV-HTLV-III><LMIC><Left><Location><Lymphadenopathy-Associated Virus><M. tuberculosis/HIV><Measures><Mentors><Mentorship><Methods><Miyagawanella><Modeling><Morbidity><Morbidity - disease rate><Motivation><NIH><NIH Office of AIDS Research><National Institutes of Health><Nurses><PRISM framework><PRISM model><Parents><Participant><Pelvic Inflammatory Disease><Persons><Physicians><Play><Population><PrEP><Practical Robust Implementation and Sustainability Model><Pragmatic, Robust Implementation and Sustainability Model><Pregnancy Complications><Prevalence><Process Measure><Provider><Qualitative Methods><Qualitative Research><RE-AIM><Reach, Effectiveness, Adoption, Implementation, and Maintenance><Recommendation><Reproductive Health><Research><Research Career Program><Research Infrastructure><Research Institute><Research Methodology><Research Methods><Research Personnel><Research Priority><Research Specimen><Researchers><Risk><Role><STD prevention><STI prevention><Sample Size><Sampling><Self Care><Sensitivity and Specificity><Sexual Health><Sexually Transmitted Diseases><Sexually Transmitted Disorder><Sexually Transmitted Infection><South Africa><Specimen><Sub-Saharan Africa><Subsaharan Africa><Symptoms><Testing><Time><Training><Transmission><Trichomonas Infections><Trichomonosis><United States National Institutes of Health><Venereal Diseases><Venereal Disorders><Venereal Infections><Virus-HIV><Woman><Work><accurate diagnostics><assess effectiveness><bedsonia><behavior change><career><causation><clinical epidemiology><co-infection><coinfection><complications during pregnancy><design><designing><determine effectiveness><didactic curriculum><didactic education><disease causation><effectiveness assessment><effectiveness evaluation><enroll><epidemiologic><epidemiological><evaluate effectiveness><evaluate implementation><evaluation of implementation><examine effectiveness><experiment><experimental research><experimental study><experiments><faces><facial><female morbidity><future implementation><high risk><home test><home-based test><homes><implementation determinants><implementation evaluation><implementation factors><implementation research><implementation science><improved><incomes><infection management><interest><low and middle-income countries><men><morbidity among females><morbidity among women><morbidity in females><morbidity in women><multidisciplinary><novel><nurse><parent><pathogen><peer><pelvic inflammation disease><pelvic inflammation disorder><pelvic inflammatory disorder><pelvic inflammatory syndrome><personal care><point of care testing><pre-exposure prophylaxis><preference><pregnancy-related complications><prevent sexually transmitted disease><prevent sexually transmitted infections><primary outcome><qualitative reasoning><rapid testing><reach, efficacy, adoption, implementation, and maintenance><research and methods><rural South Africa><sample collection><scale up><screening><screening program><screenings><sexual health intervention><sexually acquired infection><sexually transmitted disease prevention><sexually transmitted infection prevention><skills><social role><specimen collection><standard of care><structural determinants><structural factors><transmission process><trichomoniasis><tubal factor infertility><tubal infertility><uptake><women's morbidity><young woman>