The Sunday Mail
HIV prevention researcher and expert from the University of Zimbabwe’s Clinical Trials Research Centre Dr Tariro Chawana-Mutingwende was recently awarded research funding to study paediatric and adolescent HIV.
The award — the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) — was presented to her by the International AIDS Society (IAS) at the IAS 2023 Scientific Conference in Brisbane, Australia.
Every year, the IAS sends out a call for applicants to apply.
This year’s focus was on paediatric and adolescent HIV and mental health management.
The application process was highly competitive and only three researchers from across the globe were selected.
Speaking to The Sunday Mail, Dr Chawana-Mutingwende said being the recipient of the award will help influence others.
“I was selected as one of the three successful applicants awarded research funding for two years to study paediatric and adolescent HIV.
“The award puts Zimbabwe in the limelight as a country with the expertise and capacity to conduct global health research and care for people with HIV, including special populations,” she said.
A holder of a Bachelor of Medicine and Bachelor of Surgery (MBChB), and Master of Sciences (MSc) and Doctor of Philosophy (DPhil) degrees in Clinical Pharmacology, the ecstatic Dr Chawana-Mutingwende said the award has an impact on her career.
She added that it will support her post-doctoral work.
From 2012, Dr Chawana-Mutingwende’s main area has been research on clinical pharmacology of antiretroviral drugs in adolescents with HIV, with focus on interventions to improve virological treatment outcomes and adherence to antiretroviral therapy.
“I have a HIV Vaccines Trials Network Scientific Leadership Development Award as well. This one focuses on vaccines and broadly neutralising antibodies for prevention of HIV,” she added.
The major highlights of her career include achieving a DPhil in 2018, publishing 11 peer-reviewed manuscripts in high-impact journals for adolescent HIV studies, and conducting global research on HIV prevention and HIV treatment.
If she could leave one mark on the medical field, Dr Chawana-Mutingwende hopes her work will contribute to the eradication of new paediatric HIV infections.
“Paediatric and adolescent HIV and mental health management is critical.
“Most of the new HIV acquisitions are occurring in the adolescents and young people.
“High pregnancy rates in this age group pose a risk of new paediatric HIV acquisition during pregnancy, delivery or the breastfeeding period,” she explained.
Dr Chawana-Mutingwende added that literature shows that about 50 percent of adolescent girls and young women (15-24 years old) are diagnosed with HIV for the first time when they present for their first antenatal visit.
“Some women register for antenatal care late or do not register at all, putting their babies at risk of HIV acquisition.
“Additionally, the new diagnosis may cause anxiety and depression in the young mothers, requiring mental health care as well,” she said.
Antiretroviral treatment, she added, significantly reduces HIV-related morbidity and mortality.
Zimbabwe successfully attained the UNAIDS 95-95-95 targets.
“However, peripartum adolescents and young women with HIV lag behind. They have less antenatal care engagement, ART (antiretroviral therapy) access, adherence and retention to care compared to older women,” Dr Chawana-Mutingwende lamented.
She further said adolescent and young mothers experience vertical (mother-to-child) HIV transmission rates three times higher than older women — and a higher proportion of their infants acquire HIV compared to infants of older mothers.
“Zimbabwe data shows that 37-55 percent of adolescent girls and young women on ART were experiencing elevated viral load — 67,6 percent of whom had clinically significant drug resistance due to poor adherence — which is a result of complex psychosocial factors unique to this group.
“Careful management of this population can reduce new infant HIV acquisition,” she emphasised, adding that treatment and care of perinatal young mothers will reduce perinatal infant HIV acquistion and aid elimination of mother-to-child transmission.
She further noted that unprotected transactional and non-transactional sex with older men, drug abuse, poverty and poor health-seeking behaviour for sexual reproductive health, coupled with barriers to accessing sexual reproductive health for minors, remained prevalent.
In Brisbane, the World Health Organisation announced that people living with HIV who have an undetectable viral load have zero risk of transmitting HIV to their sexual partners.
“Indeed, undetectable equals untransmissible (U=U). Adequate adherence to antiretroviral treatment reduces transmission of the virus to sexual partners and children.
“However, adherence isn’t always adequate in this group, leading to transmission to infants and partners in some cases,” she added.
While oral PrEP (pre-exposure prophylaxis) is highly effective for HIV prevention in those without HIV if taken correctly, adequate adherence to this daily pill is often challenging.
“The newly approved long-acting cabotegravir injection will improve adherence and is safe, even during pregnancy.”