STIs, HIV Prevention

STIs, HIV Prevention, Clinical Trials, Behavioral Science

Jenell Stewart, DO, MPH, is an Infectious Diseases physician-scientist focused on the prevention of Sexually Transmitted Infections (STIs) and Human Immunodeficiency Virus (HIV) and improving clinical care for women who engage in transactional sex. She has a strong track record of dedication to STI and HIV research in low-resource settings and extensive experience in international collaborations. Bringing together research methods on biomedical primary prevention, adherence behavior, and social marginalization, Dr. Stewart has two primary areas of research: first, clinical trials of prevention of bacterial STIs among cisgender women, and second, community-based care models for HIV prevention.

From 2020 to 2022, she directed the dPEP Kenya Trial in collaboration with colleagues at the Kenya Medical Research Institute (KEMRI) and under the mentorship of Dr. Jared Baeten. They focused on the prevention of bacterial STIs among cisgender women taking HIV PrEP using an antibiotic as a “morning-after pill.”

The women taking HIV PrEP in Kenya, like much of the world, have high rates of bacterial STIs, which in many cases, are as high or higher than men having sex with men taking HIV PrEP in high-income countries. These STIs can have damaging, long-term effects such as infertility, chronic pain, pregnancy complications including harm to the newborns, and increased risk of HIV. Unfortunately, the current options available for prevention and diagnosis are limited.

After comparing the efficacy results of doxycycline PEP for the prevention of chlamydia, syphilis, and gonorrhea among cisgender women in Kenya who were taking HIV pre-exposure prophylaxis (PrEP), to cisgender men and transgender women in France and the USA, she focused on understanding why doxycycline PEP did not prevent STIs among cisgender women. Ongoing and future work is focused on drug-resistant STIs and understanding adherence behavior.

In addition, she is working on two implementation science studies evaluating improved HIV PrEP access and delivery in community-based settings. As a Principal Investigator, in collaboration with Dr. Maria Corcorran at the University of Washington, she is working on an NIH-funded pilot study on improving care for women who inject drugs and exchange sex in the United States. They are developing and implementing a combination of primary care and preventative services, such as PrEP and buprenorphine, at venue-based locations, using a co-design process in collaboration with women with lived experience. As a co-investigator on a Bill and Melinda Gates Foundation grant in collaboration with Dr. Katrina Ortblad and Dr. Elizabeth Bukusi, they are evaluating the delivery of long-acting HIV PrEP options in community-based pharmacies in Kenya.