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Ickovics Receives Over $8 Million Research Grant to Reduce HIV and Sexually Transmitted Infections among Pregnant Teens

	Jeannette Ickovics, Ph.D., professor and head of the Social and Behavioral Sciences Program at the Yale School of Public Health, will lead an $8 million study to try to reduce HIV and sexually transmitted infections among pregnant adolescents.

Reducing risk for HIV and other sexually transmitted infections (STIs) during and after pregnancy among adolescents in underserved communities is the focus of a grant totaling over $8 million to Yale School of Public Health (YSPH) and the Clinical Directors Network, Inc., in collaboration with the Centering Pregnancy and Parenting Association.

The Yale researchers will receive $5 million and the Clinical Directors Network (CDN) will receive over $3 million in a linked grant award from the National Institutes of Mental Health (NIMH) and the Office of AIDS Research. Researchers will study adolescents receiving prenatal care in 14 Community Health Centers (CHCs) funded by the Health Resources and Services Administration, serving predominantly African American and Latina communities in the metropolitan New York area.

Led by Jeannette Ickovics, Ph.D., professor and head of the Social and Behavioral Sciences Program at YSPH, and CDN President and CEO Jonathan N. Tobin, associate clinical professor of epidemiology and population health at Albert Einstein College of Medicine of Yshiva University, the team will test the dissemination and translation of an innovative model of group prenatal care called CenteringPregnancy Plus (CP+) into a network of safety net healthcare providers. CP+ combines instruction on HIV prevention along with prenatal care. The approach uses group visits to promote social learning and emphasizes the dynamic relationship between an individual and her social environment. CP+ has helped to improve birth outcomes and to reduce HIV/STI risk in a previous NIMH-funded study conducted at Yale.

“The goal of this study is to translate what we have learned about this health management approach to community health centers and to prevent sexually transmitted infections and rapid repeat pregnancies among vulnerable and underserved young women,” said Ickovics. “Because all women are motivated to have a healthy pregnancy, this can be a vital window of opportunity for health promotion.”

“Our research shows that teens engage in HIV-risk reduction during and immediately after pregnancy,” Ickovics added. “With effective intervention, changes initiated during pregnancy could be maintained postpartum.”

CP+ focuses on self-care, social support and empowerment. The program builds on the work of grant participant Sharon Schindler Rising, developer of the CenteringPregnancy(r) model of prenatal care. CP+ provides prenatal care in a group setting with eight to 12 women at the same stage of pregnancy, allowing women to have 10 times more interaction with their health care provider at no extra cost to the health system. Women receive their prenatal check-up, share and gain support from other women, as well as knowledge and skills related to pregnancy, childbirth and parenting from week 14 of pregnancy through one month postpartum.

Rising, of the CenteringPregnancy and Parenting Association in Cheshire, Connecticut, said CP+ is a promising way to nurture long-term relationships between adolescent women and their health care providers and to provide sustainable care and HIV/STI prevention in a culturally-tailored setting.

“Community health centers are a wonderful place for women and families to receive care and represent the majority of sites that currently provide CP+ care nationally,” said Rising. “This study will allow us to look more closely at the specific challenges of instituting a major paradigm change in the delivery of prenatal care within these complex, very busy systems.”

Additional investigators and consultants on the grant at YSPH include Trace Kershaw, Ph.D., assistant professor of epidemiology in SBS, Jessica Lewis, L.M.F.T., research associate, and Kim Blankenship, Ph.D., associate research scientist.  Other grant researchers are Urania Magriples, M.D., associate professor in the Yale School of Medicine’s Department of Obstetrics, Gynecology and Reproductive Sciences, David Holtgrave of Johns Hopkins University, John Jemmott of University of Pennsylvania, and Peter Bernstein, M.D., of Montefiore Medical Center/Albert Einstein College of Medicine of Yeshiva University.

For more information on the project, please contact Jessica Lewis, associate director of Yale’s Connecticut Women's Health Project.