Research Recap: August 16 – August 27

A biweekly overview of recent studies published by Institute investigators and their collaborators spans a wide variety of topics, including:

PrEP’s role in engagement of primary care; the PrEP continuum of care; the potential effects of genome sequencing on patients and families; and using epigenetics to determine the effects of maternal smoking on offspring

For all faculty publications, see our Publications page. For up-to-date media coverage and research findings, visit In the Media, and follow us on Twitter. To search for a subject matter expert, visit our Investigator Directory.

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PrEP and primary care

In a

2018 study, a team of Institute investigators and collaborators found that preexposure prophylaxis (PrEP) is associated with increased receipt of other preventive care. However, because few studies on this association have explored patients’ perspectives on PrEP’s role in engagement in primary care, investigators including Whitney Sewell, Julia Marcus, Douglas Krakower, and collaborators conducted a qualitative study of adults 18 years or older. They found that seeking PrEP encouraged study participants to establish, build, and maintain a relationship with a primary care provider – some for the first time. Results, published in the Journal of Acquired Immune Deficiency Syndrome, suggests that PrEP can be a “gateway” to primary care for men who have sex with men (MSM), leading to the use of additional preventive services and subsequent related health benefits.

Institute Investigator(s): Douglas Krakower, Julia Marcus, Whitney Sewell

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Exploring the benefits and possible adverse effects of genome sequencing on patients

Genome sequencing (GS) will likely become a routine part of patient care. While many envision it as a means of screening for disease and creating targeted prevention, others caution that there may be adverse psychological effects on those screened. New work led by Kurt Christensen in NPJ Genomic Medicine examined the behavioral and psychological impact of GS on primary care and cardiology patients. The team looked at whether the results of GS can motivate behavior change, and whether the findings of screening distressed patients. Study results provide early evidence about the potential behavioral and psychological impact of integrating GS into patient care.

Institute Investigator(s): Kurt Christensen

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Screening in newborn infants: are there adverse effects on families?

Genomic sequencing in newborns (nGS) measures the presence of disease biomarkers,

potentially providing health benefits throughout the life span. While these benefits exist, so does the concern that results could have a negative psychosocial effect on families. A new study in JAMA Pediatrics co-authored by Kurt Christensen assessed the psychosocial effect of nGS on families. The study team conducted surveys of families from the BabySeq Project, a randomized clinical trial evaluating the effect of nGS on the clinical care of newborns. They found no persistent adverse psychosocial effects on families who received screening or whose infants received a monogenic disease risk finding, and results suggest that further research is needed to explore the impact of nGS on a more diverse population.

Institute Investigator(s): Kurt Christensen
 

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How maternal smoking effects the human placental epigenome

Proper placental function plays a critical role in successful pregnancy outcomes. Epigenetic responses to prenatal exposures have emerged as potential links between early life exposures and developmental health outcomes. While many studies have looked at the impact of maternal smoking during pregnancy (MSDP) on the human placental epigenome, sample sizes have been small. To address this gap, a new study co-authored by Marie-France Hivert and published in Nature Communications used data from seven independent studies (members of the PACE consortium) to examine the relationships between MDSP and variations in the placental methylome. The study reveals links between placental DNA methylation (DNAm), MSDP, and poor birth outcomes, which may better inform the mechanisms through which MSDP impacts placental function and therefore fetal growth.

Institute Investigator(s): Marie-France Hivert

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Identifying gaps in the PrEP continuum of care

HIV preexposure prophylaxis (PrEP) is highly effective in preventing HIV infection, but gaps in the PrEP continuum of care  threaten to impede progress toward national HIV prevention goals. A new study in JAMA Network Open co-authored by Julia Marcus sought to identify the factors associated with gaps in the continuum of care for users of PrEP, and where within that continuum HIV infections occurred. The team found that, within a cohort of 13,906 insured individuals aged 18 to 25, individuals who were African American, Latinx, women, of lower socioeconomic status, or with a substance use disorder were more likely to experience gaps in the PrEP continuum of care. Results highlight the need for comprehensive strategies to improve the PrEP continuum of care among high-priority populations such as those identified in the study.

Institute Investigator(s): Julia Marcus

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