Meet the CIPHER grantees

Amara Ezeamama

Year awarded: 2016
Institution: Michigan State University (MSU), Department of Psychiatry
Research site: Kampala, Uganda
Primary mentor: Michael Boivin (MSU); Philippa Musoke (Makerere University School of Medicine, Kampala, Uganda)

Amara Ezeamama is an Assistant Professor of epidemiology at Michigan State University. She is studying neurocognitive function, quality of life and psychosocial adjustment as indicators of functional survival in HIV-affected and HIV-unaffected Ugandan children.

More information on Amara | Email

“I relish the independence afforded by this CIPHER funding and have loved every minute of my post-CIPHER life. This award has strengthened existing research connections and allowed establishment of new collaborations. CIPHER has made it easier to compete for new grants and has been a much-needed vote of confidence for my research programme. I could not be more thankful for this opportunity.”

Research project: Chronic HIV, executive function, psychosocial adjustment and quality of life in Ugandan school-aged children – A study of long-term functional survival with perinatal HIV infection and exposure

The issue

The long-term implication of in utero and postnatal HAART exposure for perinatally HIV-exposed or HIV-infected children during school age is unknown. Knowledge is particularly limited for children from sub-Saharan Africa. Convergent exposure to HIV and HAART (in utero and during early life) and pervasive physiologic/psychosocial stressors in HIV-affected children may modify long-term functional outcomes in this vulnerable group.

The CIPHER project

To fill knowledge gaps, this project evaluates chronic perinatal HIV infection and exposure as a predictor of deficits in cognitive function, psychosocial adjustment and quality of life in 300 Ugandan children aged 6-10 years. It determines how HIV-affected children compare with HIV-negative perinatally HIV-unexposed children on three functional indicators:

  • Executive function deficits
  • Psychosocial distress and behavioural adjustment
  • Overall quality of life.

The research conducts six-monthly repeat assessments of functional outcomes and uses these data to determine whether perinatal HIV status is associated with sustained deficits in function outcomes over 12 months of follow up. It evaluates HAART exposure history and regimen and psychosocial stress as potential mediators and/or modifiers of HIV-related functional deficits at enrolment and follow up.

The impact

The focus of this project on long-term functional survival with chronic HIV in children fills a critical knowledge gap and is poised to inform future interventions among children living with HIV. Leveraging the CIPHER research infrastructure, Dr Ezeamama has been able to expand this project to investigate the potential modifying role of nutritional deficits on HIV-related deficits in functional outcomes.

She notes a major impact on her career development. This includes add-on funding to support nutritional and laboratory assessments in the CIPHER cohort and NIH R21 funding to implement similar investigation in Ugandan adolescents. Most recently, in collaboration with a colleague (Dr Bruno Giordani) from University of Michigan, she is implementing performance-based neurocognitive tests in Ugandan adolescents. This new data will be used to study HIV-associated neurocognitive deficits (HAND) in adolescents who acquired HIV perinatally.