Global Sexual and Reproductive Health With our partners, we conduct multidisciplinary research focused on improving sexual, reproductive and maternal health in lower-resource, high-HIV burden settings in southern Africa. Professor Chelsea Morroni NIHR Global Health Research Professor in Sexual and Reproductive Health Centre for Reproductive Health Institute for Regeneration and Repair Contact details Email: cmorroni@ed.ac.uk Research interestsOur research focuses on three core themes aimed at improving sexual and reproductive health (SRH) and maternal health in low- and middle-income countries (LMICs):Optimising women’s sexual health and wellbeing before and during pregnancy and postpartum to support better maternal and neonatal outcomes.Developing integrated approaches to STI diagnosis and management, HIV prevention and other SRH care.Implementation research, to bridge the gap between evidence and practice by designing, evaluating, and scaling interventions that can be embedded in routine service delivery.All of our work is underpinned by a commitment to research and clinical capacity strengthening and partnership building, within health systems and through collaboration with local, regional, and international partners.Key projectsDirector of Botswana Sexual and Reproductive Health Initiative (BSRHI)The Botswana Sexual and Reproductive Health Initiative (BSRHI) was established in 2014. Our aim is to address important research questions to improve sexual and reproductive health (SRH) and maternal health outcomes among women and girls. We conduct research, provide clinical services, and undertake teaching and training. We also provide technical assistance and advisory support to the Botswana Ministry of Health and other regional and international organisations. Our research focuses on pregnancy planning and prevention, HIV and contraception, STI diagnosis and treatment, safe abortion care and cervical cancer prevention.Botswana Sexual and Reproductive Health InitiativeCurrent BSRHI research projects and awardsNIHR Global Health Research Professorship – Improving Sexual Health in Pregnancy in Africa: a people-centred approach. This 5-year project is generating to inform improved sexual healthcare in pregnancy and post-partum in low resource, high HIV burden settings. Based on extensive public-patient involvement and engagement activities, the project will: (1) develop and evaluate novel diagnostic-driven STI control interventions; (2) co-design and test an intervention to improve PrEP and HIV self-testing using integrated delivery models; and (3) utilise these data to design an evidence-based ‘Better Sexual Health in Pregnancy’ intervention and an evaluation cohort. The work addresses major gaps in current STI management strategies that rely on ‘syndromic management’ which are ineffective in controlling STIs and tackles the problem of high HIV incidence during pregnancy and post-partum. Impact will be achieved through engaging key stakeholders and developing relationships to influence regional and international policy and build a well-equipped advocacy network.NIHR Global Health Research Group on Improving Quality of Maternal Healthcare in Africa We are leading the STI and pregnancy workstream. This is a prospective mixed methods study, DEFEAT Syphilis Malawi, to develop acceptable, feasible interventions to address the gaps in perinatal syphilis care defined through recent research in the Malawian setting.STEP-UPThe STI Testing to Enhance PrEP Use in Pregnancy (STEP-UP) Study is a 2-arm 1:1 randomized trial in Botswana aiming to test the effect of co-offering STI testing with expanded PrEP options on PrEP outcomes during pregnancy through the postpartum period among women in antenatal clinics. Pregnant and postpartum women in high HIV burden settings face elevated risk of HIV acquisition, yet research to improve PrEP use in pregnant and postpartum women lags behind other populations, creating inequitable PrEP access during periods of high HIV risk. Strategies to optimize PrEP use in pregnancy with rigorous safety evaluation are needed to advance delivery of expanded PrEP options. This study addresses urgent gaps by evaluating the co-delivery of diagnostic STI testing and expanded PrEP options within antenatal care to improve PrEP uptake, adherence, and sustained use during and after pregnancy. STEP-UP is a 5-year study funded by the US National Institutes of Health.The AAA trialThe Antenatal micronutrients, Aspirin and Azithromycin for maximal reduction of preterm birth and related outcomes (AAA) trial is a 6-year randomized-controlled trial and associated health systems work, funded by Open Philanthropy USA. Targeting factors such as poor maternal nutrition, inflammation, and infections with simple-to-deliver combination regimens in routine antenatal care may be of benefit in reducing the risk of small vulnerable newborn births in resource-limited settings.BASE StudyThe Botswana Adolescent girls & young women STI tEsting and treatment (BASE) Study aims to implement an STI screening and treatment intervention in Botswana to provide data on the burden of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infection among adolescent girls and young women in Botswana. In settings such as Botswana where the syndromic approach for STIs predominates, there is a lack of data on the prevalence of STIs. This study is needed to provide evidence that can guide policymakers in Botswana and similar LMICs on the value of investing in diagnostic STI screening for adolescent girls and young women. The BASE Study is an 18-months study funded by the Gates Foundation. The GETSA Study The Genomic epidemiology of Treponema pallidum in Southern Africa (GETSA) Study aims to determine the aetiology of genital ulcer disease in South Africa and Botswana and to conduct an analysis of Treponema pallidum genomes. There is paucity of epidemiological data of syphilis in the general population as most of the syphilis burden of disease estimates are derived from antenatal surveys and mathematical modelling. There is also a lack of Treponema pallidum genomic data from Sub-Saharan African with most genomes published in literature collected from Europe, the USA and Australia. Closing this gap and ensuring geographic inclusivity is therefore urgently warranted. The GETSA Study is 4 year study funded by Open Philanthropy USA. The Maduo StudyMaduo (“Results” in Setswana) is a recently completed US National Institutes of Health -funded study aiming to determine the burden of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among asymptomatic pregnant women and to investigate the impact of chlamydia and gonorrhoea testing on post-delivery CT/NG prevalence and vertical CT/NG transmission to infants. The study also seeks to access acceptability and feasibility and cost-effectiveness of chlamydia and gonorrhoea testing and treatment during antenatal care as well as partner notification preferences and experiences. The CODA StudyThe Contraceptives and Dolutegravir-based ART (CODA) Study aims to investigate whether drug-drug interactions occur when levonorgestrel sub-dermal contraceptive implants or DMPA injectables are concurrently used with dolutegravir (DTG)-based ART therapy. Provision of contraception is complicated in high HIV prevalence settings due to proven drug-drug interactions between some anti-retroviral therapy agents and hormonal methods. DTG is highly effective in managing HIV and is a WHO recommended first-line agent. However, thus far, there is little data on the effect of DTG on hormonal contraception. Rigorous and complete evidence on the risk of drug-drug interactions between hormonal contraceptives and DTG is urgently needed to inform local and international guidance. The CODA Study, a 4-year project, is funded by ViiV Healthcare. PREPARE StudyThe PRomoting Equity for Pregnant Adolescents in REsearch (PREPARE) is a multi-country study seeking to address questions and confusions around the ethical permissibility of including pregnant adolescents in HIV/co-infections research. The study is funded by the US National Institutes of Health for 5 years and is being conducted in collaboration with the University of Northern California at Chapel Hill and Botswana-Baylor Children's Clinical Centre of Excellence. ADAPI StudyThe ADAPI Study is Wellcome ECAT PhD project aiming to validate the Desire to Avoid Pregnancy (DAP) Scale, as a measure of pregnancy intention among women living with HIV in Botswana. Previous studies from Botswana have reported that almost half of pregnancies among women living with HIV are unintended. Work on improving pregnancy planning and prevention in Botswana, and similar low resource, high HIV burden settings, is needed. Better understanding pregnancy intention and implementation of valid measures that prospectively assess pregnancy preferences will enable the design of interventions and clinical services to help women meet their fertility goals and enhance reproductive rights.Publications Full list of publications - Research Explorer Group membersDr Aamirah Mussa, Programme Manager & Research FellowDr Karen Shambira, Physician Reseach CoordinatorDr Tlamelo Setshwaelo, Clinical Project ManagerDr Bonolo Phinius, Postdoctoral research fellowYasmin Dunkley, Implementation Scientists and Capacity Strengthening Lead Bama Bame, Research Nurse CoordinatorShelby Chakona, Research NurseLawrence Selei, Research Nurse MidwifeNeo Zambe, Senior Admin OfficerLefhela Tamuthiba, Senior Research Assistant Neo Ndlovu, Senior Research AssistantMbabi Bapabi, Senior Research AssistantNeo Moshashane, Senior Research AssistantKehumile Ramontshonyana, Senior Research AssistantMaipelo Tsuaneng, Research AssistantAratwa Tumagole, Research AssistantMavis Hengari, Research AssistantGeorge Marumo, Research AssistantDr Elizabeth Wastnedge, ECAT Wellcome PhD Student Dr Rebecca Ryan, Clinical Research FellowDr Alexandria Chung, Volunteer Clinical Research FellowDr Holly Lamden, Volunteer Clinical Research FellowMedia and engagementHow to grapple with soaring world population an answer from down south - UK Guardian articleFalling fertility: lessons learned from Botswana – UK Guardian Science Weekly podcastCollaboratorsInternalProf Andrew HorneProf Sharon CameronDr John Reynolds WrightExternalDr Geraldine Barrett, University College LondonProf Dvora Joseph Davey, University of Cape TownDr Suzanne Day, University of North Carolina, Chapel HillDr Sebastian Fuller, University of OxfordDr Bridget Freyne, University College DublinProf Justus Hofmeyr, University of BotswanaProf Saye Khoo, University of LiverpoolProf Jeffrey Klausner, University of Southern CaliforniaProf David Lissauer, Malawi Liverpool Wellcome Programme and University of LiverpoolDr Rebecca Luckett, Botswana Harvard Health Partnership (BHP)Prof Michael Marks, London School of Hygiene and Tropical MedicineProf Linda Mipando, Kamuzu University of Health Sciences and University of LiverpoolProf Sikhulile Moyo, Botswana Harvard Health Partnership (BHP)Prof Remco Peters, Foundation for Professional Development, South Africa and the WHOProf Sarah Pett, University College LondonProf Jillian Pintye, University of WashingtonProf Mark Polizzotto, The Australian National UniversityProf Doreen Ramogola-Masire, University of BotswanaProf Corinne Rocca, University of California, San FranciscoDr Adriane Wynn, University of California, San Diego Dr Rebecca Zash, Harvard Medical SchoolJhpiego BotswanaBummhi BotswanaFundersNational Institute for Health and Care Research, UKNational Institutes of Health, Fogarty, USANational Institutes of Health, NICHD, USANational Institutes of Health, NIAID, USAGates FoundationGovernment of CanadaOpen Philanthropy USA The Wellcome Trust, UKViiV HealthcareMerckNational Health and Medical Research Council, AustraliaNorwegian University of Science and Technology This article was published on 2025-05-06