It is widely known that antiretroviral treatment (ART) has been successful in reducing mother-to-child HIV transmission. Some studies report that infants of women living with HIV (WLHIV) who start ART before conception may have a higher risk of adverse birth and infant neurodevelopmental outcomes than those starting ART during pregnancy. However, differences in the potential adverse effects of ART based on their timing (i.e., preconception, first trimester, etc.) require further investigation. Many studies define ART exposures based only on the timing of initiation (i.e., initiated prior to conception vs early in pregnancy vs later in pregnancy), rather than considering continued exposures over multiple trimesters during pregnancy, and thus may not correctly reflect the effects of multiple time points of exposure. This is true especially when ART regimens change during pregnancy. Also, observational studies may be missing information for each time point of exposure, creating a statistical challenge when attempting to compare ART effects across preconception and each trimester. We explore a method that can evaluate potential periods of heightened vulnerability to ART exposure while accounting both for missing data and correlated exposures.
Jemar R. Bather is a biostatistics Ph.D. candidate at Harvard University and a Fostering Diversity in HIV Research Fellow at Massachusetts General Hospital. Before joining Harvard, he was a quantitative research assistant at New York University, publishing work in diverse outlets such as Public Health Reports and Patient Education and Counseling. His current research focuses on statistical methods for improving perinatal and reproductive outcomes among infants and women living with HIV. Beyond his research, Jemar specializes in coaching prospective doctoral applicants through their application process. Applicants that he worked with are now in Ph.D. programs at Stanford, Emory and Boston Universities. Jemar holds a B.S. in statistics from Pennsylvania State University, an M.S. in applied statistics from NYU and an M.A. in biostatistics from Harvard University. He is also the founder of the NYU Chapter of the National Statistics Honor Society. For this service and his involvement with NYU’s statistics club, he received the President’s Service Award and the Samuel Eshborn Service Award.