|School||UCSF School of Medicine|
|Address||SFGH Bldg 80, WD 86|
I am currently Assistant Adjunct Professor of Medicine at the University of California at San Francisco (UCSF). I trained in infectious diseases (MD, Columbia 2002) and epidemiology (MPH, Columbia 2002). My research seeks to apply perspectives from implementation and dissemination sciences to understand the effectiveness of global antiretroviral treatment (ART) programs for HIV-infected patients. Currently, the Global Fund, US President’s Emergency Fund for AIDS Relief (PEPFAR) and national governments have invested billions of dollars for AIDS programs and started five million persons on ART in resource limited settings. Yet the best strategies for engagement in care and treatment with life-long, complicated and potentially toxic medications include many unanswered questions. For patients who present to care, failure to initiate ART is underappreciated and a major barrier that is poorly understood. Once on ART, early mortality – likely to due to unascertained opportunistic infections – is high and the causes incompletely understood. Among patients who stabilize on ART, loss to follow-up is ubiquitous in African ART programs. To address these problems I am involved in a number of studies including (1) assembly of a cohort of HIV-infected patients in southwestern Uganda as part of an NIH funded consortium in East Africa; (2) a nested case control study to identify causes of early mortality in Uganda; (3) extending novel methods into the cohort setting to study engagement in care and (4) and using causal methods to understand longitudinal treatment effects in data collected in these settings. Overall, I hope to bring clinical contextual knowledge to bear on analysis of data from “real world” settings to improve the effectiveness of global ART implementation. Furthermore, I hope this research can yield generalizable lessons for science of implementation in health care that may be of use in other settings and other disease conditions.
Implementation Science, Socioeconomically marginalized groups, Clinic, Hospital, International (public health), International (medical), Practice guidelines, hiv, tuberculosis, Brief implementation science training courses
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