Edward Machtinger, MD, Professor of Medicine, is Director of the Women’s HIV Program (WHP) and Director of the Center to Advance Trauma-informed Health Care (CTHC) at the University of California, San Francisco (UCSF).
The focus of Dr. Machtinger’s research and health policy expertise is aligning the services of the U.S. primary health care system to more effectively address the traumatic roots of most physical and mental illness and disparities in health. His work also seeks to expand access to mental health and substance use treatment through full integration of these fields into primary medical care.
Dr. Machtinger is Co-Principal Investigator (with Dr. Shannon Thyne from UCLA) of the UCLA/UCSF ACEs Aware Family Resilience Network (UCAAN), a University of California multi-campus initiative housing the State of California's "ACEs Aware" portfolio of programs and grants addressing the health impacts of adverse childhood experiences (ACEs) and toxic stress. UCAAN is a partnership between the University of California, the California Department of Health Care Services and the California Office of the Surgeon General. The initiative is the California Surgeon General's signature effort to reduce toxic stress among California’s families by half in a generation.
Dr. Machtinger is Principal Investigator and Co-director (with Drs. Anda Kuo and Marguerita Lightfoot) of the California ACEs Learning and Quality Improvement Collaborative (CALQIC), a 49-clinic, seven-region, statewide initiative to train providers of care to screen for and respond to adverse childhood experiences (ACEs) among children and adults in the state’s 13+ million member Medi-Cal system.
He is Co-Principal Investigator (with Dr. Marguerita Lightfoot from Oregon Health Sciences University) of a study funded by Genentech to design and evaluate a "Whole Family Wellness" intergenerational response to adversity among low-income children and families. The study is based on a conceptual framework designed to overcome the fragmentation of health care services experienced by families, authored by study Co-Investigators Drs. Alicia Lieberman, Ken Epstein, and Alex Briscoe.
Dr. Machtinger’s other current grants include a 3-year award from the Health Resources Services Administration Special Projects of National Significance (SPNS) to improve care for Black women living with HIV and a 5-year award from the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop and implement a new model of outpatient trauma—informed substance use treatment.
Since 2018, as Principal and Co-Principal Investigator, Dr. Machtinger has received over $100 million dollars in grant support.
In partnership with Naina Khanna, the Executive Director of Positive Women’s Network-USA, Dr. Machtinger convened a national strategy group to develop a model of trauma-informed health care to guide national implementation and evaluation efforts.
His latest publications include: a conceptual framework for trauma-informed health care; an expert consensus guide to inquiry and response to past trauma in adult health care settings; a meta-analysis describing high rates of trauma and PTSD among US woman living with HIV; a study demonstrating a significant association of recent trauma and HIV antiretroviral medication failure; and an analysis of the causes of death among U.S. men and women living with HIV that documents startlingly high rates of death from trauma-related physical and mental health conditions.
Dr. Machtinger's work also focuses on developing practical interventions to more effectively treat trauma-related illnesses that can be integrated into standard primary care clinics. In partnership with Rhodessa Jones, the Director of the Medea Project: Theater for Incarcerated Women, he published a study describing the transformative impact of an expressive therapy intervention using theater for women of color with experiences of significant trauma. The study clarified key ingredients for healing from trauma in this population: fostering sisterhood and community, increasing self-acceptance, and developing the self-confidence to publicly advocate for issues that affect the safety and well-being of one's family and community. He also published a study demonstrating the positive impact of a clinic-based group intervention for transgender women with co-occurring substance use disorder and PTSD.
Dr. Machtinger is a respected thought leader and advocate nationally for health policy pertaining to trauma-informed care and the integration of physical and behavioral health care. He was a keynote speaker at two recent National Academies of Science, Engineering and Medicine workshops: "Key Policy Challenges to Improve Care for People with Mental Health and Substance Use Disorders" (2019) and "Improving Access to and Equity of Care for People with Serious Illness" (2019). He advised the Presidential Federal Working Group on the Intersection of HIV/AIDS, Violence Against Women and Gender-related Health Disparities and was a keynote speaker at the White House release of their 2014 report. He served on the Substance Abuse and Mental Health Administration (SAMHSA) General Adult Trauma Screening and Brief Interventions (GATSBI) working group, providing expertise on developing best practices for trauma-informed health care. Dr. Machtinger was also a lead presenter at the U.S. Department of Health and Human Services (DHHS) HIV/AIDS Bureau Conference on Women, Trauma and HIV and served on the technical expert panel convened by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Health Resources and Services Administration (HRSA).
Currently, he serves on the Executive Committee of the AIDS Research Institute (ARI) at UCSF, the Executive Committee for the oversight of Congressional Ryan White funds to women and children in San Francisco, and as member of Treatment Starts Here, a working group overseeing California’s response to the opiate overdose crisis.
Dr. Machtinger is also a respected clinician, teacher and mentor and was the recipient of the UCSF School of Medicine 2013 Osler Distinguished Teaching Award. Dr. Machtinger's other interests include the well-being of animals and the environment and the relationship between human health, animal welfare, and environmental stewardship. He is a graduate of Harvard Medical School and performed his residency in internal medicine at UCSF.