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Edward Machtinger, MD

Title(s)Professor, Medicine
SchoolSchool of Medicine
Address350 Parnassus
San Francisco CA 94117
Phone415-353-2521
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    University of California, San Francisco, San FranciscoResidency 1999Internal Medicine
    Harvard University, BostonM.D.1996School of Medicine
    New York University, New YorkBA1991Classic Texts/Latin American Studies

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    Edward Machtinger, MD, is a Professor of Medicine, 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 the Principal Investigator and Co-director of the California ACEs Learning and Quality Improvement Collaborative (CALQIC), a 53-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. CALQIC is a pillar of ACEs Aware, the California Surgeon General's signature effort to reduce toxic stress among California’s families by half in a generation. He is Principal Investigator of a study nested in CALQIC to design and evaluate a "Whole Family Wellness" intergenerational response to adversity among low-income children and families.

    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 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, Dr. Machtinger has received over 18 million dollars in grant support.

    Dr. Machtinger convened, with Positive Women’s Network-USA, a national strategy group to develop a trauma-informed health care model to guide national implementation and evaluation efforts. In partnership with the Robert Wood Johnson Foundation, he developed and now leads a national demonstration site of trauma-informed health care at UCSF. His team is conducting among the first prospective implementation studies of this model of health care delivery.

    Dr. Machtinger is a member of Treatment Starts Here, a working group overseeing California’s response to the opiate overdose crisis. In this capacity, he advocates for the crucial role of relational healing (e.g., trust, connection, acceptance, and love), in conjunction with powerful biomedical tools, to achieve the most successful treatment outcomes.

    His latest publications include: a conceptual framework for trauma-informed health care; an expert consensus guide to inquiry and response to past trauma in health care settings; a meta-analysis describing high rates of trauma and PTSD among US HIV-positive woman; 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 startling high rates of death from trauma-related physical and mental health conditions.

    Dr. Machtinger is also focused on developing practical interventions to more effectively treat trauma-related illnesses that can be integrated into standard primary care clinics. These interventions focus on the healing power of reducing isolation and increasing self-acceptance, healthy relationships, and the self-confidence to publicly advocate for issues that affect the safety and well-being of one's family and community. He published studies describing the positive impacts of an expressive therapy intervention using theater for women of color with experiences of significant trauma, as well as of a 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 National Institutes of Health prioritization committee for women and girls with HIV across all institutes and helped lead the effort to include addressing trauma as a national research priority. 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). He serves on the Executive Committee of the AIDS Research Institute (ARI) at UCSF and the Executive Committee for the oversight of Congressional Ryan White funds to women and children in San Francisco.

    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.

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    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help. to make corrections and additions.
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    Altmetrics Details PMC Citations indicate the number of times the publication was cited by articles in PubMed Central, and the Altmetric score represents citations in news articles and social media. (Note that publications are often cited in additional ways that are not shown here.) Fields are based on how the National Library of Medicine (NLM) classifies the publication's journal and might not represent the specific topic of the publication. Translation tags are based on the publication type and the MeSH terms NLM assigns to the publication. Some publications (especially newer ones and publications not in PubMed) might not yet be assigned Field or Translation tags.) Click a Field or Translation tag to filter the publications.
    1. The Association of Trauma with the Physical, Behavioral, and Social Health of Women Living with HIV: Pathways to Guide Trauma-informed Health Care Interventions. Womens Health Issues. 2019 Sep - Oct; 29(5):376-384. Cuca YP, Shumway M, Machtinger EL, Davis K, Khanna N, Cocohoba J, Dawson-Rose C. PMID: 31303419.
      View in: PubMed   Mentions: 1     Fields:    Translation:Humans
    2. Providing Primary Care for HIV in the Context of Trauma: Experiences of the Health Care Team. Womens Health Issues. 2019 Sep - Oct; 29(5):385-391. Dawson-Rose C, Cuca YP, Shumway M, Davis K, Machtinger EL. PMID: 31272763.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    3. From Treatment to Healing: Inquiry and Response to Recent and Past Trauma in Adult Health Care. Womens Health Issues. 2019 Mar - Apr; 29(2):97-102. Machtinger EL, Davis KB, Kimberg LS, Khanna N, Cuca YP, Dawson-Rose C, Shumway M, Campbell J, Lewis-O'Connor A, Blake M, Blanch A, McCaw B. PMID: 30606467.
      View in: PubMed   Mentions: 6     Fields:    
    4. A Feasibility Study of a Telehealth Intervention on Health Care Service Utilization among Transgender Women of Color in Washington, DC. ACI Open. 2018 Jan 1; 02(01):e1-e9. Manya Magnus, Elizabeth Edwards, Aurnell Dright, Leandrea Gilliam, Angela Brown, Matthew Levy, Neal Sikka, Marc Siegel, Vittoria Criss, Christopher Watson, Edward Machtinger, Irene Kuo. .
      View in: Publisher Site   Mentions:
    5. Gender differences in causes of death among persons with HIV/AIDS in San Francisco, California, 1996-2013. Int J STD AIDS. 2018 02; 29(2):135-146. Hessol NA, Schwarcz SK, Hsu LC, Shumway M, Machtinger EL. PMID: 28728525.
      View in: PubMed   Mentions: 2     Fields:    Translation:Humans
    6. Seeking Safety Group Therapy for Co-Occurring Substance Use Disorder and PTSD among Transgender Women Living with HIV: A Pilot Study. J Psychoactive Drugs. 2017 Sep-Oct; 49(4):344-351. Empson S, Cuca YP, Cocohoba J, Dawson-Rose C, Davis K, Machtinger EL. PMID: 28524758.
      View in: PubMed   Mentions: 1     Fields:    Translation:Humans
    7. From treatment to healing: the promise of trauma-informed primary care. Womens Health Issues. 2015 May-Jun; 25(3):193-7. Machtinger EL, Cuca YP, Khanna N, Rose CD, Kimberg LS. PMID: 25965151.
      View in: PubMed   Mentions: 36     Fields:    Translation:Humans
    8. An expressive therapy group disclosure intervention for women living with HIV improves social support, self-efficacy, and the safety and quality of relationships: a qualitative analysis. J Assoc Nurses AIDS Care. 2015 Mar-Apr; 26(2):187-98. Machtinger EL, Lavin SM, Hilliard S, Jones R, Haberer JE, Capito K, Dawson-Rose C. PMID: 25027284.
      View in: PubMed   Mentions: 2     Fields:    Translation:Humans
    9. Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav. 2012 Nov; 16(8):2091-100. Machtinger EL, Wilson TC, Haberer JE, Weiss DS. PMID: 22249954.
      View in: PubMed   Mentions: 84     Fields:    Translation:Humans
    10. Recent trauma is associated with antiretroviral failure and HIV transmission risk behavior among HIV-positive women and female-identified transgenders. AIDS and Behavior. 2012; 8(16):2160-2170. Machtinger, E. L., Haberer, J. E., Wilson, T. C., & Weiss, D. S.
    11. Atraumatic splenic rupture: an unusual manifestation of acute HIV infection. AIDS Patient Care STDS. 2011 Aug; 25(8):461-4. Vallabhaneni S, Scott H, Carter J, Treseler P, Machtinger EL. PMID: 21711142.
      View in: PubMed   Mentions: 4     Fields:    Translation:Humans
    12. Language, literacy, and characterization of stroke among patients taking warfarin for stroke prevention: Implications for health communication. Patient Educ Couns. 2009 Jun; 75(3):403-10. Fang MC, Panguluri P, Machtinger EL, Schillinger D. PMID: 19171448.
      View in: PubMed   Mentions: 13     Fields:    Translation:Humans
    13. A visual medication schedule to improve anticoagulation control: a randomized, controlled trial. Jt Comm J Qual Patient Saf. 2007 Oct; 33(10):625-35. Machtinger EL, Wang F, Chen LL, Rodriguez M, Wu S, Schillinger D. PMID: 18030865.
      View in: PubMed   Mentions: 17     Fields:    Translation:Humans
    14. Seven steps to better adherence: a practical approach to promoting adherence to antiretroviral therapy. AIDS Read. 2007 Jan; 17(1):43-51. Machtinger EL, Bangsberg DR. PMID: 17274147.
      View in: PubMed   Mentions: 2     Fields:    Translation:Humans
    15. Language, literacy, and communication regarding medication in an anticoagulation clinic: a comparison of verbal vs. visual assessment. J Health Commun. 2006 Oct-Nov; 11(7):651-64. Schillinger D, Machtinger EL, Wang F, Palacios J, Rodriguez M, Bindman A. PMID: 17074733.
      View in: PubMed   Mentions: 18     Fields:    
    16. The importance of establishing regimen concordance in preventing medication errors in anticoagulant care. J Health Commun. 2006 Sep; 11(6):555-67. Schillinger D, Wang F, Rodriguez M, Bindman A, Machtinger EL. PMID: 16950728.
      View in: PubMed   Mentions: 14     Fields:    Translation:Humans
    17. Health literacy and anticoagulation-related outcomes among patients taking warfarin. J Gen Intern Med. 2006 Aug; 21(8):841-6. Fang MC, Machtinger EL, Wang F, Schillinger D. PMID: 16881944.
      View in: PubMed   Mentions: 46     Fields:    Translation:Humans
    18. Etiology of pruritic papular eruption with HIV infection in Uganda. JAMA. 2004 Dec 01; 292(21):2614-21. Resneck JS, Van Beek M, Furmanski L, Oyugi J, LeBoit PE, Katabira E, Kambugu F, Maurer T, Berger T, Pletcher MJ, Machtinger EL. PMID: 15572719.
      View in: PubMed   Mentions: 15     Fields:    Translation:HumansAnimalsCells