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.