Amy Caroline Justice MD, MSc, PhD, MSCE
Professor of Medicine (General Medicine) and of Public Health (Health Policy); Section Chief of General Internal Medicine VA Connecticut Healthcare System
Research Interests
Chronic disease; HIV infection; Veterans Aging Cohort Study
Current Projects
Veterans Aging Cohort StudyResearch Summary
Dr. Justice has done research in outcomes in chronic HIV infection, for the past 16 years. Her goal is to use HIV infection as a model for improving outcomes in chronic disease by studying the association between mutable mediators of clinical outcome in HIV and intervening on these mediators. She is the Principal Investigator on the Veterans Aging Cohort Study (VACS). This research, initially funded by career development awards from the National Institute on Aging and The Robert Wood Johnson Foundation, considers the complex roles of aging, symptoms, medical treatment, adherence, patient-provider relationships, disease severity, and medical and psychiatric comorbid illness in determining survival and quality of life for people with HIV infection. VACS has received 5 years of funding from NIAAA to conduct an expansion of the study to include HIV negative controls and additional study sites. The study is focused on understanding the likely interactive and overlapping role of alcohol use and abuse in determining outcomes among veterans aging with HIV infection and comparing this role to age-race-site matched HIV negative veterans.
Selected Publications
- Korthuis PT, Fiellin DA, McGinnis KA, Skanderson M, Justice AC, Gordon AJ, Almario-Doebler D, Asch SM, Fiellin LE, Bryant K, Gibert CL, Crystal S, Goetz MB, Rimland D, Rodriguez-Barradas MC, Kraemer KL for the Veterans Aging Cohort Study. Unhealthy alcohol and illicit drug use are associated with decreased quality of HIV care. J Aquir Immune Defic Syndr (in press).
- Althoff KN, Buchacz K, Hall HI, Zhang J, Hanna DB, Rebeiro P, Gange SJ, Moore RD, Kitahata M, Gebo KA, Martin J, Justice AC, Horberg M, Hogg RS, Sterling TR, Cescon A, Klein MB, Thorne J, Crane H, Mugavero MJ, Napravnik S, Kirk GD, Jacobson LP, Brooks JT for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). Trends in antiretroviral therapy use, HIV RNA plasma viral loads and CD4 T-lymphocyte counts among human immunodeficiency virus (HIV)-infected persons in care in the United States, 2000-2008. Ann Intern Med (in press).
- Edelman EJ, Gordon K, Becker WC, Goulet JL, Skanderson M, Gaither JR, Brennan Braden J, Gordon AJ, Kerns RD, Justice AC, Fiellin DA. Receipt of opioid analgesics by HIV-infected and uninfected patients. J Gen Intern Med 2012; Aug 16 (Epub ahead of print). PMID: 22895747.
- Dubrow R, Silverberg MJ, Park LS, Crothers K, Justice AC. HIV infection, aging, and immune function: implications for cancer risk and prevention. Curr Opin Oncol 2012 Sep; 24(5):506-516. PMID: 22759737.
- High KP, Brennan-Ing M, Clifford DB, Cohen MH, Currier J, Deeks SG, Deren S, Effros RB, Gebo K, Goronzy JJ, Justice AC, Landay A, Levin J, Miotti PG, Munk RJ, Nass H, Rinaldo CR, Shlipak MG, Tracy R, Valcour V, Vance DE, Walston JD, Volberding P for the OAR working group on HIV and aging. HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH office of AIDS research by the HIV and aging working group. J Aquir Immune Defic Syndr 2012 Jul; 60(Supp 1):S1-S18. PMID: 22688010. PMCID: PMC3413877.
- Armah KA, McGinnis K, Baker J, Gibert C, Butt AA, Bryant KJ, Goetz MB, Tracy R, Oursler KK, Rimland D, Crothers K, Rodriguez-Barradas MC, Crystal S, Gordon A, Kraemer K, Brown S, Gerschenson M, Leaf DA, Deeks SG, Rinaldo C, Kuller LH, Justice AC, Freiberg MS. HIV status, burden of comorbid disease, and biomarkers of inflammation, altered coagulation and monocyte activation. Clin Infect Dis 2012 Jul; 55(1):126-136. PMID: 22534147.
- Justice AC, Freiberg MS, Tracy R, Kuller L, Tate JP, Goetz MB, Fiellin DA, Vanasse GK, Butt AA, Rodriguez-Barradas MC, Gibert C, Oursler KA, Deeks SG, Bryant K and the VACS Project Team. Does an index composed of clinical data reflect effects of inflammation, coagulation, and monocyte activation on mortality among those aging with HIV? Clin Infect Dis 2012 Apr; 54(7):984-994. PMID: 22337823. PMCID: PMC3297653.
- Sigel K, Wisnivesky J, Dubrow R, Justice AC, Gordon K, Brown ST, Goulet J, Butt AA, Crystal S, Rimland D, Rodriguez-Barradas MC, Gibert C, Park L, Crothers K. HIV as an independent risk factor for lung cancer. AIDS 2012 Feb; 26(8):1017-1025. PMID: 22382152.
- Justice AC, McGinnis KA, Skanderson M, Chang CC, Gibert CL, Goetz MB, Rimland D, Rodriguez-Barradas MC, Oursler KK, Brown ST, Braithwaite RS, May M, Covinsky KE, Roberts MS, Fultz SL, Bryant KJ; VACS Project Team. Towards a combined prognostic index for survival in HIV infection: the role of 'non-HIV' biomarkers. HIV Med. 2010 Feb;11(2):143-51. Epub 2009 Sep 14. PubMed PMID: 19751364.
- Justice AC. HIV and aging: time for a new paradigm. Curr HIV/AIDS Rep. 2010 May;7(2):69-76. PubMed PMID: 20425560.
Selected Publications
- Korthuis PT, Fiellin DA, McGinnis KA, Skanderson M, Justice AC, Gordon AJ, Almario-Doebler D, Asch SM, Fiellin LE, Bryant K, Gibert CL, Crystal S, Goetz MB, Rimland D, Rodriguez-Barradas MC, Kraemer KL for the Veterans Aging Cohort Study. Unhealthy alcohol and illicit drug use are associated with decreased quality of HIV care. J Aquir Immune Defic Syndr (in press).
- Althoff KN, Buchacz K, Hall HI, Zhang J, Hanna DB, Rebeiro P, Gange SJ, Moore RD, Kitahata M, Gebo KA, Martin J, Justice AC, Horberg M, Hogg RS, Sterling TR, Cescon A, Klein MB, Thorne J, Crane H, Mugavero MJ, Napravnik S, Kirk GD, Jacobson LP, Brooks JT for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). Trends in antiretroviral therapy use, HIV RNA plasma viral loads and CD4 T-lymphocyte counts among human immunodeficiency virus (HIV)-infected persons in care in the United States, 2000-2008. Ann Intern Med (in press).
- Edelman EJ, Gordon K, Becker WC, Goulet JL, Skanderson M, Gaither JR, Brennan Braden J, Gordon AJ, Kerns RD, Justice AC, Fiellin DA. Receipt of opioid analgesics by HIV-infected and uninfected patients. J Gen Intern Med 2012; Aug 16 (Epub ahead of print). PMID: 22895747.
- Dubrow R, Silverberg MJ, Park LS, Crothers K, Justice AC. HIV infection, aging, and immune function: implications for cancer risk and prevention. Curr Opin Oncol 2012 Sep; 24(5):506-516. PMID: 22759737.
- High KP, Brennan-Ing M, Clifford DB, Cohen MH, Currier J, Deeks SG, Deren S, Effros RB, Gebo K, Goronzy JJ, Justice AC, Landay A, Levin J, Miotti PG, Munk RJ, Nass H, Rinaldo CR, Shlipak MG, Tracy R, Valcour V, Vance DE, Walston JD, Volberding P for the OAR working group on HIV and aging. HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH office of AIDS research by the HIV and aging working group. J Aquir Immune Defic Syndr 2012 Jul; 60(Supp 1):S1-S18. PMID: 22688010. PMCID: PMC3413877.
- Armah KA, McGinnis K, Baker J, Gibert C, Butt AA, Bryant KJ, Goetz MB, Tracy R, Oursler KK, Rimland D, Crothers K, Rodriguez-Barradas MC, Crystal S, Gordon A, Kraemer K, Brown S, Gerschenson M, Leaf DA, Deeks SG, Rinaldo C, Kuller LH, Justice AC, Freiberg MS. HIV status, burden of comorbid disease, and biomarkers of inflammation, altered coagulation and monocyte activation. Clin Infect Dis 2012 Jul; 55(1):126-136. PMID: 22534147.
- Justice AC, Freiberg MS, Tracy R, Kuller L, Tate JP, Goetz MB, Fiellin DA, Vanasse GK, Butt AA, Rodriguez-Barradas MC, Gibert C, Oursler KA, Deeks SG, Bryant K and the VACS Project Team. Does an index composed of clinical data reflect effects of inflammation, coagulation, and monocyte activation on mortality among those aging with HIV? Clin Infect Dis 2012 Apr; 54(7):984-994. PMID: 22337823. PMCID: PMC3297653.
- Sigel K, Wisnivesky J, Dubrow R, Justice AC, Gordon K, Brown ST, Goulet J, Butt AA, Crystal S, Rimland D, Rodriguez-Barradas MC, Gibert C, Park L, Crothers K. HIV as an independent risk factor for lung cancer. AIDS 2012 Feb; 26(8):1017-1025. PMID: 22382152.
- Justice AC, McGinnis KA, Skanderson M, Chang CC, Gibert CL, Goetz MB, Rimland D, Rodriguez-Barradas MC, Oursler KK, Brown ST, Braithwaite RS, May M, Covinsky KE, Roberts MS, Fultz SL, Bryant KJ; VACS Project Team. Towards a combined prognostic index for survival in HIV infection: the role of 'non-HIV' biomarkers. HIV Med. 2010 Feb;11(2):143-51. Epub 2009 Sep 14. PubMed PMID: 19751364.
- Justice AC. HIV and aging: time for a new paradigm. Curr HIV/AIDS Rep. 2010 May;7(2):69-76. PubMed PMID: 20425560.
- Braithwaite RS, Kozal MJ, Chang CCH, Roberts MS, Fultz SL Goetz MB, Gibert C, Rodriguez-Barradas M, Mole L, Justice AC. Adherence, virologic and immunologic outcomes for HIV-infected veterans starting combination antiretroviral therapies. AIDS (in press).
- Crothers K, Goulet JL, Rodriguez-Barradas M, Gilbert C, Butt A, Braithwaite RS, Peck R, Justice AC. Decreased awareness of current smoking among health care providers of HIV-positive compared to HIV-negative veterans. J Gen Intern Med (in press).
- Butt AA, Justice AC, Skanderson M, Rigsby MO, Good CB, Kwoh CQ. Rate and predictors of treatment prescription for hepatitis C. Gut 2007, 000: 1-6.
- Braithwaite RS, Roberts MS, Justice AC. Incorporating quality of evidence into decision analytic modeling. Ann of Intern Med, 2007: 146: 133-141.
- Gange SJ, Kitahata MM, Saag MS, Bangsberg DR., Bosch RJ, Brooks JT, Calzavara L, Justice AC, et al. Cohort Profile: The north American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). Int J Epidemiol (in press).


