Frederick Lewis Altice MD, MA

Professor of Medicine (Infectious Diseases) and of Epidemiology (Microbial Diseases); Director, Clinical and Community Research; Director, HIV in Prisons Program; Director, Community Health Care Van; Icon Professor of Medicine, University of Malaya-Centre of Excellence for Research in AIDS (CERiA); Professor of Epidemiology and Public Health, Division of Epidemiology of Microbial Diseases

Research Interests

Interface between infectious diseases and substance abuse; HIV, HCV, and tuberculosis treatment in vulnerable populations (including injection drug users and prison inmates); Antiretroviral therapy; extended release naltrexone, buprenorphine and methadone treatment in management of co-morbid conditions; Healthcare integration; Adherence interventions; Behavioral interventions

Current Projects

  1. Alcohol Pharmacotherapies Among Released Prisoners: Randomized, placebo-controlled trial of depot-naltrexone for HIV+ prisoners with alcohol dependence who are transitioning to the community. Funding: NIAAA. Principal Investigators: Altice and Springer
  2. HIV, Buprenorphine, and the Criminal Justice System. Placebo, RCT of buprenorphine among HIV+, opioid dependent pretrial detainees in DC. Funding: NIDA. Principal Investigators: Altice and Taxman
  3. Naltrexone for Opioid Dependent Released HIV+ Criminal Justice Populations: Multisite, randomized, placebo-controlled trial of depot NTX among HIV+, opioid dependent released prisoners. Funding: NIDA. Principal Investigators: Altice and Springer.
  4. Prison Interventions and HIV Prevention Collaboration in Ukraine: To develop and test HIV prevention and treatment interventions using implementation research techniques in the criminal justice system in Ukraine and its two partners - Kazakhstan and Georgia. Funding: NIDA. Principal Investigator: Altice
  5. Project Harapan: 2x2 Randomized controlled trial of methadone maintenance and Holistic Health Recovery Project among HIV+ prisoners with opioid dependence in Malaysia. Funding: NIDA. Principal Investigator: Altice
  6. Project Connect: Randomized controlled trial of directly administered antiretroviral therapy among HIV+ prisoners with opioid dependence who are transitioning to the community. Funding: NIDA. Principal Investigator: Altice
  7. Transitions: This is a Special Project of National Significance to develop and evaluate evidence-based models for integrating substance abuse treatment and contingency management into a comprehensive jail-release program. The program utilizes buprenorphine treatment as a conduit to care. Funding: HRSA Principal Investigator: Altice
  8. Project Choices: This program builds on our previous SAMHSA work where we developed the first mobile buprenorphine induction and stabilization program in the country. In this project, we target our buprenorphine expansion for released prisoners with or at risk for HIV/AIDS. We also integrate other evidence-based interventions as part of the expansion and enhancement of services.
  9. Project Bridge: Methadone and buprenorphine as primary and secondary HIV prevention for HIV+ persons released from prison.
  10. NIDA R01 DA032106 (Duerr, PI; Altice, Co-I) 07/01/11-06/30/16

    Title: HIV Testing and Treatment to prevent onward HIV Transmission among high-risk MSM in Peru.

    Description: To address the Seek, Test and Treat initiative by: 1) identifying acute and recent HIV infection and conducting a RCT of immediate versus delayed ART; and 2) conduct a RCT of newly diagnosed HIV+ MSM with alcohol use disorders to XR-NTX + counseling versus Placebo + counseling in Peru.

    NIDA R01 HD075630 (Petry PI; Altice Co-I) 09/01/12 – 08/31/16

    Title: ART Adherence and Secondary Prevention of HIV.

    Description: To conduct a RCT using contingency management (CM) verus CM + video direct observation among HIV+ patients with problematic adherence.

    NIDA R01 DA032290 (Copenhaver, PI; Altice, Co-I) 04/11/12 – 03/31/17

    Title: Secondary HIV Prevention and Adherence Among Drug Users.

    Description: RCT comparative effectiveness trial to test the efficacy and cost-effectiveness of an adapted, brief, version of an evidence-based intervention (EBI) called Holistic Health for HIV (3H+) vs. the original EBI -- Holistic Health Recovery Program for HIV+ drug users (HHRP+).

    HRSA H97HA24963 (Altice, PI) 09/01/12-08/31/17

    Title: Special Project of National Significance: mHEALTH: Medical Home Engagement and Aligning Lifestyles and Transition from Homelessness

    Description: To create a new innovative model of managing complex HIV+ patients with mental illness and homelessness.


Research Summary

Focus has broadly been on the interface between infectious diseases and substance use disorders, with additional interests in research in community, criminal justice and clinical care settings. As a clinical epidemiologist, health services and intervention researcher, has created novel programs for the treatment of HIV, HCV, and tuberculosis in vulnerable populations, including injection drug users and prison inmates. Specifically, has been an international leader in research related to adherence to antiretroviral therapy, particularly among HIV+ drug users, and has made considerable inroads into novel approaches using directly administered antiretroviral therapy and other structural interventions to facilitate adherence both nationally and internationally.

Dr. Altice is currently leading a number of studies that bridge the gap between the correctional and community setting, specifically on the use of directly observed antiretroviral therapy and medication-assisted therapy for the treatment of substance use disorders. Current research includes methadone and buprenorphine as primary and secondary HIV prevention, directly administered antiretroviral therapy, peer-driven interventions, secondary prevention among drug users and prisoners, medication-assisted therapies for the treatment of substance use disorders using methadone, buprenorphine and naltrexone. International research projects are currently underway in Malaysia, Indonesia, Ukraine, Russia and Argentina. Planned projects are underway in Brazil.

Extensive Research Description

Frederick L. Altice is a professor of medicine, epidemiology and public health. He is a clinical epidemiologist and intervention researcher at Yale University School of Medicine. Dr. Altice's primary research examines the relationship between infectious diseases and substance use disorders. His work has also focused on the criminal justice system, examining linkages between the community and correctional settings. Specific topics include; substance use disorders including opioids, stimulants and alcohol use disorders on HIV treatment outcomes and healthcare integration strategies. He has been a pioneer in the creation and evaluation of innovative strategies to engage HIV-infected drug users in care as well as develop strategies to facilitate adherence to antiretroviral medications. He is developing and creating methods to assess health services integration as a means to promote improved health outcomes, especially for HIV, viral hepatitis, tuberculosis, mental illness and substance use disorders. Additionally, his research seeks to understand the relationship of medication-assisted therapies, such as methadone, buprenorphine and extended-release naltrexone and its role in primary and secondary HIV prevention. His research projects extend internationally in the United States, Malaysia, Peru, Ukraine, Russia, Kazakhstan, Azerbaijan and Argentina.

Dr. Altice received his M.D. at Emory University. He is a professor of medicine at the University of Malaya in Kuala Lumpur where he conducts research in collaboration with colleagues at the Centre of Excellence on Research in AIDS and the Centre of Addiction Studies. He has been the principal investigator of several projects for the National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, the Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Agency, the Health Services Resource Agency's Special Projects of National Significance and Center for Substance Abuse Treatment.


Selected Publications

  • Wickersham JA, Zahari MM, Azar MM, Kamarulzaman A, Altice FL. Methadone dose at the time of release from prison significantly influences retention in treatment: Implications from a pilot study of HIV-infected prisoners transitioning to the community in Malaysia. Drug Alcohol Depend. 2013:In Press.
  • Wickersham JA, Marcus R, Kamarulzaman A, Zahari MM, Altice FL. Implementing methadone maintenance treatment in prisons in Malaysia. Bull World Health Organ. 2013;91(2):124-9.
  • Vagenas P, Ludford KT, Gonzales P, Peinado J, Cabezas C, Gonzales F, Sanchez J, Altice FL. Being Unaware of Being HIV-Infected is Associated with Alcohol Use Disorders and High-Risk Sexual Behaviors Among Men Who have Sex with Men in Peru. AIDS Behav. 2013:In Press.
  • Morozova O, Azbel L, Grishaev Y, Dvoryak S, Wickersham JA, Altice FL. Ukrainian prisoners and community reentry challenges: implications for transitional care. Int J Prisoner Health. 2013;9(1):5-19.
  • Morano JP, Walton MR, Zelenev A, Bruce RD, Altice FL. Latent Tuberculosis Infection: Screening and Treatment in an Urban Setting. J Community Health. 2013:In Press.
  • Morano JP, Gibson BA, Altice FL. The burgeoning HIV/HCV syndemic in the urban Northeast: HCV, HIV, and HIV/HCV coinfection in an urban setting. PLoS One. 2013;8(5):e64321.
  • Meyer JP, Zelenev A, Wickersham JA, Williams CT, Teixeira PA, Altice FL. Women Released from Jail Experience Suboptimal HIV Treatment Outcomes Compared to Men: Results from a Multi-Center Study. American Journal of Public Health. 2013: In Press.
  • Meyer JP, Wickersham JA, Fu JJ, Brown SE, Sullivan TP, Springer SA, et al. Partner violence and health among HIV-infected jail detainees. International J Prisoner Health. 2013;9(3):1-18.
  • Meyer JP, Qiu J, Chen NE, Larkin GL, Altice FL. Frequent emergency department use among released prisoners with human immunodeficiency virus: characterization including a novel multimorbidity index. Acad Emerg Med. 2013;20(1):79-88.
  • Meyer JP, Althoff AL, Altice FL. State-of-the-Art Care for HIV-infected People Who Use Drugs: Evidence-Based Approaches to Overcoming Healthcare Disparities. Clin Infect Dis. 2013: In Press.

Read more...

Edit Profile