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.

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

  • Zelenev, A., Marcus, R., Cruzado-Quinones, J., Spaulding, A., Desabrais, M., Lincoln, T., Altice, F.L., 2012. Patterns of Homelessness and Implications for HIV Health after Release from Jail AIDS Behav, In Press.
  • Thompson, M.A., Mugavero, M.J., Amico, K.R., Cargill, V.A., Chang, L.W., Gross, R., Orrell, C., Altice, F.L., Bangsberg, D.R., Bartlett, J.G., Beckwith, C.G., Dowshen, N., Gordon, C.M., Horn, T., Kumar, P., Scott, J.D., Stirratt, M.J., Remien, R.H., Simoni, J.M., Nachega, J.B., 2012. Guidelines for Improving Entry Into and Retention in Care and Antiretroviral Adherence for Persons With HIV: Evidence-Based Recommendations From an International Association of Physicians in AIDS Care Panel. Ann Intern Med, In Press.
  • Springer, S.A., Qiu, J., Saber-Tehrani, A.S., Altice, F.L., 2012. Retention on Buprenorphine Is Associated with High Levels of Maximal Viral Suppression among HIV-Infected Opioid Dependent Released Prisoners. PLoS One 7, e38335.
  • Schwarz, R., Zelenev, A., Bruce, R.D., Altice, F.L., 2012. Retention on buprenorphine treatment reduces emergency department utilization, but not hospitalization, among treatment-seeking patients with opioid dependence. J Subst Abuse Treat, In Press.
  • Saber-Tehrani, A.S., Springer, S.A., Qiu, J., Herme, M., Wickersham, J., Altice, F.L., 2012. Rationale, study design and sample characteristics of a randomized controlled trial of directly administered antiretroviral therapy for HIV-infected prisoners transitioning to the community - A potential conduit to improved HIV treatment outcomes. Contemp Clin Trials 33, 436-444.
  • Lincoln, T., Simon-Levin, D., Smith, J., Donenberg, G., Springer, S.A., Zaller, N., Altice, F.L., Moore, K., Jordan, A.O., Draine, J., Desabrais, M., 2012. Prevalence and Predictors of Psychiatric Distress Among HIV+ Jail Detainees at Enrollment in an Observational Stud. AIDS Behav, In Press.
  • de Voux, A., Spaulding, A.C., Beckwith, C., Avery, A., Williams, C., Messina, L.C., Sarah Ball, S., Altice, F.L., 2012. Early Identification of HIV: Empirical Support for Jail-Based Screening. PLoS ONE 7, e37603.
  • Bruce, R.D., Eiserman, J., Acosta, A., Gote, C., Lim, J.K., Altice, F.L., 2012. Developing a modified directly observed therapy intervention for hepatitis C treatment in a methadone maintenance program: implications for program replication. Am J Drug Alcohol Abuse 38, 206-212.
  • Althoff, A., Zelenev, A., Meyer, J.P., Fu, J.J., Brown, S.E., Vagenas, P., Avery, A., Cruzado, J., Spaulding, A., Altice, F.L., 2012. Correlates of Retention in HIV Care after Release from Jail: Results from a Multi-site Study. AIDS Behav, In Press.
  • Al-Darraji, H.A.A., Kamarulzaman, A., Altice, F.L., 2012. Isoniazid Preventive Therapy in Correctional Facilities: A Systematic Review. Int J Tuberc Lung Dis, In Press.

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