Robert Heimer, PhD

Professor of Epidemiology (Microbial Diseases) and of Pharmacology; Director, Emerging Infections Program

Research Interests

Hepatitis C; Injections; HIV Infections

Public Health Interests

Drug Abuse/Addition; HIV/AIDS

Research Summary

Dr. Heimer is also the Director of the Yale office of the Connecticut Emerging Infections Program. This Centers for Disease Control and Prevention-funded program is one of eleven programs nationwide that seek to assess, through population-based surveillance, the public health impact of emerging infectious diseases and to evaluate methods for their prevention and control in the community. The Yale program currently focuses on chronic liver disease (especially hepatitis C), foodborne illnesses, and respiratory illnesses.

Dr. Heimer's major research efforts include scientific investigation of the mortality and morbidity associated with injection drug use. Areas of investigation include syringe exchange programs, HIV survival in syringes, hepatitis B vaccination, hepatitis C transmission risks, overdose prevention and resuscitation, and pharmacological treatment of opiate addiction. His research combines laboratory, operational, and ethnographic analyses to evaluate the effectiveness of intervention programs in preventing the negative medical consequences of injection drug use. Dr. Heimer is Director of the Interdisciplinary Research Methods Core at Yale's Center for Interdisciplinary Research on AIDS.

Extensive Research Description

Robert Heimer is a professor of epidemiology and public health and pharmacology at Yale University School of Medicine. He is also a director for the Yale Center for Interdisciplinary Research on AIDS. His primary research interests are mortality and morbidity in relation to injection drug use and HIV transmission. Dr. Heimer’s research provides health and prevention practitioners with information by examining consequences of drug abuse in the United States and Russia. He is the principal investigator for Yale Emerging Infections Program and for a project titled “Environmental Factors in HIV Transmission about Suburban IDUs.”

Robert Heimer received his M.S. and Ph.D. from Yale University. He is also a member of a Substance Use Working Group. Grants for his international work include: International Feasibility Study of Pharmacy-Based HIV Prevention: St. Petersburg Influences on HIV Prevalence and Service Access among IDU’s in Russia and Estonia.Influences on HIV Prevalence and Service Access among IDUs in Russia and Estonia (REGIMES)
We are studying the impacts of ethnicity and stigma on HIV prevalence and on access to HIV prevention and care services in St. Petersburg and Kohtla-Järve.
1 R01 DA029888-01 (Heimer/Uuskula)
09/01/2010– 07/31/2015
NIDA

Environmental Factors in HIV Transmission among Suburban IDUs (SHERPA)

Recent evidence suggests that injection drug use is increasing among suburban residents. Little research has focused on this trend, and the economic, social, and medical consequences have not been considered. To close this gap, we are proposing to identify, recruit, and study a valid sample of injectors who reside in Connecticut suburbs using respondent driven sampling (RDS).
5 R01 DA023408-04 (Heimer)
07/01/2007– 04/30/2012
NIDA

Drug Policy, Incarceration, Community Re-entry, and Race Disparities in HIV/AIDS (SHARRPP)
The project analyzes the interconnections among drug policies in the US, the massive migration in and out of the criminal justice (CJ) system that these policies have created, and race disparities in HIV risk.
7 R01 DA025021-02 (Blankenship)
09/15/2009– 07/31/2014
NIDA

Online Respondent-Driven Sampling & Data Collection for Men Who Have Sex with Men
The study assesses the feasibility of improving representativeness of samples of MSM recruited online, a population at acute risk for sexually transmitted infections.
1 R21 MH090920-01A1 (White)
01/01/2011– 12/31/2012
NIMH

Connecticut Emerging Infections Program (CT-EIP)
The Yale Emerging Infections Program, in partnership with the State of Connecticut Department of Public Health is responsible for carrying out surveillance for emerging and re-emerging infections of particular interest to the CDC, most notably foodborne, respiratory, hepatitis, lyme disease, and other infectious disease.
2009-0238 (Heimer)
12/30/2008– 12/29/2011
CDC

International Feasibility Study of Pharmacy-Based HIV Prevention: St. Petersburg
The study assesses the feasibility of using pharmacies as public health venues to provide HIV-prevention to injection drug users (IDUs) in St. Petersburg, Russia. This application is one of the linked R21 proposals developed by India,Vietnam, Russia and USA in preparation for a large-scale, multi-site randomized controlled intervention trial. The expected results of these studies will help to develop the training for the pharmacists to provide HIV- related services to IDUs as highly effective intervention that could be implemented in a wide variety of cultural settings.
5 R21 DA027228-02 (Shaboltas)
09/15/2009– 08/31/2012
NIDA

Alcohol and HIV Risk Reduction in St. Petersburg, Russian Federation
We are developing and testing a theory-based risk reduction intervention for men and women who drink alcohol, who are seeking VCT at STI clinics and are at risk for contracting and transmitting HIV in St. Petersburg, Russia.
5 R01 AA17389-04 (Abdala)
09/30/2007– 06/30/2011
NIAAA

Center for Public Health Excellence in HIV Prevention in the Russian Federation
The primary aim of the projects are (1) setting up a scientific and methodological center for research and development to facilitate efficiency improvement of organizations engaged in HIV control and prevention in the Russian Federation, (2) analyzing previously collected biobehavioral and surveillance data, (3)conducting studies on HIV prevalence in IDU and bridge populations in two Russian cities, and (4) developing manuals and courses to teach research methods on these topics.
CRDF 47.079 (Levina and Heimer)
6/15/2008- 3/31/2011
Civilian Research & Development Foundation

Monitoring and Evaluation of Program to Promote Youth Friendly Sexual and Reproductive Health Services in 8 CIS Nations
The primary aims of this project are to provide the implementers of the program with the reporting tools to determine the impact of their efforts and to analyze the reports to inform the project funder (the government of Finland) of project accomplishments and failures.
UREC6R52A Heimer (PI)
07/01/09– 07/31/11
UNFPA

Training and Research in HIV Prevention in Russia
This training grant continues to develop a cadre of researchers at four institutions in St. Petersburg thereby building capacity in Russian institutions to address their expanding HIV/AIDS epidemic.
5D43TW001028-10 (Heimer)
09/30/98– 05/31/16
Fogarty International Center

Center for Interdisciplinary Research on AIDS (CIRA)
Conduct research aimed at the prevention of HIV infection and reduction of the negative consequences of HIV disease in vulnerable and underserved populations. Through multidisciplinary collaborations, such research will identify determinants of risky behaviors, evaluate interventions in local, high-risk populations,develop and test models to assess the impact of these interventions on the epidemic, and determine transferability of specific intervention approaches between the United States and selected developing countries.
5 P30 MH062294-08 (Cleary)
09/30/2008– 06/30/2013
NIMH

Assessing Epidemiological Risks of Parenteral HCV Transmission in Drug Users
This project has been designed to understand the risks for transmission of the hepatitis C virus (HCV) through unsafe drug injection and evaluate methods to reduce transmission. The study protocol fuses into laboratory-based research the real-world observations on drug injection practices to analyze (1) the potential for HCV transmission resulting from the use of HCV-contaminated injection equipment, (2) the duration of HCV viability in injection equipment, (3) the potential for disinfectants to inactivate HCV, and (4) the potential for exposure to infectious HCV in various drug preparation and injection practices common in parts of the world where the HCV epidemic among injection drugs users is still rapidly increasing.
R01 DA030420-A101 (Heimer)
07/01/2011 – 06/30/2016
NIDA

Selected Publications

  • Beletsky L, Grau LE, White E, Bowman S, Heimer R. (2012) Prevalence, characteristics, and predictors of police training initiatives by US SEPs: building an evidence base for structural interventions. Drug & Alcohol Dependence, 119:145-149.
  • Levina OS, Heimer R, Odinokova V, Bodanovskaya Z, Irwin KS, Niccolai LM. (2012) Sexual partners of street-based female sex workers in St. Petersburg: A model of partnership characteristics as a basis for further research. Human Organization, 71:32-43.
  • Heimer R, Dasgupta N, Irwin KS, Phinney Harvey A, Givens A, Grau LE. (2012) Chronic pain, addiction severity, and misuse of opioids in Cumberland County, Maine. Addictive Behaviors, 37:346-349.
  • Beletsky L, Agrawal Kapur A, Moreau B, Kumar P, Weiss-Laxser N, Moreau B, Heimer R. (2011) Police training to align law enforcement and HIV prevention: preliminary evidence from the field. American Journal of Public Health, 101:2012-2105.
  • Ober AJ, Iguchi MY, Weiss RE, Gorbach PM, Heimer R, Ouellet LJ, Shoptaw S, Anglin MD, Zule WA. (2011) The relative role of perceived partner risks in promoting condom use in a three-city sample of high-risk, low-income women. AIDS & Behavior, 15:1347-5
  • Niccolai, LM, Verevochkin SV, Toussova OV, White E, Barbour R, Kozlov AP, Heimer R. (2011) Estimates of HIV incidence among drug users in St. Petersburg, Russia: Continued growth of a rapidly expanding epidemic. European Journal of Public Health, 25:6
  • Grau LE, White E, Niccolai LM, Toussova OV, Verevochkin SV, Kozlov AP, Heimer R. (2011) HIV disclosure, condom use, and awareness of HIV infection among HIV-positive, heterosexual drug injectors in St. Petersburg, Russian Federation. AIDS & Behavior,15:
  • Beletsky L, Grau LE, White E, Bowman S, Heimer R. (2011) The roles of law, client race, and program visibility in shaping police interference with the operation of US syringe exchange programs. Addiction, 106:357-365.
  • Green TC, Grau LE, Colon N, Carver HW, Kinzly ML, Heimer R (2011) Trends in fatal opioid intoxications in Connecticut: 1997-2007. Drug & Alcohol Dependence, 115:221-228.
  • Paintsil E, He H, Peters C, Lindenbach BD, Heimer. (2010) Survival of hepatitis C virus in syringes: implication for transmission among injection drug users. Journal of Infectious Diseases, 202:984-990.
  • Beletsky L, Grau LE, White E, Bowman S, Heimer R. (2010) The roles of law, client race, and program visibility in shaping police interference with the operation of US syringe exchange programs. Addiction, 106:357-365.
  • Cepeda JA, Odinokova V, Heimer R, Grau LE, Lyubimova A, Safiullina L, Levina O, Niccolai LM (2010) Drug network characteristics and HIV risk among injection drug users in Russia: The roles of trust, size, and stability. AIDS & Behavior, On-line First, 2
  • Grau LE, White E, Niccolai LM, Toussova OV, Verevochkin SV, Kozlov AP, Heimer R. (2010) HIV disclosure, condom use, and awareness of HIV infection among HIV-positive, heterosexual drug injectors in St. Petersburg, Russian Federation. AIDS & Behavior, On
  • Rudolph A, Crawford N, Latkin C, Heimer R, Benjamin, E, Jones K, Fuller C (2010) Sub-populations of illicit drug users reached by targeted street outreach and respondent driven sampling strategies: Implications for research and public health practice. A
  • Abdala N, White E, Toussova OV, Krasnoselskikh TV, Verevochkin SV, Kozlov AP, Heimer R (2010) Comparing sexual risks and patterns of alcohol and drug use between injection drug users (IDUs) and non-IDUs who report sexual partnerships with IDUs in St Pete
  • Niccolai, LM, Verevochkin SV, Toussova OV, White E, Barbour R, Kozlov AP, Heimer R. (2010) Estimates of HIV incidence among drug users in St. Petersburg, Russia: Continued growth of a rapidly expanding epidemic. European Journal of Public Health, 2010
  • Green TC, Bluthenthal RN, Singer M, Beletsky L, Grau LE, Marshall PA, Heimer R. (2010) Prevalence and predictors of transitions to and away from syringe exchange use over time in three US cities with varied syringe dispensing policies. Drug & Alcohol D
  • Niccolai LM, Toussova OV, Verevochkin SV, Barbour R, Heimer R, and Kozlov AP. (2010) High HIV prevalence, suboptimal HIV testing, and low knowledge of HIV-positive serostatus among injection drug users in St. Petersburg, Russia. AIDS & Behavior, 14:932
  • Heimer R, White E. (2010) Estimation of the number of injection drug users in St. Petersburg, Russia. Drug & Alcohol Dependence, 109:79-83.
  • Green TC, Kershaw T, Lin H, Heimer R, Goulet JLm Kraemer KL, Gordon AJ, Maisto SA, Day NL, Bryant K, Fiellin DA, Justice AC. (2010) Patterns of drug use and abuse among aging adults with and without HIV: A latent class analysis of a US Veteran cohort.
  • Zelterman D, Tulupyev A, Abdala N, Heimer R. (2010) Statistical design for a small serial dilution series. Statistics in Medicine, 9:411-420.
  • Paintsil E, Verevochkin SV, Dukhovlinova E, Niccolai LM, Barbour R, White E, Toussova OV, Kozlov AP, Heimer R. (2009) Hepatitis C virus infection among drug injectors in St. Petersburg, Russia: social and molecular epidemiology of an endemic infection.
  • Grau LE, Green TC, Singer M, Bluthenthal R, Marshall PA, Heimer R. (2009) Getting the message straight: effects of a brief hepatitis prevention intervention among injection drug users. Harm Reduction Journal 2009, 6:e36.
  • Connally NP. Durante AJ. Yousey-Hindes KM. Meek JI. Nelson RS. Heimer R. (2009) Peridomestic Lyme disease prevention: results of a population-based case-control study. American Journal of Preventive Medicine. 37:201-206.
  • Niccolai LM, Shcherbakova IS, Toussova OV, Kozlov AP, Heimer R. (2009) The potential for bridging of HIV transmission in Russian Federation: Sex risk behaviors and HIV prevalence among drug users (DUs) and their non-DU sex partners. Journal of Urban Heal
  • Toussova OV, Shcherbakova IS, Volkova GV, Niccolai LM, Heimer R, Kozlov AP. Potential bridges of heterosexual HIV transmission from drug users to the general population in St. Petersburg, Russia: is it easy to be a young female? Journal of Urban Health,86
  • Iguchi MY, Ober AJ, Berry SH, Fain T, Heckathorn DD, Gorbach P, Heimer R, Kozlov AP, Ouellet, LJ, Shoptaw S, Zule WA (2009) Simultaneous Recruitment of Drug Users and Men Who Have Sex with Men in the United States and Russia using Respondent Driven Sampli
  • Green TC, Grau LE, Blinnikova KN, Torban M, Krupitsky EM, Ilyuk R, Kozlov AP, and Heimer R (2009) Social and structural aspects of the overdose risk environment in St. Petersburg, Russia. International Journal of Drug Policy,20:270-276.
  • Kruse GR, Barbour R, Heimer R, Shaboltas AV, Toussova OV, Hoffman IF, Kozlov AP (2009) Drug Choice, Spatial Distribution, HIV Risk, and HIV Prevalence among Injection Drug Users in St. Petersburg, Russia. Harm Reduction Journal, 6:e22.
  • Hu Y, Grau LE, Scott G, Seal KH, Marshall PA, Singer M, Heimer R (2008) Economic Evaluation of Delivering Hepatitis B Vaccine to Injection Drug Users. American Journal of Preventive Medicine, 35:25-32.
  • Grau LE, Green TC, Torban M, Blinnikova K, Krupitsky EM, Ilyuk R, Kozlov AP, Heimer R. (2009) Psychosocial and Contextual Correlates of Opioid Overdose Risk among Drug Users in St. Petersburg, Russia. Harm Reduction Journal, 6:e17.
  • Green TC, Grau LE, Heimer R (2008) Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose prevention and response programs in the Unites States. Addiction, 103:979-989.
  • Heimer R, Grau LE, Singer M, Scott G, Marshall PA, Hu Y, and Seal KH (2008) Hepatitis B virus prevalence and vaccination rates among Hispanic injection drug users participating in a vaccination campaign operated at syringe exchange programs. Journal of
  • Heimer R, Barbour R, Shaboltas AV, Hoffman IF, and Kozlov AP (2008). Spatial distribution of HIV prevalence and incidence among injection drugs users in St. Petersburg, Russia: Implications for HIV transmission. AIDS, 22:123-130.
  • Heimer, R. (2008) Community coverage and HIV prevention: Assessing metrics for estimating HIV incidence through syringe exchange. International Journal of Drug Policy,19S:S65-S73.

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