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Frederick Lewis Altice, MD, MA

he/him/his
Professor of Medicine (Infectious Diseases) and of Epidemiology (Microbial Diseases)
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Additional Titles

Affiliated Faculty, Yale Institute for Global Health

Director, Yale Center for Clinical and Community Research, Department of Medicine

Director, HIV in Prisons Program, Infectious Diseases

Director, Community Health Care Van, Intersection of Infectious Diseases and Substance Use Disorders/Addiction Medicine

Academic Icon Professor of Medicine, University of Malaya-Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine , University of Malaya

About

Titles

Professor of Medicine (Infectious Diseases) and of Epidemiology (Microbial Diseases)

Affiliated Faculty, Yale Institute for Global Health; Director, Yale Center for Clinical and Community Research, Department of Medicine; Director, HIV in Prisons Program, Infectious Diseases; Director, Community Health Care Van, Intersection of Infectious Diseases and Substance Use Disorders/Addiction Medicine

Positions outside Yale

Academic Icon Professor of Medicine, University of Malaya-Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine , University of Malaya

Biography

Frederick (Rick) L. Altice is a professor of Medicine, Epidemiology and Public Health and is a clinician, clinical epidemiologist, intervention and implementation science researcher at Yale University School of Medicine and School of Public Health. Dr. Altice’s primary research focuses on interventions and implementation science at the interface between infectious diseases and addiction and he has conducted research in several global health settings. He also has a number of projects working in the criminal justice system, including transitional programs addressing infectious diseases, medications for opioid use disorder (methadone, buprenorphine, extended release naltrexone), mental illness, homelessness and social instability. Specific topics include alcohol, opioid, stimulant and nicotine use disorders on HIV treatment outcomes, HIV and addiction treatment, interface with the criminal justice system, and pharmacokinetic drug interactions between treatment for substance use disorders and antiretroviral and tuberculosis therapy. At a basic level, his research focuses on clinical epidemiology, especially in key populations at risk for HIV (e.g., MSM, TGW, PWID, prisoners, sex workers) and development, adaptation and evaluation of of biomedical and behavioral interventions to improve treatment outcomes. His research, however, has evolved and included development and testing of mobile technologies (mHealth) to intervene with key populations to promote health outcomes. His research is especially concentrated in health services research techniques with a focus on implementation science, seeking to introduce and scale-up evidence-based interventions in numerous contexts. A number of implementation science strategies are underway to examine scale-up of medication-assisted therapies to treat opioid use disorder in community, criminal justice and in primary care settings. Most recently, his work has been augmented through use of decision science techniques to understand and promote patient preferences, including the development of informed and shared decision-making aids. His work has emerged primarily with a global health focus with funded research projects internationally in Malaysia, Ukraine, Moldova, Armenia, Kyrgyzstan, Peru, and Indonesia. He has participated in projects through the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Agency, Special Projects of National Significance with HRSA, and the Center for Substance Abuse Treatment. He is currently also collaborating on projects with the WHO, UNAIDS, USAID, PEPFAR and UNODC. Current internationally funded projects in dedicated research sites that are being conducted in Malaysia, Ukraine, Moldova, Azerbaijan, Armenia, Kyrgyzstan and Peru. His research and training sites in Malaysia (2005), Peru (2010) and Ukraine (2005) are dedicated training and research sites for the Global Health Equity Scholars Fogarty Training Program and the Doris Duke International Fellowship program. He is currently the director for two International Implementation Science Research and Training Centers with collaborations between Yale University and the University of Malaya and Sichuan University.

Appointments

Education & Training

MA
Yale University, Honorary (2008)
Fellow
Yale University School of Medicine (1992)
Resident
Yale University School of Medicine (1989)
MD
Emory University (1986)
MA
Universidad de Santiago de Compostela, Spanish Literature (1982)

Research

Overview

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 the Academic Icon 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.

CURRENT STUDIES

  1. Malaysian Center for Implementation Science: This five-year hybrid training program in HIV implementation science is positioned to train the next generation of implementation science in Malaysia. The program will train 4 faculty scholars from University of Malaya who will increasingly assume training and 10 PhD candidates who will earn their PhD in public health. Both faculty and students will complete a Certificate Program in Implementation Science. Each summer, 25-30 real-world implementers will participate in a 2-week implementation science boot camp, where training will involve additional training in human rights. Funding: Fogarty International Center; Principal Investigators: Altice and Kamarulzaman.
  2. 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 and in several other countries in Eastern Europe and Central Asia (Ukraine, Moldova, Armenia, Georgia, Kyrgyzstan). Funding: NIDA. Principal Investigator: Altice
  3. Integrating Methadone, HIV and TB treatment into Primary Care Settings in Ukraine: This type II implementation science, step-wedge, cluster, randomized controlled trial using an implementation science strategy compares quality health indicators for patient randomized to treatment with methadone in addiction specialty care settings (control) with methadone in primary care settings with or without pay-for-performance incentives. Implementation will be provided through Project ECHO-like collaborative learning models to provides a collaborative learning environment to make primary care clinicians competent at treatment with methadone, and provide HIV and TB treatment. Cost-effectiveness analyses included.
  4. Expanding Medication-Assisted Therapies in Ukraine: This implementation science study uses both quantitative and quantitative surveys of PWID and physicians/nurses followed by coaching using the NIATx treatment improvement model to increase entry and retention on OAT.
  5. MEDIUM: This Type II hybrid implementation science study uses a cluster, randomized trial of 36 sites in Ukraine to compare the outcomes on depression outcomes in addiction treatment centers of deploying a SBIRT strategy for patients with opioid use disorder and co-morbid depression. The three arms are standard of care, SBIRT or SBIRT using a pay-for-performance strategy. Both of the SBIRT arms receive facilitation using Project ECHO-like collaborating learning models. Funding: NIDA/NIMH (Altice, MPI).
  6. Multisite Opioid and HIV Response Endeavor (MOhRE): This Special Project of National Significance (SPNS) is an implementation science study collaboration between Yale University and five states profoundly impacted by the opioid epidemic (Kentucky, West Virginia, Vermont, Connecticut, New Hampshire) and where there is a focus on rural responses to the epidemic. After completing a gap and legal analysis, Project MOhRE uses the NIATx treatment improvement model to scale-up treatment using medications for opioid use disorder and to integrate these services with HIV treatment and prevention. Funding: HRSA (Altice, PI).
  7. Harapan II: This is a study of HIV/TB infection in prisons in Malaysia to identify the most optimal strategy for screening for TB in this setting, to conduct a RCT of prevention of latent TB infection comparing 26 weeks of daily isoniazid vs 12 weeks of weekly isoniazid/rifapentine, and a RCT of HIV/TB patients with opioid dependence who are transitioning to the community who will be randomized to a preference trial comparing implantable naltrexone vs methadone vs no medication-assisted therapy. Cost-effectiveness and TB prevention modeling will be conducted.
  8. CoReCT: The two key elements of this study is to create a data to care (D2C) strategy to identify people with HIV who are recently out of HIV care and randomize them to a disease intervention specialist (DIS) that is adapted from the ARTAS intervention vs standard of care. This multisite study involves Connecticut, Massachusetts and Philadelphia. Funding: CDC (Altice, MPI with Villanueva)
  9. NIDA R01 DA032290 (Copenhaver, PI; Altice, Co-I) 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+). Funding: NIDA.Principal Investigator: Altice.
  10. Using Artificial Intelligence and Machine Learning to Develop a ChatBot: This formative research is to develop an ChatBot that MSM can embed within a social networking app to help guide and promote HIV testing in the Malaysian context where homosexuality is illegal in both Sharia and secular law. It is an improvement over many app-based testing strategies since it does not require major app updates and human resources to maintain it and works within apps that MSM already use frequently. Funding: NIAID; Principal Investigator: Altice.
  11. Implementation of an AI/ML Informed ChatBot to Promote HIV Testing in MSM: This 5-year study refines a ChatBot informed by artificial intelligence and machine learning to promote HIV testing and screen for and address depression and amphetamine-type substance use in MSM. The app involves a Type 1 implementation science trial using the REAIM framework and will take place in Malaysia. Funding: Fogarty International Center; Principal Investigators: Altice, Ni.

RECENTLY COMPLETED

  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 Investigator: Altice
  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. Project Harapan I: 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
  5. Exploring the Within Prison Risk Environment and HIV Transmission in Kyrgyzstan: This study will use qualitative surveys of opioid dependent prisoners with and without HIV and examine how the risk environment as prisoners transition to the community. Funding: NIDA.Principal Investigator: Meyer (Altice, Co-I).
  6. NIDA R01 HD075630 Title: ART Adherence and Secondary Prevention of HIV. Description: To conduct a RCT using contingency management (CM) verus CM + direct video observation among HIV+ patients with problematic adherence. Funding: NIDA. Co-investigator: Altice (PI: Petry).
  7. EnhanceLink: 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. 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. AHORA-L: Title: HIV Testing and Treatment to prevent onward HIV Transmission among high-risk MSM in Peru. This RCT compares HIV treatment outcomes (viral suppression and ART adherence) in newly diagnosed HIV+ MSM with alcohol use disorders and newly initiating ART over 12 months. (PI: Duerr, Co-I: Altice - Protocol Chair: Altice.
  10. Modeling HIV/HCV Transition Dynamics of Injection Networks of PWID. This study uses data from over 500 PWID and their 2500 individuals in their injection network. Modeling will include identification of the most effective strategy to use treatment as prevention with or without various HIV prevention (OAT / NSP) strategies. Funding: NIDA.Principal Investigator: Altice.
  11. mHealth: 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. Funding: HRSA; Principal Investigator: Altice.
  12. Project SMART: This is a pilot feasibility study comparing a control condition (medication monitoring) versus automated text reminders and automated text reminders plus nurse-based counseling in HIV+ patients with cocaine use disorders with the outcome being ART adherence. Funding: NIDA.Principal Investigator: Altice.

Medical Subject Headings (MeSH)

Acquired Immunodeficiency Syndrome; AIDS-Related Opportunistic Infections; Behavioral Medicine; Chemicals and Drugs; Cognitive Behavioral Therapy; Community Medicine; Community-Based Participatory Research; Decision Making; Epidemiology; Global Health; Health Care; Health Status Disparities; Healthcare Disparities; Hepatitis, Viral, Human; HIV Infections; Implementation Science; Infectious Disease Medicine; Mobile Health Units; Social Medicine

Research at a Glance

Yale Co-Authors

Frequent collaborators of Frederick Lewis Altice's published research.

Publications

2024

Clinical Trials

Current Trials

Academic Achievements & Community Involvement

  • activity

    American Public Health Association

  • activity

    American College of Physicians

  • activity

    Infectious Disease Society of America

  • activity

    International AIDS Society

  • activity

    Society for Correctional Physicians

Clinical Care

Overview

Clinical Specialties

Internal Medicine; HIV & AIDs Medicine; Addiction Medicine

Board Certifications

  • Internal Medicine

    Certification Organization
    AB of Internal Medicine
    Original Certification Date
    1989

Get In Touch

Contacts

Academic Office Number
Office Fax Number
Mailing Address

Infectious Diseases

135 College Street

New Haven, CT 06510-2283

United States

Administrative Support

Locations

  • Yale Center for Clinical and Community Research Office

    Lab

    270 Congress Avenue

    New Haven, CT 06519

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