Skip to Main Content

HIV and Substance Use Syndemic

OUD affects individuals from urban, suburban, and rural communities alike, with persons at low income levels, residents of rural areas, and persons with mental illness being among those at highest risk of prescription opioid misuse and abuse patterns.

It is therefore a public health priority to ensure expansion of evidence-based treatments for persons with OUD to reduce opioid overdose and the transmission of HIV and HCV.We have three aims for O-SWG activity:

  1. To improve collaborations of the researchers and clinicians with considerable expertise in opioid research at Yale and its partners to forge more interdisciplinary research to tackle vital issues in the opioid epidemics in the U.S. and abroad, with specialattention to New England.
  2. To nurture young investigators and those new to the opioid research arena in developing excellent research ideas and proposals.
  3. To link regionally with important state, academic, and service agency partners, alongside communitiesand practitioners, for community-participatory research endeavors. This includes our special relationship with UCONN and UPR.

An innovative element of our work is new interdisciplinary attention to the question of primary prevention of opioid misuse. Why has the desire for the euphoric and pain-dulling effects opioids increased in so many places in the US during this third crisis? The answers are complex and most likely not easily remediated because they lie in social and economic transformations over the last three decades. Large numbers of young and middle-aged people are unemployed or underemployed, adrift without adequate social support, and seeking escape within the context of an eroded social safety net. Until these problems are addressed, we must mitigate the immediate problems of often-untreated opioid use disorder, relapse, and overdose. This will require destigmatizing opioid use disorder by recognizing it as a treatable chronic disease, with a favorable prognosis if properly treated. The research agenda for novel approaches, interventions, and efforts for scale-up is highlighted here as the basis for our O-SWG aims and workplan.


  • Director

    Professor of Medicine (AIDS) and Associate Clinical Professor of Nursing; Director, Infectious Disease Outpatient Clinic, Veterans Administration Healthcare Services, Newington

    Research Interests
    • Acquired Immunodeficiency Syndrome
    • Alcoholism
    • Buprenorphine
    • Community Health Workers
    • HIV
    • Mobile Health Units
    • Naltrexone
    • Opioid-Related Disorders
    • Prisoners
    • Risk-Taking
    • Randomized Controlled Trial
    • Substance-Related Disorders
    • Patient Navigation
    • Pre-Exposure Prophylaxis
    • Addiction Medicine
    Sandra Springer, MD is a Professor of Medicine in the Department of Internal Medicine, Section of Infectious Diseases at the Yale School of Medicine. Dr. Springer is Board-Certified in Internal Medicine, Infectious Diseases and Addiction Medicine. She is also an attending physician at the Veterans Administration Connecticut Healthcare System (VACHS) and the Director of the Infectious Disease Clinic at the Newington site of the VACHS. She is an appointed member of the International Antiviral Society–USA (IAS–USA) Antiretroviral Guidelines Panel as well as a Core Faculty member and has been appointed to the National Academies of Sciences, Engineering, and Medicine’s Committee on Framework for the Consideration of Chronic Conditions in Women. She mentors students across disciplines including public health, medicine, and the social sciences. Her research centers on the integration of substance use and infectious diseases with a focus on opioid use treatment and the treatment and prevention of HIV infection in people with carceral experience. In 2022, she was awarded the NIDA Avant Garde award for her innovative proposal to bring mobile health care for substance use and infectious diseases to where people live, through a mobile pharmacy and clinic. She is the director of her clinical research lab InSTRIDE (Integrating Substance use Treatment Research with Infectious Disease for Everyone) which encompasses a multidisciplinary team including research staff, clinicians, community health workers, and patient navigators as well as a mobile health unit and a mobile pharmacy and clinic.
  • Co-Director

    Professor of Epidemiology (Microbial Diseases) and of Pharmacology; Affiliated Faculty, Yale Institute for Global Health

    Research Interests
    • Acquired Immunodeficiency Syndrome
    • Epidemiology
    • Foodborne Diseases
    • Hepatitis C
    • Injections
    • Public Health
    • Russia
    • Vietnam
    • Global Health
    • HIV Infections
    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, virus 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, behavioral, and structural analyses to evaluate the effectiveness of intervention programs in preventing the negative medical consequences of injection drug use. Dr. Heimer is a member of Yale’s Center for Interdisciplinary Research on AIDS (CIRA) and former Director of its Interdisciplinary Research Methods Core. His current work focuses on the contexts and consequences of the opioid crisis in CT and the systemic of HIV, viral hepatitis, and injection drug use nationally and globally. Dr. Heimer previously served as Principal Investigator of the Yale office of the Connecticut Emerging Infections Program. This Centers for Disease Control and Prevention-funded program is one of ten 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 foodborne illnesses, and respiratory illnesses (especially influenza), Lyme and other tickborne diseases, Clostridium difficile, and the prevention of human papillomavirus infections. Dr. Heimer received his training in molecular biology and pharmacology at Columbia College (BA) and Yale University (MA, PhD). He began his work on the prevention of HIV among injection drug users in 1990 with an evaluation of the city-run New Haven needle exchange program and his work on emerging infections in 1995 with studies of the tick-borne agent of human ehrlichiosis.
  • Co-director

    Dr. Carmen Albizu-García is a physician and a Professor at the Health Services Evaluation program within the Department of Health Services Administration at the Puerto Rico Graduate School of Public Health and a researcher at the Center for Evaluation and Sociomedical Research. She has co-authored research manuscripts in mental health services research, addressing factors associated with services utilization among the medically indigent. Dr. Albizu-García recently examined the extent of turnover in mental health and substance abuse (MHSA) provider networks within public sector managed behavioral care over a one-year period and its association to provider and practice characteristics. Her current preliminary studies explore mental health services provider's perceptions of their organizational climate as well as its correlates.