Patients with substance use disorders are disproportionately affected by infectious diseases, particularly HCV and HIV. It is challenging to bridge the gap between the disparate disciplines of substance abuse and infectious diseases. I have fortunately and deliberately achieved considerable success in managing each of these conditions clinically. Through clinical activities, directed mentorship, participation in research and contribution to the medical literature at the interface of infectious diseases and substance abuse, I am now in a position to redirect my training to develop into an independent, patient-oriented researcher. In order to make this transition from clinician to researcher, I have identified three major career goals: 1) To gain expertise in the pharmacological treatment of substance abuse and the implementation of therapeutic research in the substance abuse treatment setting;2) To develop expertise in research methods necessary to design, implement, and evaluate effective and integrated interventions in community settings resulting in improved health outcomes for drug users with substance abuse disorders and HCV and/or HIV;and 3) To enhance my professional development toward an independent research career path in patient-oriented research at the challenging intersection of substance abuse and infectious diseases. I will accomplish these goals through didactic coursework and seminars, directed and multidisciplinary mentorship and participation in two feasible and related research projects. As part of my didactic coursework, I will obtain a Masters in Science in Epidemiology. My first research project will be to conduct an analysis of the treatment outcomes of HCV treatment among prisoners using a retrospective analytic approach. The second research project will occur in two phases and will seek to develop and evaluate novel strategies for the treatment of HCV infection among opioid-dependent patients within a drug treatment program. Intervention development will occur with both methadone (MMT) and buprenorphine (BMT) maintenance treatment. Among these, the adherence to therapy intervention will compare onsite or co-location of HCV services with HCV services provided off-site from the drug treatment program. Data used from the two phases of this study will provide an effect estimate that will be used for a R01 submission to conduct a randomized controlled trial.
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