Spotlight: Chukwuemeka Okafor, Ph.D.

Maryann Zacharias Uncategorized

Chukwuemeka Okafor, PHD

Chukwuemeka Okafor, PHD

Dr. Okafor Giving his presentation

Dr. Okafor Giving his presentation

On Thursday, June 30th, 2016 Chukwuemeka Okafor, MPH, Ph.D, defended his dissertation titled, “Marijuana Use Among HIV-Seropositive and HIV-Seronegative Men: Long Term Trends, Predictors of Use, and Impact on Cognitive Function.”

Dr. Okafor earned his Bachelors in Biochemistry from the University of Lagos in Nigeria and his Masters in Health Behavior from the University of North Florida in 2012. He then came to the University of Florida to pursue his Ph.D in Epidemiology as a graduate fellow through the College of Public Health and Health Professions. Dr. Okafor has since focused on the cognitive and inflammatory impacts of substance use, including cannabis use, in individuals living with HIV.

Dr. Okafor has been a major contributor to SHARC since he joined in 2012. He has helped recruit participants in the Florida Cohort Study, presented several posters using SHARC data, and has been actively involved with the WHAT-IF? project.

During his time with SHARC, Dr. Okafor finds that his most significant accomplishments must be the collaborations he was able to do with faculty and students. “It was truly and amazing learning experience that was productive in the end,” he said. These collaborations culminated in the publication of two primary-authored papers. In addition to this, another important accomplishment for Dr. Okafor was obtaining an F31 research training grand from NIDA, and he acknowledged, “The many interactions with the faculty in SHARC proved very helpful in fine-tuning my research protocol/study design for the training grant.”

Currently, Dr. Okafor is working on publishing two of the papers from his dissertations. The first looks at long-term trends in the prevalence of marijuana use and the second looks at the effects of cumulative exposure to marijuana cognitive function among HIV-positive and HIV-negative men.

Regarding his future goals, Dr. Okafor plans to pursue an academic research career that will focus on biomedical HIV prevention approaches, particularly among high-risk groups that include young minority men who have sex with men, as well as among drug users. Dr. Okafor has accepted a post-doctoral position at the University of California, Los Angeles, and plans to continue research there.

Spotlight: Jon Mills, M.B.A, Ph.D.

Maryann Zacharias Uncategorized

Jon Mills

Jon Mills, MBA, PHD

On June 2, 2016, Jon Mills, MBA, PhD, defended his dissertation titled, “Comparative Effectiveness of Dual-Action versus Single-Action Antidepressants for Treatment of People Diagnosed with Co-Occurring HIV/AIDS and a Major Depression: A Growing Syndemic,” a study that involved a collaboration with the CFAR Network of Integration Clinical Systems (CNICS) cohort study.

Dr. Mills was a doctoral student at SHARC. He completed his Masters in Business Administration at the University of Colorado and went on to pursue a PhD in Health Services Research as a student at the University of Florida.

Dr. Mills was an active student member of SHARC. He has attended all SHARC conferences and presented posters using SHARC data. He was the leader of the Medical Monitoring Project (MMP) working group and is the primary author on three abstracts and one manuscript using this data.

His most recent paper as a primary author is titled, “The comparative impact of different patient-centered medical home domains on satisfaction among individuals living with type II diabetes.” The study focused on diabetes, however, patient-centered medical homes (PCMHs) are a model of providing care that is quite applicable to people living with HIV/AIDS. Dr. Mills hopes to complete a study at some point in the future analyzing collaborative care models like PCMHs in a population with HIV/AIDS and depression.

When asked about his most significant accomplishments at SHARC, Dr. Mills stated,“The main accomplishment was taking advantage of an incredible opportunity to collaborate with an exceptional group of faculty, students and staff. I experienced first hand the importance of collaboration especially when addressing a health issue as complex as HIV/AIDS and the co-morbidities common among this population.  Our task is not a one person job.”

Regarding his future goals, Dr. Mills has expressed interest in pursuing a career in academia. He intends to continue his research studying the impact of interventions, policies, and treatment for people suffering from co-occurring psychiatric/substance use disorder and HIV/AIDS. He would also like to continue developing expertise in comparative effectiveness research (CER), stating, “I learned from my dissertation that CER is much more complex than meets the eye. I find CER to be an essential type of research in translational science especially in the absence of a paradigm shift in treatment (e.g. discovery of a cure of HIV/AIDS).

Vanessa Ayala Wins Best Poster Presentation Award

Maryann Zacharias Uncategorized

MPH student Vanessa Ayala

From FIU’s Stemple News:

Most people don’t expect to catch Shark Week on TV until late June. But at FIU, we celebrated our own SHARC week a little earlier…

This year’s SHARC Conference took place on FIU’s Modesto A. Maidique Campus on May 18 and included workgroups, speakers and a poster session where students and investigators presented some of their work. However, this conference didn’t address the dangers of sharks in our waters and instead dealt with the twin dangers of alcohol and HIV.

“SHARC” stands for Southern HIV Alcohol Research Consortium and it’s a collaboration between researchers at FIU and the University of Florida who are on a mission to improve health outcomes and reduce HIV transmission among the diverse range of populations affected by alcohol and HIV infection in the Southeastern United States. Within this mission, the SHARC team is focusing on persons living in Florida, a state with high HIV incidence, substantial population diversity, and a high number of older persons living with HIV.

Although these are preliminary findings,  it suggests that there is more to learn about the process of testing, getting diagnosed and getting linked to the appropriate care resource for those who are incarcerated.

During the conference, Vanessa Ayala, who is pursuing a Masters in Public Health with a specialization in Epidemiologypresented a poster on linkage to care for those who were diagnosed with HIV in correctional facilities versus those who were diagnosed elsewhere. She found that those who were diagnosed in correctional facilities took longer to get linked to care, which has policy implications.

SHARC is funded by the National Institute on Alcohol Abuse and Alcoholism. Its principal investigators are Bob Cook, M.D., Ph.D. of UF and Maria Jose Miguez, M.D., Ph.D. of FIU. Other FIU investigators include FIU Stempel College faculty Jessy Devieu, M.P.H., Ph.D. andGladys Ibañez, Ph.D.For her work, Vanessa received the award for Best Poster Presentation.

Read the original article here.
Ms. Ayala was also featured in the ASPPH Friday newsletter!

Alcohol Use and Treatment in Women Living with HIV

Maryann Zacharias Uncategorized

From The Association of Schools and Programs of Public Health, written by Jill Pease:

A pair of recent University of Florida studies examines reasons for alcohol consumption and use of alcohol treatment among women living with HIV.

About half of women who are HIV positive report consuming alcohol and 14 to 24 percent drink at hazardous levels. Hazardous drinking can lead to adverse health effects, such as lower medication adherence and increased risky sexual behavior, and, as a result, higher levels of HIV virus in the body and more rapid disease progression. To better understand the unique reasons that women with HIV drink alcohol, a UF team conducted four focus groups in Jacksonville, FL, Washington, DC, and Chicago, IL.

Robert Cook, MD, MPH

Dr.Robert Cook

“Most all of the existing data on alcohol and HIV is from studies that mostly included men,” said lead author Dr. Robert Cook, a professor of epidemiology and medicine at the UF College of Public Health and Health Professions and the College of Medicine, and director of the Southern HIV Alcohol Research Consortium. “Women often drink alcohol for different reasons than men do. For example they are more likely to drink in response to depression. Therefore, we were interested in learning the consequences of drinking in women, as well as the potential benefits women get from drinking.”

The team found that women’s reasons for drinking included managing pain, coping with emotions or social engagement. Participants reported several consequences to their drinking, such as negative effects to their health, including poor medication adherence, risky or regrettable behavior and adverse effects on relationships. The findings appear in the journal BMC Public Health.

In the second study, published in the Journal of Substance Abuse Treatment, a team led by Dr. Xingdi Hu, a recent graduate of the UF doctoral program in epidemiology, studied use of alcohol treatment programs in nearly 500 women with HIV who were participants in the Women’s Interagency HIV Study cohort. About one in five said they had recently used some kind of alcohol treatment, with Alcoholics Anonymous being the most commonly reported program.

“We were surprised to learn that women with fewer economic resources were more likely to obtain treatment,” said Dr. Cook, the study’s senior author. “Usually, it’s the other way around — people with more resources get more health services. But in this case, perhaps if participants were unemployed they had more time available to engage in treatment, or they could take advantage of a treatment program that has little to no costs, such as Alcoholics Anonymous.”

Taken together, the two studies provide researchers with important information for developing alcohol interventions and implementing them in public health settings.

“Our research suggests that women may be more receptive to treatment if we can ensure that we can manage any symptoms that they were treating with alcohol, such as pain or depression,” Dr. Cook said. “We also need to think of ways to provide substance abuse interventions that involve little or no cost, for example, cell phone apps.”

Researchers Explore Key Lessons from HIV Programs to Redesign Refugee Health Services

Maryann Zacharias Uncategorized

Dr. Miriam Rabkin (photo credit: ASPPH)


Dr. Wafaa El-Sadr (photo credit: ASPPH)

The worldwide response to the HIV epidemic provides a standard which researchers, policymakers, and providers can use to better service those with non-communicable, chronic diseases, particularly in emergencies. In a recent study, Dr. Wafaa El-Sadr, professor of epidemiology at Columbia University and ICAP global director, and Dr. Miriam Rabkin, professor of epidemiology at Columbia and director of Health Systems Strategy at ICAP, and Fouad M. Fouad, assistant research professor of epidemiology and population health at the American University of Beirut, explored evidence-based approaches, intensive patient education, and the use of outreach workers and peer educators as potential lessons from HIV programs in order to reevaluate and redesign refugee health services.

The refugee crisis is a contemporary problem, highlighting the significance of this research. While the health needs of displaced groups have expanded in recent years, health and relief organizations have traditionally concentrated on infectious diseases, acute illness, and reproductive health. Chronic, non-communicable diseases (NCDs) such as cardiovascular disease, cancer, and diabetes, are gaining attention as a serious burden for refugees, and especially for refugees from middle-income countries, such as Syria, Iraq, and Ukraine.

According to Dr. El-Sadr, “The challenge of providing services for chronic illness in the context of displacement is a daunting one, given that a key element of effective care for NCDs is continuity – the need to deliver coordinated services over time, but evidence from HIV programs shows that continuity care can be delivered in challenging settings – including in complex humanitarian emergencies – and suggests key priorities for NCD services for forcibly displaced people.”


Brown Unviersity Develops Coding System to Characterize Topics of Patient Speech in a Motivational Intervention for Alcohol and HIV/Sexual risk in Emergency Department Patients

Maryann Zacharias Uncategorized


Dr. Christopher W. Kahler (photo credit: ASPPH)

Brown University’s Dr. Christopher W. Kahler, professor and department chair of behavioral and social sciences, and colleagues developed a topic coding system and found that topic coding may be a valuable resource for counselors.

Coding patient language allows for healthcare professionals to gain insight into patient behavior. It is a way to understand the causes behind behavior change and could thus lead to more efficient and effective methods in health behavior counseling. According to the paper, behavior change counseling covers topics such as the patient’s behavior pattern, barrier and facilitators of change, and change plans. Dr. Kahler and his colleagues explore how the topics discussed in a health behavior intervention correlate to patient change language across two target behaviors: alcohol use and sex risk.

In the study, researchers used the new Generalized Behavior Intervention Analysis System (GBIAS) in coding sessions of an effective intervention that reduced both alcohol use and sexual risk behaviors. The demonstration resulted in insight that could be valuable to counselors when dealing with alcohol and sex with patients.

The study was published in Patient Education and Counseling. To read the complete paper, click here.

2016 CHAART Scientific Meeting

Maryann Zacharias Uncategorized


CHAART Consortia from the 2016 Scientific Meeting in Washington, D.C.

The CHAART Scientific Meeting took place February 8-9, 2016 in Washington, D.C. The meeting was organized by the consortium to improve outcomes in HIV/AIDS, alcohol, aging, and multi-substance use  and included active participation by the NIAAA scientific staff and other CHAART members, including SHARC’s very own Robert Cook, MD, MPH, Natalie Kelso, MSW, and Eric Porges, Ph.D.


Spotlight: Alex Zirulnik, M.P.H. and Ezekial Ojewale, M.D., M.P.H.

Maryann Zacharias Uncategorized


Ezekiel Ojewale and Alex Zirulnik visiting the FIU Campus


Alex Zirulnik, M.P.H. plays an important role in Southern HIV and Alcohol Research Consortium (SHARC) as the Florida Cohort research coordinator. Zirulnik grew up in Jackson, Mississippi and attended University of Florida for his higher education. He earned his bachelor’s degree in Microbiology from the University of Florida College of Agriculture and his Masters of Public Health, with a focus on epidemiology, from the University of Florida College of Public Health and Health Professions. He is also certified in Public Health. Regarding his future goals, Zirulnik looks forward to attending medical school, moving out West to attend a residency in Emergency Medicine, and living a life full of adventure.

As a research coordinator, Zirulnik is very involved with the Florida Cohort project.

“I enjoy bringing together a population that often finds themselves secluded from research. [Through the project] I’ve had the opportunity to work with patients and hear their stories which has been very influential on my medical career pursuits. I also enjoy the many opportunities to collaborate with researchers all across the state of Florida.”

Alex will be leaving SHARC this summer in order to attend the University of Florida College of Medicine.

Taking over Zirulnik’s role this summer will be Ezekiel Ojewale, M.D., M.P.H. Ojewale grew up in Nigeria and left when he was 19 years old. He attended Hillsborough Community College, University of South Florida, Medical University of Lublin Poland, and the University of Florida and has earned both his Medical Degree and Masters of Public Health. Ojewale looks forward to getting his residency and saving lives through the practice of medicine, while applying the skills he has acquired during his M.P.H. to better serve the population as a whole.

Ezekiel believes there is much to gain from the Florida Cohort project.

“[I enjoy] relating with people and learning new things…along the way.”

Interventions for Alcohol Use among PLWH

Maryann Zacharias Uncategorized


Dr. Betsy McCaul


Dr. Geetanjali Chander

On March 31, 2016, SHARC welcomes special guests Dr. Betsy McCaul and Dr. Geetanjali Chander from Johns Hopkins University to speak about interventions for alcohol use among people living with HIV. Mary “Betsy” McCaul, Ph.D. is a Professor of Psychiatry and Behavioral Sciences at Johns Hopkins Medicine in Baltimore. Geetanjali Chander, M.D., is the Director of the General Internal Medicine Fellowship Program and Associate Professor of Medicine at Johns Hopkins Medicine in Baltimore.

Watch their presentation here.

Johns Hopkins performs first transplants between donors and recipients infected with HIV

Maryann Zacharias Uncategorized


Dorry Segev, MD, PhD (right) Image credit: Johns Hopkins Medicine

In a groundbreaking procedure, Johns Hopkins Medicine has performed the first liver and kidney transplant from an HIV-infected donor to an HIV-infected recipient.

Associate professor of surgery and epidemiology Dorry L. Segev, M.D, Ph.D. fought tirelessly for six year to make this possible. According to the National Organ Transplant Act of 1984, HIV was the only condition absolutely banned, but the Act was drawn up during a time when the AIDS epidemic was considered untreatable and indisputably fatal. Today, however, it is a manageable chronic disease.

According to research published in the American Journal of Transplantation in 2011, approximately 1,000 lives could be saved each year if the prohibition was lifted, as it would make 500 to 600 eligible donors.

“The need for organs can often be more urgent for those with HIV,” Sergev said. According to him, HIV often patients also have various other co-infections. Many have hepatitis and kidneys are needed by those who also have hypertension and diabetes or complications from HIV or the antiretroviral drugs that control the virus.

Hayley Gorenberg, deputy legal director for Lambda Legal, a civil rights organization that serves the lesbian, gay, bisexual, and transgender communities and people with HIV, called the transplants a “triumph of science over stigma.” According to her, “The change in law and policy to catch up with what medicine can do for people is a huge step forward,” she said. “The lives and the quality of life of hundreds will be affected every year.”

Read more about the transplant here, here, and here.