Frederick L. Altice, M.D.
Professor of Medicine
Director of Clinical and Community Research
Director of HIV in Prisons Program
Director of the Community Health Care Van
Clinical Interests
Dr. Altice is the Director and began the HIV in Prison Program in 1991. The program provides infectious diseases consultation at many of the Connecticut's correctional facilities throughout the state. Services include the management of HIV/AIDS, viral hepatitis, tuberculosis and sexually transmitted infections. Among the 22,000 correctional inmates, approximately 600-800 HIV-infected patients within the correctional system are receiving HIV care.
The Community Health Care Van (CHCV), directed and begun by Dr. Altice in 1993, operates in tandem with the New Haven Needle Exchange Program. The CHCV operates in four distinct neighborhoods five days per week and provides care to approximately 40 people per day. The CHCV provides a wide array of primary and acute medical services, including HIV testing, and screening for tuberculosis, STDs, mental illness, pregnancy, substance abuse treatment, HIV primary care, hypertension, diabetes, and opiate drug treatment with Buprenorphine. Physicians, mid-level practitioners, social workers, case managers, HIV counselors and outreach workers staff the program. The CHCV was the first mobile program in the U.S. to provide onsite buprenorphine treatment and is now implementing assertive community treatment for patients with HIV, substance use disorders and severe mental illness. The CHCV has been touted as a national model of health care delivery for active drug users.
Research Interests
Dr. Altice’s research interests are focused on the interface between infectious diseases and substance abuse. As a clinical epidemiologist, health services and intervention researcher, he has created novel programs for the treatment of HIV, HCV, and tuberculosis in vulnerable populations, including injection drug users and prison inmates. Specifically, he has been an international leader in research related to adherence to antiretroviral therapy, particularly among HIV+ drug users, has made considerable inroads into novel approaches using directly administered antiretroviral therapy and other structural interventions to facilitate adherence both nationally and internationally.
Dr. Altice has been at the forefront of integrating buprenorphine and methadone treatment into managing co-morbid conditions, including the management of HIV, HCV, TB and mental illness. He is the Principal Investigator on over 15 federally-funded grants, including numerous clinical investigations funded by the National Institutes on Health, the Substance Abuse and Mental Health Services Administration, Special Projects of National Significance for the Health Resources Services Agency and other federal agencies, Dr. Altice is currently leading studies that bridge the gap between the correctional and community setting, specifically on the use of directly observed antiretroviral therapy and opiate-substitution therapy. In addition to publishing his research in peer-reviewed journals, Dr. Altice has authored several significant books and book chapters. He lectures nationally and internationally on the subject of HIV, viral hepatitis, substance abuse and the management of medically complicated patients.
Current research includes methadone and buprenorphine as primary and secondary HIV prevention, directly administered antiretroviral therapy, peer-driven interventions, secondary prevention among drug users and prisoners and includes international projects in Malaysia, Ukraine and Iran.
Professional Memberships
- 1992 – present American Public Health Association
- 1993 – present Fellow, American College of Physicians
- 1993 – present Infectious Disease Society of America
- 1994 – present International AIDS Society
- 1995 – present Fellow, Morse College, Yale University
- 1997 – present Society for Correctional Physicians
- 2001- present American Correctional Association
- 2001- present NIDA K Training & Career Development Subcommittee,
National Institute on Drug Abuse Initial Review Group
- 2004- present AAHIVM-American Academy of HIV Medicine
- 2005- present American Society of Addiction Medicine
Education
B.A. Biology and B.A. Spanish (Summa Cum Laude)
Texas A & M University, 1982
M.A. Spanish Literature
Universidad de Santiago de Compostela, Spain, 1982
M.D. (Magna Cum Laude)
Emory University School of Medicine, 1986
American Board of Internal Medicine, Internal Medicine, 1989
American Board of Internal Medicine, Infectious Diseases, 1992, 2002
Selected Publications
- Altice FL, Mostashari F, Checko P, Singh R, Tanguay S, Blanchette EP, Selwyn PA. Predictors of HIV Infection Among Newly-Sentenced Male Prisoners. JAIDS; 1998;
18: 444-453.
- Altice FL, Friedland GH. The Era of Adherence with HIV therapy. Ann Int Med, 1998; 129 (6): 503-505.
- Altice FL, Mostashari F, Friedland GH. Trust and the Acceptance of and Adherence To Antiretroviral Therapy. JAIDS, 2001;28(1):47-58.
- Lazzarini Z, Altice FL. A Review of the Legal and Ethical Issues for the Conduct of HIV-Related Research in Prisons. AIDS & Public Policy Journal. 2001; 15(3):103-125.
- Pollack H, Khoshnood K, Blankenship K, Altice FL. The Impact of Needle Exchange-Based Health Services on Emergency Department Use. JGIM. 2002; 17(5):341-348.
- Broadhead R, Heckathorn D, Altice FL, van Hulst Y, Carbone M, Friedland G, O’Connor PG, Selwyn P. Increasing Drug Users’ Adherence to HIV Therapeutics: Results of a Peer-driven Intervention Feasibility Study. Social Science & Medicine. 2002; 55(2) 235-246.
- Altice FL, Springer S, Buitrago M, Hunt DP, Friedland GH. Pilot study to enhance HIV care using needle exchange based health services for out-of-treatment injecting drug users. J. Urban Health, 2003. 80(3):416-27.
- Altice FL, Bruce RD. Hepatitis C Virus Infection In U.S. Correctional Institutions. Curr Hep Rep, 2004; 3:112-118.
- Altice FL, Mezger JA, Hodges J, Bruce RD, Marinovich A, Walton M, Springer S, Friedland GH. Developing a Directly Administered Antiretroviral Therapy Intervention for HIV Infected Drug Users: Implications for Program Replication. Clin Infect Dis 2004; 38:S376-87.
- Smith-Rohrberg D, Bruce RD, Altice FL. Review of Corrections Based Therapy for Opiate-Dependent Patients: Implications for Buprenorphine Treatment Among Correctional Populations. J.Drug Issues, 2004; 34(2):451-480.
- Springer S, Pesanti E, Hodges J, Macura T, Altice FL. Effectiveness of Antiretroviral Therapy among HIV Infected Prisoners and the Lack of Sustained Benefit after Release to the Community. Clin Infect Dis, 2004; 38(12):1754-60.
- Altice FL, Marinovich A, Khoshnood K, Blankenship KM, Springer SA, Selwyn PA. Correlates of HIV Infection Among Incarcerated Women: Improving Detection of HIV Infection. J Urban Health, 2005; 82(2), 312-326.
- Resch SL, Altice FL, Paltiel AD. Cost effectiveness of HIV screening for incarcerated pregnant women. JAIDS. 2005;38(2) 163-73.
- Altice FL, Bruce RD, Walton M, Buitrago M. Adherence to Hepatitis B Virus Vaccination At Syringe Exchange Sites. J of Urban Health. 2005;82(2):312-26.
- Basu S, Smith-Rohrberg D, Hank S, Altice FL. HIV Testing in Correctional Institutions: Evaluating Existing Strategies, Setting New Standards. AIDS & Public Policy Journal. 2005; 20(1-2):3-24.
- Altice FL, Sullivan LS, Rohrberg-Smith D, Basu S, Stancliff S, Eldred L. The Potential Role of Buprenorphine in the Treatment of Opioid Dependence in HIV-Infected Individuals and in HIV infection prevention. Clin Infect Dis, 2006; 43 (S4): 178-83.
- Smith-Rohrberg D, Mezger J, Walton M, Bruce RD, Altice FL. Impact of Enhanced Services on Virological Outcomes in a Directly Administered Antiretroviral Therapy Trial for HIV+ Drug Users. JAIDS, 2006. 43 (S1): 48-53.
- Ravi A, Blankenship K, Altice FL. The Association between History of Violence and HIV Risk: A Cross-Sectional Study of Female Prisoners in Connecticut. Journal of Women's Health Issues 2007,(17)1049-3867.
- Basu S, Smith-Rohrberg D, Bruce RD, Altice FL. Models for Integrating Buprenorphine Therapy into HIV Care. Clin Infect Dis 2006 42:716-721.
- Bruce RD, Altice FL, Gourevitch MN, and Friedland GH. Pharmacokinetic Drug Interactions Between Opioid Agonist Therapy and Antiretroviral Medications: Implications and Management for Clinical Practice. JAIDS; 2006; 41(5): 563-572.
- Bruce RD, Altice FL. Clinical Care of the HIV-Infected Drug User. Infectious Diseases Clinics of North America, 2007. 21: 149-179. PMCID: 2128697.
- Bruce RD, Dvoryak S, Sylla LN, Altice FL. HIV treatment access and scale up for delivery for Injection Drug Users in Ukraine for Opiate Substitution Therapy with Buprenorphine: Program Description and Policy Implications. International Journal of Drug Policy, 2007;18: 328-8. PMCID: PMC2084072.
- Sylla LN, Bruce RD, Kamarulzaman A, Altice FL. Integration and Co-Location of HIV/AIDS, Tuberculosis and Substance Abuse Treatment Services: Paradigms for Complex Patient Populations. International Journal of Drug Policy, 2007; 18: 306-12.
- Altice FL, Smith-Rohrberg D, Bruce RD, Springer SA, Friedland G. Superiority of Directly Administered Antiretroviral Therapy Compared to Self-Administered Therapy among HIV-Infected Drug Users Enrolled in a Six-Month Prospective, Randomized Controlled Trial. Clinical Infectious Diseases, 2007;45.
- Springer S, Friedland GH, Doros G, Pesanti E, Altice FL. Antiretroviral Treatment Regimen Outcomes Among HIV-infected Prisoners. HIV Clin Trials. 2007 Jul-Aug;8(4):205-12.
- Maru DSR, Kozal MJ, Bruce RD, Springer SA, Shield DS, Altice FL. Directly Administered Antiretroviral Therapy for HIV-Infected Drug Users Does Not Have an Impact on Antiretroviral Resistance: Results From a Randomized Controlled Trial. JAIDS. 2007;46(5):555-63.
- Safren SA, Wingood G, Altice FL. Strategies for Primary HIV Prevention That Target Behavioral Change. Clinical Infectious Diseases. 2007; 45:S300-S307.
- Copenhaver MM, Bruce RD, Altice FL. Behavioral counseling content for optimizing the use of buprenorphine for opioid dependence in community-based settings: A review of the empirical evidence. American Journal of Drug and Alcohol Abuse. 2007; 33(5):643-54.
- Maru DS, Bruce RD, Walton M, Mezger JA, Springer SA, Shield D, Altice FL. Initiation, Adherence, and Retention in a Randomized Controlled Trial of Directly Administered Antiretroviral Therapy. AIDS & Behavior, 2007; 11(7):946-57.
- Bruce RD, Govindasamy S, Sylla LN, Kamarulzaman A, Altice FL. Case Series of Buprenorphine Injectors in Kuala Lumpur, Malaysia. American Journal of Drug and Alcohol Abuse, 34:4, 511-517.
- Smith-Rohrberg Maru D, Bruce RD, Basu S, Altice, FL. Clinical Outcomes of Hepatitis C Treatment in a Prison Setting: Feasibility and Effectiveness for Challenging Treatment Populations. Clinical Infectious Diseases. 2008; 47(7):952-61.
- WHO, UNODC, UNAIDS. Policy. Altice FL, Chair of Guidelines Committee. Policy Guidelines for Collaborative TB and HIV Services for Injecting and Other Drug Users: An Integrated Approach. 2008. (WHO publications on tuberculosis)
- Maru DSR, Bruce RD, Walton M, Springer SA, Altice FL. Persistence of Virological Benefits Following Directly Administered Antiretroviral Therapy among Drug Users: Results from a Randomized, Controlled Trial. JAIDS 2009; 50(2):176-81.
- Copenhaver M, Altice FL. Adaptation of an evidence-based intervention targeting HIV-infected prisoners transitioning to the community: The process and outcome of formative research for the Positive Living Using Safety (PLUS) intervention. AIDS Patient Care and STDs. (In Press)
- Bruce RD, Govindasamy S, Sylla LN, Kamarulzaman A, Altice FL. Lack of Reduction in Buprenorphine Injection After Introduction of Co-formulated Buprenorphine/Naloxone to the Malaysian Market. American Journal of Drug and Alcohol Abuse. (In Press)
- Gupta S, Altice FL. Hepatitis B Virus Infection in US Correctional facilities: Implications of Diagnosis and Management. JURH418R. Journal of Urban Health. (In press)
- Springer SA, Chen S, Altice FL. Depression and Symptomatic Response from a Randomized Controlled Trial of Directly Administered Antiretroviral Therapy among active drug users. AIDS Care. (In press)
