Five Researchers Receive CHERISH Pilot Awards to Advance the Treatment of Substance Use Disorders, HCV, and HIV

Dion Allen is a doctoral candidate in the Sociobehavioral and Administrative Pharmacy Department at Nova Southeastern University College of Pharmacy. Allen finds immense value in connecting with experienced investigators through the CHERISH pilot grant.

“I was thrilled to see that CHERISH’s mission aligned with my topic on pre-exposure prophylaxis use in a vulnerable population. It seemed like the perfect opportunity to pursue, and I was eager to apply,” Allen said. This will be Allen’s first time leading a study as the principal investigator.

With the support of CHERISH Research Affiliate Ioana Popovici, Allen’s pilot project, “An Economic Analysis of Factors Associated with Preexposure Prophylaxis (PrEP) for HIV Prevention Use Among Women,” will identify gaps contributing to low PrEP uptake in women and the potential role of family planning clinics and specialty substance abuse treatment centers to facilitate uptake.

Prevention is one major pillar for ending the HIV epidemic, with PrEP coverage being instrumental in reaching the goal of less than 3,000 new diagnoses per year. “Women represent a large proportion of those at risk of HIV but only a small percentage of those who use PrEP. I expect this study will give insights to reducing this gender disparity in PrEP use and achieving equity for women,” Allen said.

Megan Rose Curtis is an associate physician at Brigham and Women’s Hospital and a first-year post-doctoral fellow in the Boston University Clinical HIV/AIDS Research Training (BU-CHART) Program at the Boston Medical Center. Through the BU-CHART program, Curtis is constructing a novel state-transition simulation model to evaluate the cost-effectiveness of interventions focused on improving health and economic outcomes for individuals with perinatally-acquired HCV. She applied for the CHERISH pilot grant to gain proficiency in analyzing large databases containing health electronic health records to evaluate healthcare utilization in this population.

With the support of Rachel Epstein, former CHERISH pilot grant recipient, and Benjamin Linas, BU-CHART director and CHERISH Population Data & Modeling Core director, her project, “Characterizing the cascade of care for perinatally acquired hepatitis C virus infection,” involves securing a large dataset to assess healthcare utilization along the pediatric care cascade.

“In the context of the opioid epidemic, HCV is becoming more prevalent among pregnant people. Because HCV can be transmitted from the mother to the infant, there is growing concern about perinatally-acquired HCV. However, little is known about the burden of perinatally-acquired HCV or utilization of healthcare among this population,” she said. Curtis aims to construct the pediatric HCV testing-to-treatment cascade to highlight gaps in access to care and identify high-risk populations.

Curtis lives in Providence, RI, where she enjoys spending time outside with her family which includes her son, husband, and 11-year-old toy poodle.

Shimrit Keddem is a new investigator in the Department of Family Medicine and Community Health at the University of Pennsylvania and the Department of Veterans Affairs. Her research focuses on improving sexual and reproductive health among vulnerable populations, specifically screening and prevention of sexually transmitted infections.

An experienced health services researcher, Keddem will use the CHERISH pilot grant opportunity to collaborate with clinical colleagues at the University of Pennsylvania, learn about the processes for rolling out new technologies within a primary healthcare setting, and develop strategies for improving the implementation of injectable PrEP to serve historically marginalized patients.

“Since our department is the largest prescriber of HIV PrEP in the University of Pennsylvania Health System, the CHERISH pilot grant was an ideal opportunity to evaluate the rollout of the recently approved long-acting injectable PrEP. Conducting research in this area can identify practical, logistical, and behavioral challenges to the implementation process and inform how healthcare systems can address the identified challenges creatively and effectively,” Keddem said.

Two of her close collaborators working on the pilot project, “Characterizing Injectable HIV PrEP Implementation in Family Medicine,” include Navid Roder, clinical assistant professor in the Department of Family Medicine and Community Health at the University of Pennsylvania, and Peter Cronholm, associate professor in the Department of Family Medicine and Community Health at the University of Pennsylvania.

Residing in Philadelphia, PA, Keddem describes a day well spent involving an exploration of the many neighborhoods and restaurants in the city.

Revathy Suryanarayana is a doctoral candidate pursuing her PhD in the Department of Policy Analysis and Management at Cornell University. Her research has covered health and labor economics with a focus on substance use behavior and policies in India and the United States. Skilled at performing data analysis and econometric modeling, Suryanarayana looks forward to working in a multidisciplinary setting to analyze health insurance claims datasets in the U.S. and meeting other investigators.

Through her pilot project, “The Impact of Out-of-Pocket Costs on Initiation and Completion of HCV Treatment Among Medicare Beneficiaries,” Suryanarayana will study the relationship between out-of-pocket costs and HCV treatment initiation and completion among Medicare patients diagnosed with HCV, including older Baby Boomers and younger Medicare beneficiaries who have mental health and substance use disorders.

“The introduction of the all-oral direct-acting antiviral medications in 2014 was a major innovation in HCV treatment.  However, these medications are characterized by very high cost, which is often cited as a significant barrier to receiving HCV treatment,” Suryanarayana said. She anticipates her pilot to inform how the introduction of generic direct-acting antivirals may be an effective strategy to increase HCV treatment initiation.

This study is a product of her collaboration with Yuhua Bao, CHERISH investigator and associate professor of population health sciences at Weill Cornell Medicine. “During the course of my graduate experience, I had the opportunity to collaborate with Dr. Yuhua Bao on research involving opioid-related policies and adverse childhood outcomes in the U.S. As a non-native U.S. resident, collaborating with Dr. Bao has been extremely fruitful in understanding the complex healthcare system in the U.S.,” Suryanarayana said. Bao and Shashi Kapadia, CHERISH Research Affiliate and an assistant professor of medicine in the Division of Infectious Diseases at Weill Cornell Medicine, will serve as co-investigators on this project.

Suryanarayana currently resides in Ithaca, NY, where her perfect day includes scenic walks by waterfalls and a book by her side.