High Rates of Violence, HIV Infection for Adolescents in Sex Trade on U.S.-Mexico Border

Researchers at University of California, San Diego School of Medicine report that more than one in four female sex workers in two Mexican cities on the U.S. border entered the sex trade younger than age 18; one in eight before their 16th birthday. These women were more than three times more likely to become infected with HIV than those who started sex work as adults. They were also three times more likely to be violently coerced to engage in sex with male clients and seven times less likely to use a condom during their first month in the sex trade.

The study is published August 4 in the Journal of the American Medical Association. … Read the full story from the UC San Diego News Center


The study comes from the Division of Global Public Health in the Department of Medicine. Jay G. Silverman, PhD, professor of medicine and director of research for the Center on Gender Equity and Health, is lead author.

The senior author is Kimberly Brouwer, PhD, associate professor of medicine and leader in the Scientific Working Group on HIV Prevention at the UC San Diego Center for AIDS Research.

Read the article full text (UC San Diego only)

Drs. Joachim Ix, Davey Smith Elected to American Society for Clinical Investigation

Two Department of Medicine physician-scientists have been elected to the American Society for Clinical Investigation (ASCI) this year.

Dr. Joachim Ix

Dr. Joachim Ix

Joachim H. Ix, MD, MAS, FASN, a nephrologist and epidemiologist, is professor and chief of the Division of Nephrology-Hypertension. He holds a secondary appointment in the Division of Preventive Medicine, Department of Family and Preventive Medicine.

Dr. Davey Smith

Dr. Davey Smith

Translational research virologist Davey M. Smith, MD, MAS, professor of medicine in the Division of Infectious Diseases, directs the Center for AIDS Research Translational Virology Core and is medical director of the Early Intervention Program at the UC San Diego Antiviral Research Center.

ASCI membership is a distinction that recognizes the nation’s most outstanding physician-scientists.

Preventing Drug-Abuse-Related HIV in Tijuana by Educating Police

Dr. Steffanie Strathdee

Dr. Steffanie Strathdee

The NIH Record recently highlighted Dr. Steffanie Strathdee, Dr. Leo Beletsky, and their binational team for their efforts to prevent drug abuse-related HIV in Tijuana, Mexico, by changing the knowledge, attitudes and behaviors of the Tijuana police.

With support from the Open Society Institute and the UC San Diego Center for AIDS Research, the pilot phase of the project taught Tijuana police instructors how to prevent needle stick injuries by proper syringe handling, which advises them against breaking needles they apprehend from drug users. The training program is now being adopted by Tijuana’s police academy, whereby the police trainers will be teaching the program to their colleagues.

“We believe this program is the best way to reduce needle sharing among people who inject drugs, which is driven by policing practices,” Strathdee said.

The program will soon be tested in a newly funded grant by the National Institute on Drug Abuse, Proyecto ESCUDO (Project Shield): Harmonizing Law Enforcement and HIV Prevention through a Police Education Program.

Steffanie Strathdee, PhD, is Associate Dean of Global Health Sciences and Harold Simon Professor and Chief of the Division of Global Public Health and Director of the Global Health Initiative.

Strathdee co-leads Proyecto ESCUDO with Leo Beletsky, JD, MPH, adjunct assistant professor in the Division of Global Public Health at UC San Diego and assistant professor of law and health sciences at the Northeastern University School of Law.

Dr. Helen King and Dr. Philipp Wiesner Present Mentored Research Study Results at Grand Rounds

Dr. Helen King

Dr. Helen King.

Dr. Philipp Wiesner

Dr. Philipp Wiesner.

Helen King, MD, and Philipp Wiesner, MD, junior residents in the categorical track of the UCSD Internal Medicine Residency Program, presented results of their elective mentored research projects at Medicine Grand Rounds on May 15.

The Internal Medicine Residency Training program offers trainees two months of elective time during their second or third year to undertake a research project under the guidance of a faculty mentor.

Dr. Helen King

Helen King, MD, Mercer University

King’s research project was “HIV Preexposure Prophylaxis: Barriers to Access for Men Who Have Sex With Men.” |  Watch the video (UCSD only)

“I have been interested in HIV medicine for some time now,” King said, “and since being a resident at UCSD have had the opportunity to have more exposure.

“I went to Dr. Davey Smith knowing that he might have some interesting projects, and he helped me get involved with the PrEPARE Study.”

Davey Smith, MD, MAS

Davey M. Smith, MD, MAS

Smith (at right), a translational research virologist, directs the Translational Virology Core of the UC San Diego Center for AIDS Research and is medical director of the Antiviral Research Center’s Early Intervention Program.

He is associate professor of medicine in the Division of Infectious Diseases.

The PrEPARE study evaluates preexposure prophylaxis for HIV in men who have sex with men, an approach in which an HIV-negative individual who is at high risk for HIV infection takes a daily HIV medication to lower his risk of infection.

“It has been proven effective in high-risk men who have sex with men,” King said. “Our study was aimed at identifying real-life barriers to accessing the medication, such as cost.”

The study pinpointed several barriers including cost and concern about side effects.

Of her research experience, King said, “I was lucky enough to work on a project that was interesting to me and to work with a great mentor.”

Dr. Philipp Wiesner

Philipp Wiesner
MD, Universität Regensburg

Philipp Wiesner presented the project “Oxidized Phospholipids in Inflammation and Atherosclerosis.” |  Watch the video (UCSD only)

“I started to work in the field of atherosclerosis in medical school,” Wiesner said. “I spent 2 years as a postdoctoral fellow and continued to work in this area during residency.

“My topic was a perfect fit, as I could continue to work in the same area in which I already had experience as well as continue to work with my previous mentors.”

Dr. Joseph Witztum

Joseph Witztum, MD

Wiesner’s primary mentor is Joseph Witztum, MD, professor of medicine in the Division of Endocrinology & Metabolism. Witztum leads the renowned atherosclerosis research laboratory that was established at UCSD by Dr. Daniel Steinberg.

Steinberg, emeritus professor of medicine and pioneering lipid researcher, was the founding head of the Division of Metabolic Diseases.

Dr. Yury Miller

Yury Miller, MD, PhD

Wiesner’s other mentors are lab members Yury Miller, MD, PhD, and Sotirios “Sam” Tsimikas, MD. Miller is associate professor of medicine in the Division of Endocrinology & Metabolism and Tsimikas is professor of clinical medicine and director of vascular medicine in the Division of Cardiology.

Dr. Sotirios "Sam" Tsimikas

Sotirios “Sam” Tsimikas, MD

Some of Wiesner’s research work, not included in his Grand Rounds presentation, recently has been accepted for publication in the Journal of Lipid Research.

Said Wiesner, “I am really glad our program gives us the opportunity to take two months off to do research. Residency is busy as it is and without this, many residents would not have the chance to get exposed to clinical or laboratory based research.”

Wiesner said it has always been his plan to have a career as an academic physician-scientist.

Presenting Grand Rounds on May 15: Dr. Helen King and Dr. Philipp Wiesner

Dr. Helen King

Dr. Helen King
MD, Mercer University

Dr. Philipp Wiesner

Dr. Philipp Wiesner
MD, Universität Regensburg

Helen King, MD, and Philipp Wiesner, MD, junior residents in the categorical track of the UCSD Internal Medicine Residency Program, will present results of their elective mentored research projects at Medicine Grand Rounds on May 15.

King’s research project is “HIV Preexposure Prophylaxis: Barriers to Access for Men Who Have Sex With Men.”  Philipp Wiesner will present the project “Oxidized Phospholipids in Inflammation and Atherosclerosis.”

The Internal Medicine Residency Training program offers trainees two months of elective time during their second or third year to undertake a research project under the guidance of a faculty mentor.

UC San Diego Researcher Receives $2.5 million Award from the National Institute on Drug Abuse

Davey Smith, MD, associate professor of medicine in the Division of Infectious Diseases at the University of California, San Diego School of Medicine and the VA San Diego Health System is one of three recipients of the 2012 Avant-Garde Award for HIV/AIDS research. This prestigious award, announced today by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, is intended to stimulate high-impact research that may lead to groundbreaking opportunities for the prevention and treatment of HIV/AIDS in drug abusers. … Read the full story from the UCSD Newsroom


David M. Smith, MD, MASDavey M. Smith, MD, MAS, is a physician-scientist specializing in the study of HIV transmission. He directs the Translational Virology Core at the Center for AIDS Research and the Early Intervention Program at the Antiviral Research Center at UCSD.Dr. Smith received his internal medicine residency training, including a year as chief medical resident, and his fellowship training in infectious diseases at UCSD. He earned his Masters of Advanced Studies (MAS) degree in clinical research at UCSD as well.

More about Dr. Smith’s work:

More about the award:

U.S. News Again Ranks UC San Diego Among Nation’s Best Graduate Schools

Each year, graduate programs at the University of California, San Diego are highly ranked by U.S. News & World Report, as noted in the 2013 edition of America’s Best Graduate Schools, released today…. Read the story from the UCSD Newsroom.

UCSD School of Medicine campus in La Jolla
In the rankings just released, the UCSD School of Medicine tied with Weill Cornell Medical College for 16th in research and ranked 27th in primary care. The School of Medicine maintained its ranking as #8 in the nation for AIDS programs.

In the HIV/AIDS specialty, the Department of Medicine offers research and clinical training via the teaching activities of the Division of General Internal Medicine and Division of Infectious Diseases. The two divisions operate a variety of clinical and research entities including the Owen Clinic, the Antiviral Research Center, the AIDS Research Institute and the Center for AIDS Research.  |  See details of the UCSD School of Medicine rankings in U.S.News & World Report

In the Media: Dr. Davey Smith

Dr. Davey Smith is featured in “Advances in HIV/AIDS Research” on the KUSI Medical Report.

Davey M. Smith, M.D., M.A.S., is Associate Professor of Medicine in the Division of Infectious Diseases and Director of the Viral Pathogenesis Core at the UCSD Center for AIDS Research.

Dr. Ajay Bharti Receives NIMH Grant for HIV/Malaria Co-Infection Study

Dr. Ajay R. BhartiInfectious diseases researcher Ajay R. Bharti, MD, has received a four-year K23 career development grant from the National Institute of Mental Health.The grant will fund his mentored, patient-oriented research study, “Impact of Malaria Co-Infection on HIV-Associated Neurocognitive Disorders.”

Dr. Bharti is an investigator at the UCSD HIV Neurobehavioral Research Center and Assistant Professor of Medicine in the Division of Infectious Diseases. He completed a fellowship in infectious diseases at UCSD in 2007.

In the project, Dr. Bharti will determine the impact of malaria co-infection and malaria treatment on HIV-associated neurocognitive impairment in a population of HIV-infected adults.  |  Read the abstract of Dr. Bharti’s grant

It is known that malaria and HIV infection occur together in significant numbers of people, but their combined effect on the brain has not been investigated.

Dr. Bharti will conduct the study in Taramani, Chennai, in southern India, where there is a high prevalence of both HIV and malaria. The Y.R. Gaitonde Center for AIDS Research and Education in Taramani is a clinical research site of the UCSD unit of the AIDS Clinical Trials Group.

The long-term goal of Dr. Bharti’s research is to develop better means of detecting, assessing, and treating HIV- and malaria-associated neurobehavioral deficits in adults.

Dr. Bharti’s co-mentors in the project are Scott Letendre, MD, and Davey Smith, MD, MAS, in the Division of Infectious Diseases.

Dr. Letendre, Associate Professor of Medicine, is an investigator in the UCSD unit of the AIDS Clinical Trials Group. Dr. Smith, Associate Professor of Medicine, directs the Viral Pathogenesis Core of the UCSD Center for AIDS Research.

Both are investigators at the UCSD Antiviral Research Center and HIV Neurobehavioral Research Center.

New Global Medicine Program at Work in Mozambique

UCSD internal medicine resident Seth Goldman, M.D., with Dr. Sam Patel of UEM on the wards at Maputo Central Hospital.

UCSD internal medicine resident Seth Goldman, M.D., with Dr. Sam Patel of UEM on the wards at Maputo Central Hospital. Photo by Mike Preziosi, MD.

At Maputo Central Hospital in Mozambique, the patients suffer from diseases that a doctor might never see in the U.S.: malaria, cholera, or drug resistant tuberculosis, for example. Important research takes place despite limited resources. Internal medicine residents divide their time between their clinical duties and the moonlighting jobs that finance their medical education.

Beginning this month, UCSD internal medicine doctors are working side by side with their counterparts in Maputo. The new Global Medicine elective rotation in the UCSD Internal Medicine Residency Training Program is underway.

It’s a bilateral exchange of faculty and residents between UCSD and the Universidade Eduardo Mondlane (UEM) School of Medicine in Maputo. The purpose is to enrich the training programs and the research efforts at both institutions.

Dr. Seth Goldman, a third-year resident in internal medicine, is the first UCSD trainee to take part. He’ll spend almost 4 weeks in Maputo, departing as the next resident arrives from UCSD to take his place.

Dr. Preziosi with Mozambican residents

Global Medicine Program Clinical Director Mike Preziosi, MD (center), with Mozambican internal medicine residents Lucia Chambal (left) and Manuel Tomas (right).

Supervising the residents in Maputo is Michael Preziosi, MD, who graduated from the Internal Medicine Residency Program in June. He’ll spend a full year in Maputo as Assistant Professor of Medicine, and clinical director for the UCSD residents.

“Our research and education presence in Maputo will equip us to prepare our next generation of internal medicine specialists and researchers,” says Ken Kaushansky, MD, MACP, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine. Dr. Kaushansky directs the Global Medicine program for UCSD.

Drs. Marisa Magaña and Emilia Noormahomed

Dr. Marisa Magaña, former UCSD internal medicine resident, with Dr. Emilia Noormahomed of UEM.

UCSD’s Global Medicine faculty leaders include Robert (Chip) Schooley, MD, Professor of Medicine and Chief of the Division of Infectious Diseases, and colleague Professor Constance Benson, MD, who directs the Fellowship Training Program in Infectious Diseases.

This is an exciting opportunity for UCSD and for UEM,” says Dr. Schooley.

He and Dr. Benson have collaborated with researchers in Mozambique and other African nations since the mid-1990s.

It was their interest in doing research work with Dr. Emilia Noormahomed that brought UEM to the foreground when the UCSD Department of Medicine began its search for potential Global Medicine rotation sites.

Emilia Noormahomed, MD, PhD, a gifted parasitology researcher, is a former dean of the UEM School of Medicine.

She and Sam Patel, MD, Professor of Medicine and, until recently, Chair of the Department of Medicine, are UEM’s participating faculty who have worked closely with Dr. Kaushansky to design this unique partnership.

Both have accepted faculty appointments in UCSD’s Department of Medicine.


“Our long-term goal is to play a critical role in developing sustainable local capacity to lead programs in HIV, tuberculosis, and malaria in southeast Africa.”
— Dr. Schooley


City of Maputo

The city of Maputo is a major port on the Indian Ocean.
Photo by Robert Schooley, MD.

For UCSD, the Global Medicine program reflects the Department of Medicine’s commitment to enlarge its efforts in the field of global medicine. The new elective will broaden the program offered to internal medicine residency trainees.

“Our faculty, residents, and fellows will have the opportunity to see diseases such as TB and malaria that we see much less often here in the U.S.,” Dr. Schooley says, “and actually to take part in revitalizing postgraduate medical education in Moçambique.”

A generation after a civil war that drove all but a few doctors from the country, the government of Moçambique is striving to build a sustainable healthcare system that can meet the nation’s urgent need for physicians and medical leaders.

Children in cane village outside Maputo.

Children in cane village outside Maputo. Photo by Kenneth Kaushansky, MD.

UCSD’s involvement at UEM is part of this effort, as is funding for the UEM departments of parasitology and medicine by the Gilead Foundation, a nonprofit organization of the pharmaceutical company Gilead Sciences, LLC.

The Gilead Foundation contributed along with the UCSD Center for AIDS Research to the refurbishing of Dr. Noormahomed’s laboratory at UEM. It’s also a key sponsor of the UCSD Global Medicine rotation.

It’s hoped that additional philanthropic gifts from other sources will continue to support the Global Medicine exchange and other collaborative projects between UCSD and UEM.

UCSD’s presence at UEM will nourish medical research programs and promote the use of evidence-based medicine and epidemiological methods in patient care.

Maputo Central Hospital

Maputo Central Hospital, the primary teaching hospital for UEM.
Photo by Mike Preziosi, MD.

During the early months of this inaugural year, Dr. Preziosi is focusing on establishing relationships, learning the language, and determining the needs of the UEM medical trainees and researchers.

“I’m really excited,” he says. “It’s clear to me how important my job is as a continuous presence in Maputo.”

He and his UCSD colleagues will work with UEM to establish a more academic day in the medical training program. They’ll also develop a number of research studies.

“We’ll work with their residents and investigators,” he says, “to do the projects that really matter.”

Dr. Preziosi hopes to have launched the first group of new research projects by the end of the year. In June 2010, he will return to UCSD to begin his fellowship training in infectious diseases.

Mozambique shown on map of Africa.

The republic of Mozambique.
Map from CIA: The World Factbook.

The Global Medicine elective rotation is open to second- and third-year residents. During the 2009-2010 academic year, over 20 UCSD internal medicine trainees will complete the Global Medicine rotation in Maputo.

Additional UCSD Department of Medicine faculty will rotate through Maputo for 3-4 week periods over the course of the year, working alongside their Mozambican colleagues to augment the Internal Medicine training program at Maputo Central Hospital. Dr. Randy Taplitz, Clinical Director of the Division of Infectious Diseases, will join Dr. Preziosi in early August.

Department of Medicine faculty rotating through Maputo live in an apartment, located several blocks from the medical school complex, with Dr. Preziosi and the UCSD residents.

Starting later this year, UEM residents will travel to UCSD to spend 2-3-month periods in research and clinical work here.

“Our long-term goal,” says Dr. Schooley, “is to play a critical role in developing sustainable local capacity to lead programs in HIV, tuberculosis, and malaria in southeast Africa.”


Join With Us

We’re building practical, sustainable programs here at home and in our partner nations.

Your gift in any amount will go directly to help train a doctor, continue a key research project, or equip a community with the knowledge it needs to fight the spread of a preventable disease.

For more information about philanthropy and the Department of Medicine’s international programs, please contact Dan Otto, Senior Executive Director of Development, at 858-246-1563.

Give Now

UCSD Faculty Volunteers Welcomed

UCSD Department of Medicine faculty volunteers of all specialties are welcome to participate in the Global Medicine program in Maputo.

To make your interests known or to find out more, please contact:

Jesus Vera
Global Medicine Program Coordinator
Telephone 619-543-2896
Email jevera@ucsd.edu

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