Frederick L. Altice, M.D.

Associate Professor of Medicine
Director, Clinical Research
Director, HIV in Prisons Program
Director, Community Health Care Van

Clinical Interests

Dr. Altice is the Director of the HIV in Prison Program and began the program in 1991. The program provides infectious diseases consultation at many of the Connecticut's correctional facilities. Services include the management of HIV/AIDS, viral hepatitis, tuberculosis and sexually transmitted infections. There are currently between 800-1000 patients within the correctional system 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 has been touted as a national model of health care delivery for active drug users.

Research Interests

Dr. Altice is primarily interested in health outcomes and interventions associated with the prevention and treatment of infectious diseases complications among drug users. Dr. Altice currently is following longitudinal cohorts of injecting and non-injecting drug users to examine their health status, barriers to and utilization of medical, psychiatric and drug treatment services. He is also examining the impact of needle exchange-based health services on their use of services.

He is also currently funded to examine interventions that improve the health outcomes of HIV infected drug users. He is currently involved in the implementation and evaluation of peer driven interventions that focus on improving access to and utilization of health care and drug treatment services. One recent component of this type of intervention involves a specific intervention addressing adherence to antiretroviral therapy.

For the past several years, Dr. Altice is examining the efficacy and impact of directly administered antiretroviral therapy (DAART) among drug users in various settings. These include pilot studies and randomized controlled trials of DAART in community, methadone maintenance and prison settings. A novel DAART program for recently released prisoners is currently in development.

Much of the DAART studies have centered around a randomized controlled trial, is a comparison of DAART at needle exchange sites. The primary study utilizes a mobile health care program to promote adherence to antiretroviral therapy. As part of the study, a further examination of new health care relationships as it relates to health care delivery and trust is being examined among HIV infected drug users.

More recently, Dr. Altice has introduced buprenorphine into HIV clinical and community settings for opiate-dependent individuals. This work is funded by SAMHSA and HRSA. Further investigations include introducing buprenorphine into the correctional setting and exploring linkage to drug treatment upon release from prison.

Lastly, Dr. Altice is involved in epidemiological and policy studies that examine issues related to HIV and the correctional system. Studies have involved seroprevalence and seroincidence studies, studies of health care utilization, adherence to antiretroviral therapy and interventions that promote continuity of care into the community. Other studies involve examination of policies for mandatory versus voluntary testing of prisoners and pregnant women. New studies are planned to promote more effective HIV counseling and testing strategies using a novel methodology of respondent driven sampling for targeted populations.

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 NIDA K Training & Career Development Subcommittee, National Institute on Drug Abuse Initial Review Group
2004 – present AAHIVM – American Academy of HIV 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

Recent Publications

• Altice FL, Bruce RD, Walton M, Buitrago M. Adherence to Hepatitis B Virus Vaccination At Syringe Exchange Sites. Journal of Urban Health. 2005;82(1)
• AAltice FL, Springer SA, Pesanti E. Reply to Does Counseling Increase Sustained Benefit of HAART Among Prison Inmated After Release to the Community. Clinical Infectious Diseases. 2005;40:322-323
• AResch S, Altice, FL, Paltiel D. Cost Effectiveness of HIV Screening for Incarcerated Pregnant Women. JAIDS 38(1) 2005
• AAltice, FL, Bruce, RD. Hepatitis C Virus Infection In United States Correctional Institutions. Current Science - Current Hepatitis Reports Vol 3: 112-118; August 2004
• ASmith-Rohrberg D, Bruce RD, Altice, FL. Review of Corrections Based Therapy for Opiate-Dependent Patients: Implications for Buprenorphine Treatment Among Correctional Populations. Journal of Drug Issues, 34(2):451-480 Jun 2004
• ASpringer SA, Pesanti E, Hodges J, Macura T, Doros G, Altice FL. Effectiveness of AntiretroviralTtherapy among HIV-infected prisoners: Reincarceration and the lack of sustained benefit after release to the community. Clin Infect Dis. 2004 Jun 15;38(12):1754-60.
• A 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. Clinical Infectious Diseases 2004;38:S376-87
• A Altice FL, Selwyn P, Watson RE, eds. Reaching In, Reaching Out: A Guide For The Correctional Professional. Book commissioned by the Kaiser Foundation and the National Commission on Correctional Health Care. 2002
• ALiebman J, Lamberti MP, Altice FL. Effectiveness of a Mobile Medical Van In Providing Screening Services for STD's and HIV. Public Health Nursing, 2002; Sept – Oct 19(5):345-53
• ABroadhead 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 and Medicine, July 2002 55(2) 235-246.
• APollack H, Khoshnood K, Blankenship K, Altice FL. The Impact of Needle Exchange-Based Health Services on Emergency Department Use. Journal of General Internal Medicine; 17(5):341-348; May 2002
• AKhoshnood K, Blankenship KM, Pollack H, Roan CT, Altice FL. Syringe Source, Use, and Discard Among Injection Drug Users In New Haven, Connecticut. AIDS and Public Policy Journal. 15 (3/4) 88-94 2002
• AAltice FL, Mostashari F, Friedland GH. Trust and the Acceptance of and Adherence to Antiretroviral Therapy. Journal of Acquired Immune Deficiency Syndromes 28(1):47-58 2001
• AMonterroso ER, Byers RH, Wu Q, Vlahov D, DesJarlais DC, Weibel WW, Altice FL, Kerndt PR, Watters JK, Fernando MD, Holmberg SD. Prevention of Human Immunodeficiency Virus Infection in Street Recruited Injection Drug Users. JAIDS 25(1):63-70, 2000

Contact

Campus Address
135 College Street Suite 323

E-mail
frederick.altice@yale.edu

Office Phone
(203) 737-2883

Fax
(203) 737-4051