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D. Bangsberg: Antiretroviral treatment adherence: acute and chronic

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David Bangsberg, MD is an Associate Professor in the Partner AIDS Research Center at Massachusetts General Hospital with appointments in the Harvard School of Medicine. He completed medical school at Johns Hopkins Hospital in Baltimore, his internal medicine residency at Columbia Presbyterian Hospital in
New York, and Fellowships in Infectious Disease and AIDS Prevention at the University of California, San Francisco. He also holds Master's Degrees in Public Health from the University of California, Berkeley and the History and Philosophy of Science from Kings College, London. Dr. Bangsberg’s research focuses on HIV in impoverished populations. In 1996, Dr. Bangsberg launched a series of studies in HIV+ homeless and marginally housed individuals in response to concerns that poor adherence to HIV antiretroviral treatment in the urban poor would create new strains of drug resistant virus. He described the challenges in providing antiretroviral therapy to the urban poor, developed valid measures of adherence, defined the risk of antiretroviral resistance by level of adherence, and developed effective interventions to improve adherence in the HIV+ urban poor. These studies mitigated what we now recognize were exaggerated concerns regarding HIV drug resistance in the urban poor and helped shift the debate from withholding treatment to maximizing treatment effectiveness.  In 2001, Dr. Bangsberg launched a series of studies to address similar concerns that the scale-up of antiretroviral therapy to poor regions of the world would similarly lead to unacceptable levels of drug resistance due to the challenges of adhering to antiretroviral therapy in settings of extreme poverty.  Contrary to popular opinion, Dr. Bangsberg found that HIV+ people living in sub-Saharan Africa are better able to adhere to antiretroviral therapy than their counterparts in North America. This work was deemed by the editors of The Lancet as among the most important medical findings for 2006 and was described by President Bill Clinton at the “nail in the coffin “on the debate as to whether poor people living in Africa can successfully take their HIV treatment. Dr. Bangsberg founded and continues to lead the HIV research program at the Mbarara University of Science and Technology in Mbarara, Uganda. This program focuses on structural barriers to treatment access and treatment adherence, including transportation to health care settings as well as the competing demands of securing food for HIV+ individuals and their families.   In addition to faculty appointments at Harvard Medical School and Massachusetts General Hospital, Dr. Bangsberg is Senior Research Scientist at HIGH and will direct the Global Health Scholars Program.  The overarching goal of this new program is to cultivate the next generation of global health leaders by engaging faculty and scholars from across the University and the globe to address the world’s greatest challenges in health sciences. Initially focused on global infectious diseases, Scholars will participate in modular global health leadership and research training relevant to the needs of each Scholar’s home country. This intensive global health training program will also partner with multiple international sites and institutions to strengthen in-country global health research capacity and career opportunities for in-country scientists.   Dr. Bangsberg has received research awards from charitable foundations, the National Institutes of Health and the Centers for Disease Control. He was the second highest ranked National Institute of Health RO-1 funded investigator in HIV/AIDS in 2007. He is on the Editorial or Advisory Boards of PLOS Medicine, JAIDS, AIDS Patient Care and STDs, AIDS Care and AIDS and Behavior. He has authored or co-authored over 120 publications in peer-reviewed journals, and several book chapters