University of Wisconsin
School of Medicine and Public Health

Westergaard Research

Ryan Westergaard, MD, PhD, MPH | Improving Care for People with HIV, Viral Hepatitis, and Substance Use Disorders

The Westergaard research program, led by Ryan Westergaard, MD, PhD, MPH, investigates novel technologies and interventions to improve quality of life and care for people living with HIV, viral hepatitis, and substance use disorders

Mission

Our overall objective is to improve the quality and continuity of care for vulnerable populations living with HIV and viral hepatitis, with special emphasis on current or formerly incarcerated individuals, people who use drugs, and people with psychiatric illness.

Research Program Overview

We are interested in investigating the intersection of infectious diseases and opioid use disorder, smartphone applications to support engagement in HIV care and medication adherence for people who use drugs, social and behavioral impediments to community-based HIV care for people being released from prison, antiretroviral drug resistance associated with treatment interruptions in correctional settings, geographic variation in HIV risk and antiretroviral treatment effectiveness in Wisconsin, and barriers to testing and treatment for HIV and hepatitis C among injection drug users in Wisconsin.

Syndemics of HIV, Hepatitis C, and Drug Use

Our clinical research program focuses on preventing fatal opioid overdose and reducing transmission rates and gaps in the continuum of HIV and Hepatitis C care for people who inject or otherwise use drugs.

  • Injection Drug Use and Viral Infection in Rural Wisconsin: We are implementing an innovative yet widely replicable service delivery model, which we have named the Community-Based, Client-Centered Prevention Home, to deliver essential prevention services for people who misuse opioids in rural Wisconsin communities.
  • Continuum of Care for People Who Inject Drugs: We have found that HIV and HCV virologic outcomes for people who inject drugs are inferior to general clinic populations at numerous steps.
  • Health Care Utilization and Transitioning out of Prison: Recently incarcerated adults have a high risk of death from opioid overdose and frequently report HIV/HCV transmission risk behaviors, making them a high priority group for health system-based interventions aimed at improving engagement in primary care and utilization of evidence based prevention and treatment services.

Selected Publications:

Utilization of Information and Technology Interventions

We have demonstrated that the use of technology is feasible and acceptable for vulnerable HIV infected and substance using populations, and the data collected are reliable in comparison to traditional methods.

  • Optimizing HIV care for patients with substance use disorders using predictive analytics in a mobile health application is a two-stage, crossover clinical trial designed to address the problem of lapses in antiretroviral treatment. The study will test the effectiveness of an innovative mobile health (mHealth) system designed to support people living with HIV and substance use disorders who are receiving HIV care. The mHealth intervention, call A-CHESS, is an evidence-based smartphone application previously shown to reduce substance use and improve retention in addiction treatment by improving social connectedness, intrinsic motivation, and coping competence.
  • Impact on Opioid Use of Bundling Medication-Assisted Treatment with mHealth pairs medication-assisted treatment with a proven relapse-prevention system delivered via smartphone. The goals are to improve patients’ long-term recovery from opioid dependence, reduce the risk of infection from hepatitis C and HIV, and understand how medication-assisted treatment and mobile health interventions can be improved.

Selected Publications:

Academic-Public Health Partnerships for Population-Level Control of Communicable Diseases

Our program strives to build bridges and foster collaborations between academic medicine and public health agencies at the local, state and federal levels. We have a close partnership with the Bureau of Communicable Diseases within the Wisconsin Division of Public Health, jointly completing projects aimed at improving control of viral hepatitis within criminal justice settings, and leveraging public health surveillance data to inform novel strategies for care coordination to support people living with HIV.

Selected Publications:

Positions Available

There are many opportunities for motivated individuals in the Westergaard program! We are currently seeking graduate students and post-docs interested in patient-oriented projects and developing manuscripts. If you are interested in joining the group, please send your CV and a brief description of your research experience and interests to Rebecca Miller at rcmiller@medicine.wisc.edu.