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

Dr. Ryan Westergaard is an infectious disease physician, epidemiologist and the chief medical officer for the Wisconsin Department of Health Services. His research aims 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.

Dr. Ryan Westergaard's Faculty Biography

Novel Technologies and Interventions

Dr. Westergaard's research projects investigate:

  • 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
  • Barriers to testing and treatment for HIV and hepatitis C among injection drug users in Wisconsin

Research Team

Program Manager

Administrative Program Assistant

Recruitment and Retention Specialist

Program Contractors

  • Sarah Krechel, Vivent Health Research Coordinator
  • Cameron Liebert, Vivent Health Research Specialist
  • Sowmya Adibhatla, Viral Hepatitis Outreach Specialist
  • Ryan Rhode, HIV Peer Navigator

Current and Former Students and Interns

  • Karli Hochstatter, PhD Student
  • Kristen Brunsell, PhD Student
  • Quinton Taylor, MD Program Student
  • Amy Baltes, Graduate Student
  • Ali Moellner, Graduate Student
  • Maggie Seis, Graduate Student
  • Misbah Zaeem, Graduate Student
  • Emma Klein, Graduate Student
  • Josh Wilke, Shapiro Student
  • Becca Case, Shapiro Student
  • Abi Boeck, Shapiro Student
  • William Henry Bull, Shapiro Student
  • Shruti Rajan, Shapiro Student
  • Emma Gill, Shapiro Student
  • Johanna Brotz, Research Intern
  • Brittany Pufall, Research Intern
  • Leah Deshler, Research Intern
  • Brooke Beidel, Undergraduate Student
  • Staci Ikeri, Undergraduate Student
  • Giovanni Hanstad, Undergraduate Student
  • Coleman Fine, Undergraduate Student
  • Rita Simpson, Undergraduate Student
  • Queila Griffin, Undergraduate Student
  • Ella Welsh, Undergraduate Student

Active Projects

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:

Mobile Health (mHealth) Applications and Peer Support for People Living with HIV

We are implementing enhanced services including peer support and a mHealth application into an existing care model, known as the HIV Medical Home. The integrated intervention aims to increase the proportion of patients with viral suppression and reduce missed clinic appointments by supporting their needs.

Mobile Health (mHealth) Technologies and Harm Reduction Services for People Who Inject Drugs

This project seeks to characterize the most important mechanisms through which harm reduction influences overdose risk behaviors by offering a suite of internet and mobile phone-based tools for reducing overdose risk.

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.

Funding Support

Dr. Westergaard's research is supported by the National Institutes of Health and the Centers for Disease Control and Prevention.

Make a Gift

Help support research by making a gift to the Infectious Disease Fund for the Department of Medicine.