SC Connecticut News

Jeffrey Wickersham, PhD, an associate professor of medicine specializing in infectious diseases, has been driven by the increasing number of HIV infections he observed in his community. "I was bothered by seeing so many new infections and wanted to find solutions that were effective and that the community felt they had ownership of as well—that they had a stake in, that they had a role in designing and choosing," Wickersham stated.

Wickersham's journey into HIV research began when he joined Frederick Altice's lab at Yale School of Medicine (YSM) as a postdoctoral fellow in 2009. His work focused on Malaysia’s incarcerated population and HIV prevention. He noted the shift from injection drug use-driven cases to sexually transmitted ones: "The first case of HIV in Malaysia was detected in 1986... When methadone became more accessible... sexually-driven transmission of HIV exploded."

To address this issue, Wickersham collaborated with Universiti Malaya and LGBTQ NGOs to conduct public health prevention research targeting gay and bisexual men engaged in chemsex—a practice involving sexualized drug use. Previous studies have shown drugs like methamphetamine can lead to risky behaviors such as multiple sexual partners and reduced condom use.

Together with Roman Shrestha, PhD, MPH, assistant professor at the University of Connecticut, Wickersham developed a micro-randomized trial using an app called JomCare. The app aims to reduce high-risk behavior among HIV-uninfected gay or bisexual men through just-in-time adaptive interventions. The National Institute of Drug Abuse has awarded them an R01 grant for this study.

JomCare prompts participants twice daily about their substance cravings and intentions regarding drug use. Participants are randomized into one of three intervention types and monitored for 90 days through self-reports and urine tests for stimulant drugs.

"Sexualized drug use is hard to intervene on," explained Wickersham, noting the lack of medication-based therapies available for these dependencies compared to opioid dependence treatments like buprenorphine or naltrexone.

The study aims to refine intervention strategies using machine learning led by Premananda Indic, PhD from UT Tyler. Other team members include YSM’s James Dziura, MPH, PhD; Edward Boyer, MD, PhD from The Ohio State University; all contributing towards understanding conditions under which interventions effectively reduce risk-taking behaviors.

Yale School of Medicine’s Department engages extensively in patient care and research across various infectious diseases fields.