Lisa Metsch, Ph.D., Enhances HIV/AIDS Care Through Research

When Lisa Metsch, a newly minted Ph.D. in sociology, joined the Miller School faculty in 1994 to evaluate HIV prevention strategies for drug users, she noticed something both troubling and transformative: The study groups assembled to test HIV interventions included people at risk for what was then a fatal disease as well as people already living with the virus.

“There were no specialized prevention interventions,” recalled Metsch, now professor of epidemiology and public health and director of the new Division of Health Services Research and Policy. “So while you’re trying to educate people who abused drugs about the risks of HIV you’re talking to people who are living with what amounted to a death sentence about condoms and prevention.’’

Those initial observations put Metsch at the forefront of research that has improved access and care for people living with HIV/AIDS, a place the mother of three daughters and author of dozens of scientific journal articles remains today. Seventeen years and an astounding $60-plus million in grants funding later, Metsch’s extensive research portfolio continues to enhance the lives of many of the one million people living with HIV in the United States, some of whom others would just as soon forget.

For example, Metsch, who also directs the Behavioral Sciences & Community Outreach Core at UM’s NIH-funded Developmental Center for AIDS Research, recently received a $7 million grant with collaborators at the Center for AIDS Research at Emory University to establish a “retention clinic” for HIV-infected crack users in the HIV out-patient clinic at UM/Jackson Memorial Hospital. The goal is to keep them in treatment, and on the antiretroviral drugs that have transformed AIDS from a fatal to a chronic disease, by providing integrated substance-abuse treatment, mental health services and HIV care and prevention.

“Unfortunately, people who are living with HIV and using drugs are at higher risk for not coming to care, for dropping out of care, and not being on antiretroviral drugs,’’ Metsch explains. “They really are among the neediest, most vulnerable populations. They need someone to hold their hand.’’

The daughter of two New York City public school teachers, Metsch has been drawn to the vulnerable since she volunteered at Memorial Sloan-Kettering Cancer Center as an undergraduate sociology student at Columbia University in Manhattan, where she simultaneously earned a philosophy and history degree at The Jewish Theological Seminary of America. The time was the late 1980s, when much about AIDS was still unknown, and fear and prejudice spread faster than the disease.

“Those early experiences set the stage for what I wanted to do,’’ Metsch says. “To visit the rooms of people with HIV you had to put on what looked like a bubble suit. I saw people watch their friends die, and families shun loved ones.’’

Yet Metsch concentrated on another interest, geriatrics, while specializing in medical sociology and earning her doctorate at the University of Florida. But after leaving Gainesville in 1993, she landed at UM/Jackson, an epicenter of the exploding AIDS crisis and AIDS research.

Three years later, with new antiretroviral therapies commuting AIDS death sentences, she wrote her first independent grant to tailor messages to prevent drug users living with HIV from spreading the disease, and to pinpoint factors that influenced their access to the new life-saving medications.

In the ensuing years, she would serve as principal investigator or co-principal investigator on more than 30 grants that have informed national HIV policy and pioneered strategies for integrating HIV treatment with prevention. With the help of the “amazing” staff she credits for fueling her non-stop energy, she also brought such services as mobile dental care to people living with HIV who otherwise would go without.

“She not only has great ideas and ways to solve problems, but she has excellent follow-through,’’ said Lauren Gooden, a senior research associate who has worked with Metsch for 10 years and will finish her Ph.D. this month. “She’s extremely persistent, tenacious, and collaborative. She works with many people from so many fields and she has a big, generous heart. She’s passionate about helping people.’’

Metsch and her collaborators may even be on the verge of settling the public health debate over whether people who seek HIV testing should receive risk-reduction counseling as well. They are now analyzing data from more than 5,000 people who agreed to undergo HIV testing at nine clinics for sexually transmitted diseases – a big risk factor for HIV – in Washington, D.C., and six states. The two-year, $12.3 million grant funding the study is the largest awarded to a Miller School researcher under the American Recovery & Reinvestment Act.

As busy as she is, Metsch is as devoted to community service and education as she is to research. Active in her synagogue, she sits on the board of the Jewish day school her youngest daughter attends, and on the school advisory council of the Aventura K-8 public school her oldest daughter attends.

Not surprisingly, she is a favorite among Miller School students, earning the Public Health Student Association’s 2011 Lecturer of the Year award. She’s proudest, though, of helping “people seek care, stay in care and take care of themselves” and looks forward to the day when there is a cure for HIV/AIDS.

“Even then,’’ she says, “I think I will have a role because we have to make sure people have access to it.’’

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