Dillingham, Rebecca A.
Associate Professor, Medicine: Infectious Diseases and International Health
- Clinical Fellowship, Infectious Diseases, University of Virginia
- BA, History and Science, Harvard University
- MD, Medicine, University of Missouri
- MPH, University of Virginia
Multi-level intervention design and evaluation to support better integrated care and improved outcomes for people living with HIV, Hepatitis C and substance use disorder.
I am a clinical researcher with a primary interest in working with people living with human immunodeficiency virus (HIV), hepatitis C (HCV), and/or substance use disorder (SUD). In my research, we define key challenges to health for these populations and work to develop and test individual, clinic, and system-level strategies to address these challenges.
I see HIV as an important model for the management of chronic diseases more broadly, especially those chronic diseases that disproportionately affect vulnerable communities. I began my work with a focus on the potential harm of enteric infections to those living with HIV, particularly with reference to antiretroviral levels. This work has evolved into an emphasis on adherence and engagement with care and more specifically on the use of mobile technologies to enhance adherence and engagement. I have described novel challenges to adherence and engagement in rural HIV+ populations and have successfully designed and tested mobile interventions, including PositiveLinks. Based on data we collected about the impacts of PositiveLinks and the US Centers for Disease Control and Preventions (CDCs) independent review of the data, PositiveLinks has been identified as an Evidence-Informed Practice and included in the CDCs Compendium of Best Practices for Linkage and Retention in Care for PLWH. (https://www.cdc.gov/hiv/pdf/research/interventionresearch/compendium/lrc/cdc-hiv-PositiveLinks_LRC_EI_Retention.pdf ) We are now conducting larger scale trials and evaluations of PositiveLinks and adapting it for other populations and conditions. I have developed strong collaborations with the Virginia Department of Health (VDH) that facilitate scaling of our successful strategies.
In 2013, my work with HIV led me to become engaged in the care of people with HCV infection, given the frequency of co-infection. I ultimately began to care for people with mono-infection with HCV as well. With my background in HIV care, I have strived to bring a comprehensive care model to the care of people with HCV who are struggling with SUD and/or who live in rural communities with a high-burden of injection drug use. This work has included descriptive surveys of community attitudes and of care outcomes. In 2018, with support from VDH, we developed, piloted and evaluated a novel HCV care model that prioritizes people who inject drugs and that builds capacity for treatment in rural communities with a high burden of injection drug use associated infections. This model is now supported with a 5 year implementation grant from VDH.