Matthew Mimiaga has conducted HIV and drug prevention research on five continents, but his inspiration first arose when AIDS hit close to home. Before it became his life’s work, it was personal.
“It’s important to me for several reasons,” said Mimiaga, professor of behavioral and social sciences and epidemiology in the Brown University School of Public Health. “It heavily impacts the gay community, which I’m a part of. I’ve been personally impacted. A best friend of mine had HIV and passed away at age 30. And there is still a great need for education, prevention, and treatment around the world.”
Mimiaga was so eager to enter the prevention field that he didn’t wait to finish college at California Polytechnic University. In the midst of his studies in 1998, even though he hadn’t yet earned a degree, he applied for and talked his way into a post-baccalaureate internship at the Center for AIDS Prevention Studies/AIDS Health Project at the University of California–San Francisco.
After completing the yearlong internship program, he returned to finish his bachelor’s in 2001 and moved to Boston, where he began and continues to work at The Fenway Institute (TFI), Fenway Health. While working full time at TFI leading HIV prevention research, Mimiaga earned an M.P.H. in epidemiology in 2003 at Boston University School of Public Health, an Sc.D. in psychiatric epidemiology in 2007 at Harvard School of Public Health. He then completed a postdoctoral fellowship in behavioral medicine at Harvard Medical School. He was subsequently appointed to the faculty at Harvard Medical School (psychiatry) and School of Public Health (epidemiology), while managing his global health research portfolio and teams both at Harvard and TFI.
In 11 countries including Brazil, India, South Africa, and Vietnam, Mimiaga has been studying a wide variety of HIV prevention and treatment measures, often in resource-limited settings where little, if any, prevention work has been done before. In many cases those studies have focused on “how multiple co-occurring psychosocial conditions, (e.g., heavy alcohol and drug use, depression, childhood sexual abuse, and intimate partner violence), also known as a syndemic, act as intertwined epidemics to potentiate HIV transmission and acquisition.”
In South Africa, for example, Mimiaga and his colleagues discovered an unusually complicated relationship between drugs and HIV. Many people there abuse a substance called whoonga. It blends street drugs with efavirenz, an antiretroviral medication used for HIV treatment, which enhances and prolongs the effects of the street drugs. His concerns are that recreational use of efavirenz among HIV-positive people can promote viral resistance and that resale and theft can divert the stream of medicine away from people who need it.
Mimiaga has also been studying the connections between HIV and crystal methamphetamine addiction since graduate school. This drug often places the user at increased risk of becoming infected with HIV, both because it is sometimes injected and also because it can stimulate risky sexual behaviors. With funding from several NIH grants, he and his colleagues developed a promising clinical treatment that will soon be tested within a multisite, three-arm, randomized controlled efficacy trial.
At Brown Mimiaga will direct the Institute for Community Health Promotion, where faculty and students conduct research on a wide variety of behavioral and biomedical health topics. His arrival (along with close collaborator Katie Biello, a new assistant professor within ICHP) will continue to explore current topics, but also expand the institute’s research portfolio — reaching the local community and global populations — in areas such as HIV prevention, substance addiction treatment, global health, and maternal and child health.
In Providence, for example, Mimiaga and collaborators Drs. Chan and Biello plan a demonstration trial of the uptake and adherence to pre-exposure prophylaxis (Truvada) — an anti-HIV medication that can prevent HIV infection — among street-based male sex workers. (In Peru he’s doing a similar study among transgender women.)
There are several reasons Brown appeals to Mimiaga. It is big enough to provide a wealth of opportunities and the resources of a respected institute, he said, but small enough that he can work closely with faculty and senior administrators and provide real mentorship to postdoctoral trainees and students at the institute. He’s already had several meaningful conversations with Terrie Fox Wetle, dean of public health.
“Brown is very different from Harvard,” he said. “This is precisely the opportunity that I’ve really been craving and feels like a natural fit.”