My research interests in infectious disease intersect the domain of diagnostics and treatment for [HIV/AIDS and related blood-borne infections and STI (sexually transmitted infections)].
Over the past few years at McGill University (since 2009-present), my clinical/epidemiological implementation research program has focused on studying the impact of point-of-care diagnostics to prevent HIV and STI transmission.
This includes innovative self-testing strategies, development of self-test apps, synergizing health, multiplexed testing in different at risk populations, impact of oral testing and counseling in women in labor, simultaneous testing of pregnant women for co-infections, and understanding barriers to implementation of POC. A secondary area of research interest has been studying the impact of highly active antiretroviral therapy (HAART) on clinical outcomes in cohorts.
This includes exploring treatment response in HIV-1 Non B subtype infected immigrant populations in Canada, impact of treatment interruptions in jail inmates of San Francisco.I also have a keen interest in the conduct of systematic reviews & meta-analyses and am a Cochrane reviewer with expertise in Bayesian methods. Lately, my interests have branched to macro explorations from health systems perspective–including modeling the impact of POC tests and programs and exploring reduction in transmission.
- Design, conception, execution and analyses of Phase I to Phase III/IV diagnostic trials (i.e., diagnostic accuracy, feasibility, acceptability, impact) of rapid point-of care tests for HIV and multiple pathogen tests (multiplex) for Sexually Transmitted Infections (i.e., Syphilis, Hepatitis B, Hepatitis C) in vulnerable at-risk populations (i.e., sexually transmitted clinic attendees, injection drug users, pregnant women).
- Prevention of Mother-to-Child Transmission of HIV and related blood-borne infections (i.e., use of diagnostic tools as interventions to reduce transmission and efficacy of ART in PMTCT) including operations research in resource-limited settings. (i.e., exploring the PMTCT platform for optimization of health care interventions).
- Modeling the impact of diagnostic and treatment interventions on reduction in transmission at the population level.
- Antiretroviral treatment response in vulnerable population cohorts (i.e., evaluation of optimum ART treatment regimens in populations infected with non B HIV-1 subtypes; role of ART interruptions over time; intermittent therapy in incarcerated populations, and treatment in HIV/Hepatitis C co-infected populations.
- Design and analyses of Randomized controlled trials (non inferiority trials) in HIV (i.e., optimum regimens in Non B subtypes).
- Application of advanced analytic methods in longitudinal cohort with repeated measures and time dependent confounding (i.e., causal marginal structural models, generalized propensity scores, multilevel generalized linear models, propensity scores).
- Systematic Reviews and Meta-analyses of diagnostic tests and HAART (including Cochrane reviews on Structured treatment interruptions, meta-analyses of oral HIV point of care tests, meta-analyses of treatment response in PMTCT). Application of advanced methods in diagnostic research (i.e., bi-variate regression methods, hierarchical SROC models).