A day in the life of Stephen Karpiak, PhD

IAS member and Associate Director for Research at the AIDS Community Research Initiative of America’s (ACRIA) ACRIA’s Center on HIV and Aging and Associate Faculty at New York University
After a 25 year career as a research scientist at Columbia University Medical School, establishing a valid research effort based at ACRIA (AIDS Community Research Initiative of America – an organization celebrating its 20th anniversary this year) brings new challenges each day.

Eight years ago I initiated research into the issue of HIV and aging. In the United States in five years time half of all PLWHA will be age 50 and older. Our research effort (Research on older Adults with HIV - ROAH) has contributed to put the issue on radar screens locally and internationally. It has caused the education efforts of ACRIA to shift to prevention and care issues of aging with HIV. The success of our research is measured by the number of presentations, published articles and media attention. Examples include ACRIA’s critical role during the Special Meeting on HIV and Aging held in October 2010 at the White House Office of National AIDS Policy; the first Satellite Session on HIV and Aging at the 2010 International AIDS Conference in Vienna that was co chaired by the UN’s World Health Organization (WHO) HIV Director Dr. Gottfriend Hirnschall and the hundreds of media articles including features in the NY Times, BBC, CNN, CBS and AARP and of course publications in peer reviewed journals.

Our work recently resulted in gaining faculty appointments at New York University as well as significant collaborative efforts with UK’s Terence Higgins Trust, the American Academy of HIV Medicine and the American Geriatrics Society.

There is an isolation that must be overcome when working in a non-academic setting. In academia one is surrounded by informed researchers and the needed eagerness of pre- and post-doctoral students. They are absent here but networks outside ACRIA have made our research viable.

Each morning before I leave for the office, I read and read and read more making certain that I am on top of the scientific literature, epidemiological data and media attentions. I review for many journals and usually make that my next task. We have multiple research collaborations.

Today I traveled from Manhattan to Brooklyn for a weekly meeting with Dr. Tonya Taylor. I am a mentor on her career development research grant which was just awarded by the National Institutes of Health. The effort is focusing on older women with HIV, assessing their sexual health and risk factors. She is using the WIHS (Women's Interagency HIV Study) cohort which has been in existence since 1993 and is based in five US cities. We are examining psychosocial factors and mental health status and social networks as determinants of the behaviors on which she is focusing. Those same variables will be used to assess longitudinally care and health outcomes for these women. Dr. Taylor is a medical anthropologist who, after having conducted a decade of research in HIV in Africa, has decided to shift her focus to older women with HIV.

After the meeting I return to my computer to finish editing an almost 100 page manuscript that is reporting on clinical guidelines for the management of the health of older adults with HIV. The effort is led by the American Academy of HIV Medicine, with ACRIA and the American Geriatrics Society. Many older adults with HIV develop age related illnesses at very young ages and their health management has become an enormous challenge. ACRIA’s research shows that this population is socially isolated and often living with unmanaged depression. As they face managing multiple chronic illnesses (diabetes, osteoporosis, hypertension, reoccurring cancers, and cardiac issues) they do not have the needed informal support from social networks (i.e. caregivers). This lack of support (over 70% of older adults with HIV live alone – their average age is 55) must become part of the equation of optimal medical management. This report will be available in a month and hopefully coincide with the US National HIV and Aging Awareness Day which is on September 18 each year. I am a member of that team effort providing oversight for the data and epidemiology figures they use for the awareness campaign.