Jamestown resident awarded $7.5 million for HIV research
Monti, the center’s director, will oversee a series of studies that will explore the complicated and potentially deleterious interactions between excessive alcohol use and HIV. Monti said that “Brown University will serve as the nexus” between his work and the work of 24 Ph.D.-level scientists at universities throughout the world.
Earning his undergraduate degree from Providence College and his master’s degree in psychology from William and Mary, Monti returned to his home state to attend the University of Rhode Island where he earned a doctorate in psychology. Planning on staying at Brown for a one-year as part of post-doctorate work, Monti has been there since.
He says that he has always been interested in addiction as “a biobehavioral disease.”
He explained that his early work focused on alcohol and smoking and then about 20 years ago – in part because of three alcohol related adolescent deaths in his community – he adjusted his focus. One of his five published books, “Adolescents, Alcohol and Substance Abuse: Reaching Teens through Brief Intervention,” came out of this adjusted focus.
Monti has been recognized and honored throughout his career and has written 250 manuscripts and currently has two additional books being prepared for publication. He has also received a number of federal grants over the years to fund the study of addiction. He said that his current focus is the result of several smaller projects that came together. His interest was spurred by reports in the literature that indicated greater morbidity and mortality rates for HIV patients when they were also heavy drinkers.
“[Results] are coming in from countries and continents around the world,” Monti said. The speculation, Monti said, centers around the direct and indirect effect of alcohol use on antiretrovirals, which is a medication used in the treatment of HIV. The possibility exists, according to Monti, that the combination of the antiretrovirals and alcohol could cause harm beyond rendering the medicine merely ineffective.
He also explained that alcohol could affect the potential success of treatment in many ways: the “medicine’s efficacy” could be impinged on directly, alcohol use could make it more difficult to adhere to the treatment regime, and it could also potentially “worsen immune functions.”
Monti said that given the liver’s role in processing both alcohol and antiretrovirals, an increased risk to the liver may exist, and that diminished brain function, a result of extreme alcohol in combination with the antiretrovirals, could result in “neurocognitive deficits,” an impairment of cognitive function in certain parts of the brain.
Whether a patient is infected with HIV or not, Monti says that alcohol may lead to high-risk sexual behavior.
“There exists a complex interaction of biology and behavior,” he said. “It was this intersection that drew me to [the work].”
“[The grant funds a] interdisciplinary, multifaceted approach which advances science, and forms clinical responses to the problem,” Monti said.
In addition to the $7.5 million grant, Monti also received a separate $3.5 million grant from the institute to adapt and implement a protocol for an emergency room intervention that will be brief. “A drinker’s check-up,” Monti said.
The emergency room protocol will focus on alcohol abuse more broadly as it relates to risky sexual behavior (not on the use of alcohol by HIV patients) and will be centered in Providence and Pawtucket.
Using a cognitive behavioral approach, researchers will present emergency room patients with datadriven comparisons of their drinking habits to peers, among other informational data points. The “brief interventions” will be followed up with counseling.
“You don’t hammer patients over the head with it, but you present them with the information in a non-confrontational style and ask then to think about it,” Monti said. “You ask them whether they would be interested in changing and if the answer is yes, you give them some thumbnail sketches about how they might want to go about that.”
Part of the focus of the HIV-andalcohol study will include similar emergency room intervention protocols but will focus on the population of gay sexually active men through research at Boston’s Fenway Clinic.
The studies will break down the components and variables and will do so in part by broadening the reach of the studies to include sites in Kenya and Uganda where alcohol use in HIV patients is not complicated by other substance abuse as it often is in the United States. Monti said that there are nine integrated parts to the grant’s mission including education, training and dissemination.
Given the current fiscal environment, Monti recognizes the newsworthy nature of being awarded $11 million in grants and says that the work is “very gratifying.”
The center will sponsor its first conference next October.
When he isn’t writing, researching, or developing grant proposals, Monti enjoys tennis and sailing. He has lived in Jamestown for the past 14 years with his wife Sylvia. The couple has four children and two grandchildren.
“I always wanted to wind up in Jamestown,” he said.