Spotlight on…Jeffrey Samet

Jeffrey H. Samet, MD, MA, MPH, the URBAN ARCH Consortium’s Principal Investigator and Professor of Medicine and Public Heath at the Boston University Schools of Medicine and Public Health

As told to URBAN ARCH Admin Core staff, July 2015

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When did you realize you wanted to do research around HIV and alcohol use?

I wanted to do research from the get-go. In clinical training I found the addiction issues fascinating and poorly understood compared to heart and lungs clinical issues.  The year of medical school graduation was 1983 and patients with addiction problems were getting this new disease – AIDS.  Thus my research path was emerging.  I wanted to further study HIV infection in people who had addictions.  That’s where I wanted to go over the next two decades. Alcohol, per se, and HIV—I really do give credit to Kendall Bryant, who was just beginning to address the HIV and alcohol problem at NIAAA. We had put in a grant to look at some health services issues with people with alcohol problems. He said “I noticed in your bio that you run a clinic for HIV patients too, could you recruit a cohort of patients who have HIV and alcohol problems?,” and I said “we can do that.” And so, we started doing that and it made us start thinking.  There were a lot of interesting issues as time went on.

How does your research with the international cohorts in Russia and Uganda impact your work as a clinician in the United States?

It makes one appreciate the system in which medical care is delivered.  Clinical research provides great insight into how to improve those services and the international insights can be very useful domestically.  At times, in other countries, clinical teams do things really well and other times, they don’t do things really well that way. But, being in a different setting where you can see how these diseases play out, has been, to me, insightful.  Seeing the international cohorts and the care that they get opens up new perspectives on care.  Another difficult issue is the extent to which people are dying in Russia, which contrasts what is happening in Uganda, people are not dying.  Good care makes a difference.

What do you enjoy most about being the PI of the URBAN ARCH Consortium?

That one’s simple. The colleagues you get to work with and it’s really the incredible opportunities to turn good ideas into real projects and answer questions.   It is great to have colleagues in a topic area that we obviously think is interesting. Total pleasure there.

Do you have a favorite URBAN ARCH cohort?

Reminds me of “one loves all one’s children” and not that they are all my children, but you get the idea…not going there!

What surprises you most about the URBAN ARCH research that has been conducted?

I think the most surprising outcome so far is the Uganda ARCH finding.  I would have bet on the side that heavy alcohol use in patients not on ART was going to have adverse effects on their immune progression as measured by CD4 count and it didn’t. So that was a negative finding, but I thought it was really surprising.

What are you most excited about when thinking about the future of URBAN ARCH?

We put together unique populations. Unique in part due to Russia and Uganda’s international settings but even the Boston cohort with the extent of other drug use. They all have characteristics that open themselves up to studies that are hard to pull off in other places — that part gets me excited. Putting the grant renewal together gets me excited (and worried too –  lots of work to do!).

Tell the readers one fact about yourself that would surprise them.     

I stuttered as a young boy. You know, I remember going to a speech pathologist with my mom and after that, I didn’t stutter so much. But, for years, I stuttered.  But the word from my brother and sister was that “mom came back and told them before dinner that night that ‘when Jeffrey talks, everybody needs to shut up.’” That’s what the speech pathologist said. “It’s not the stutter; he can’t get in a word otherwise!”

Is there anything else you’d like to add?

We appreciate NIAAA giving us the opportunity to study these important research questions.