Adam W. Carrico, PhD
Academic Specialist
The overriding goal of my research program is to develop and test innovative interventions for substance users and other marginalized populations that enhance affect regulation, promote health behavior change, and improve health outcomes. I have pursued two distinct but related lines of research that support the potential clinical relevance of interventions designed to improve affect regulation among HIV-positive methamphetamine users.
My initial research examined the efficacy of a 10-week, group-based cognitive behavioral stress management (CBSM) intervention in two separate randomized controlled trials with HIV-positive gay men. In collaboration with Dr. Michael Antoni, I investigated the mechanisms whereby CBSM reduces distress and the extent to which these decreases in distress account for intervention effects on immune status. These studies demonstrated that improvements in cognitive coping (i.e., increased positive reframing and decreased cognitive avoidance) mediate CBSM-related reductions in distress. Building on these findings, we observed that decreases in distress during the intervention period generally mediated the sustained effects of CBSM on cellular and anti-viral immunity. Taken together, these well-controlled efficacy trials will inform my efforts to develop innovative treatments that promote affect regulation and enhance immune status among HIV-positive persons with psychiatric co-morbidities such as substance use disorders.
As a postdoctoral fellow, I examined the biological and behavioral pathways whereby psychological factors such as difficulties with affect regulation may relate to more rapid HIV disease progression. A particular focus of this research was to examine the bio-behavioral effects of stimulant use among HIV-positive persons. Utilizing baseline data from the NIMH Healthy Living Project, I observed that difficulties with affect regulation were indirectly associated with higher HIV viral load via two independent behavioral pathways, non-adherence to anti-retroviral therapy (ART) and regular stimulant use. Even after accounting for ART non-adherence, regular stimulant users on ART had a 50% higher HIV viral load, elevated neopterin (a marker of immune activation), and depleted tryptophan (an important precursor to serotonin). In a pilot study that I initiated with HIV-positive methamphetamine users on ART, affective states were associated with stimulant use and ART adherence. HIV-specific traumatic stress was independently associated with more problematic cocaine/crack use and positive affect was independently associated with a decreased likelihood of reporting injection drug use as well as better self-reported ART adherence. This line of bio-behavioral research with HIV-positive stimulant users supports the potential clinical relevance of interventions designed to improve affect regulation in this population.
Research interests
Affect Regulation; Psychological Resilience; Psychoneuroimmunology of HIV/AIDS; Substance Abuse; ART Adherence; HIV Transmission Risk Behavior
Current research
- Stonewall Treatment Evaluation Project (STEP)
- RCT of a positive affect intervention for individuals recently diagnosed with HIV
- Balance Project
- Effects of housing and HIV on risk behavior and victimization of indigent women
- Family-based HIV VCT
- Project Accept
Education
- 2008, Fellow (Reproductive Infectious Disease), UCSF
- 2006, Fellow (Health Psychology), UCSF
- 2006, Ph.D. (Clinical-Health Psychology), University of Miami
- 2006, Intern (Behavioral Medicine), VA Palo Alto Healthcare System
- 2003, M.S. (Clinical-Health Psychology), University of Miami
- 2000, B.S. (Psychology), Loyola University Chicago
Publications
Articles by Adam Carrico.
Contact
Center for AIDS Prevention Studies
University of California , San Francisco
50 Beale Street, Suite 1300
San Francisco , CA 94105
Voice: (415) 597-4992
Fax: (415) 597-9213
Email: adam.carrico@ucsf.edu
