The link between disease and behavior
By Bridget Higginbotham
There are currently about 1.1 million people in the United States living with HIV, but the disease was just emerging 20 years ago when Robert Cook, M.D., M.P.H., was in medical school. While completing his residency in rural Virginia, Cook was struck by the rapidly increasing rate of infection among people in minority groups.
“It was clearly a disease that had behavioral, social and clinical issues,” Cook said.
HIV and how substance abuse affects the disease has become one focus for Cook, an associate professor in the department of epidemiology.
While there are many risk factors for HIV that can’t be changed, drinking alcohol and using drugs are behaviors that can be prevented, Cook said. Interventions that change these damaging behaviors are one potential way to improve a patient’s outcome.
Cook’s latest study, funded by the National Institutes of Health, looks at whether medication can help reduce drinking in women with HIV who drink at hazardous levels. After a year of organizing and planning, Cook and his team are recruiting participants in Jacksonville, Chicago and Washington, D.C., for the small clinical trial.
“What’s exciting about this study to me as a physician is that this is a treatment that is readily available but is not offered routinely because we don’t have evidence that it works and is safe in this population,” Cook said. “So if our study really works, it truly could open up a wide range of treatment options that people don’t normally have access to.”
Cook is also looking at how health professionals can use technology to deliver brief interventions against infectious diseases. In 2008, he worked with the UF Digital Worlds Institute and the Alachua County Health Department to develop an engaging digital game that could be placed in STD clinics to help patients consider their own risky behavior. Cook, who is affiliated with the university’s Emerging Pathogens Institute, also is looking at how social networking and cell phones could be used to track disease and counsel patients for infectious diseases.
“I have been trying to push research in a more practical way,” Cook said. “I’m looking for things that either clinics or doctors can do related to these diseases, which often have a behavioral piece to them.”
Cook’s broad research topics lend themselves to multidisciplinary work and he has collaborated with faculty from disciplines such as geography, public policy, pathology and behavioral sciences. His other roles include serving as associate director of the College of Public Health and HealthProfessions’ Florida Center for Medicaid and the Uninsured, directing the epidemiology Ph.D. program, seeing primary care patients, and teaching and mentoring students.
“I hope that here at UF we can continue to grow with more graduate students and new faculty who want to work in this area to help University of Florida be on the map for this kind of infectious disease and epidemiology research.”