How did you first become involved with ACTG? What drew you to the network?
My path to the ACTG developed from my clinical and research work in neurology and infectious diseases, which began early in my medical training. During residency, I cared for a patient with severe viral encephalitis, and that experience shifted my focus toward neuroinfectious diseases. This interest deepened through mentorship in neuroHIV, particularly with Dana Gabuzda and Janet Lo. These experiences led me to the ACTG and to early work on A5324 with Dr. Raj Gandhi and Amy Sbrolla. I was drawn to the network because it brought together scientists committed to neurology and HIV, multidisciplinary collaboration and a shared goal of improving the lives of people living with HIV.
What area(s) of research are you focused on in your work with ACTG?
My research with the ACTG centers on neurologic complications of HIV, including a series of secondary analyses using the HAILO study to examine blood based biomarkers and cognitive performance. I am particularly interested in peripheral immune effects on brain health and in mechanisms of persistent immune activation despite viral suppression. My broader scientific portfolio includes studying hormonal regulation of depression in people with HIV. Depression is a condition that affects nearly a third of adults with HIV and often does not respond to standard therapies. At my local site, this work includes the use of neurosteroids and multiple MRI modalities. Outside of the ACTG, I am involved in expanding access to neuroimaging through portable low field MRI, which may improve diagnostic access for people with HIV in underserved settings. These research priorities align with the ACTG’s increasing focus on mechanisms that shape brain health.
Can you briefly describe A5402? What do you find most unique or exciting about this study?
A5402 is a multicenter phase II trial evaluating pramipexole extended release and escitalopram for major depressive disorder in people with HIV, including those with mild neurocognitive disorder. The study uses mood assessments, neurocognitive testing, functional measures and optional cerebrospinal fluid collection to examine treatment effects on symptoms and biologic mechanisms.
What I find most exciting is the opportunity to tailor antidepressant strategies based on mechanistic data collected from people across the world. A unique strength of A5402 is its timely focus on dopaminergic pathways, which is supported by new evidence in treatment resistant depression. A 2025 randomized trial in The Lancet Psychiatry reported a 44.1 percent response rate with pramipexole augmentation compared with 16.4 percent for placebo and a 27.9 percent remission rate compared with 7.5 percent for placebo. Benefits were sustained through 48 weeks. This evidence highlights the importance of strengthening the data for pramipexole specifically in people with HIV who have major depressive disorder, particularly because tolerability must be carefully monitored, and also globally since the Lancet trial was conducted only across in the UK.
Why is A5402 especially important now, and why is ACTG uniquely positioned to undertake it?
A5402 is exceptionally important because depression is common in people with HIV, and there is growing momentum to launch interventional trials that support brain health. A5402 is one of the first global trials in the modern ART era to focus collectively on this goal. Evidence that pramipexole improves treatment resistant depression strengthens the need to study its safety and efficacy specifically in people with HIV. Tolerability requires careful monitoring, which makes a structured clinical trial essential.
The ACTG is well positioned to lead this work because of its expertise in neuropsychological assessment across global sites, biologic sampling and multicenter trial coordination. This infrastructure allows for consistent evaluation of clinical and mechanistic outcomes across diverse locations. It increases the likelihood that results will be reproducible and that they will provide meaningful guidance for patient care.
What do you find most meaningful about your work with ACTG and why?
What I find most meaningful about working with the ACTG is the shared sense of purpose across community members, investigators, clinicians, and administrators. The network fosters collaboration across specialties, which strengthens the scientific questions we ask and the solutions we generate. It is deeply fulfilling to contribute to work that is scientifically engaging and immediately relevant to patient care.
When you are not working, what do you enjoy doing, or what helps keep you grounded?
Outside of work, I enjoy time with my family, reading or listening to audiobooks, and being outdoors. Recently I have been enjoying The Rest is History and Conan Needs a Friend. My family shares a love of soccer and travel. We were fortunate to attend the 2023 Women’s World Cup in Australia and we are now looking forward to attending a 2026 Men’s World Cup match in Boston.