Professor of Medicine and Health Policy (NYU School of Medicine)
Marc Gourevitch is Dr. Adolph and Margaret Berger Professor of Medicine and Professor of Psychiatry at the School of Medicine, New York University, where he is Director of the Division of General Internal Medicine. Dr Gourevitch earned his M.D. from Harvard Medical School, an M.P.H. from Columbia University's Mailman School of Public Health, and an A.B. from Harvard University. He is leading expert in delivering effective health services to drug users. His central research interests include drug users' health service utilization, effective strategies for fostering behavior change among patients and clinicians, clinical epidemiology among drug users and other underserved populations, and pharmacologic treatments for opioid dependence. As Principal Investigator of the NYU School of Medicine's CDC-funded Fellowship in Medicine and Public Health Research, he is dedicated to enabling fellows and junior faculty to develop applied research skills that can be focused on addressing challenges in population health. Prior to joining NYU, Dr. Gourevitch was Director of Addiction Medicine at Montefiore Medical Center and Albert Einstein College of Medicine, in the Bronx, New York. There, he implemented a system of integrated on-site primary care and psychiatric services in a network of methadone maintenance treatment programs.
Tuli, K. & Sansom, S., Purcell, D.W., Metsch, L.R., Latkin, C.A., Gourevitch, M.N. & Gomez, C.A. 2005. Economic Evaluation of an HIV Prevention Intervention for Seropositive Injection Drug Users Journal of Public Health Management & Practice, Nov/Dec 2005, Vol. 11 Issue 6, p508-515, 8p.
To assess the cost-effectiveness of Intervention for HIV-Seropositive injection drug users-Research and Evaluation (INSPIRE), designed to reduce risky sexual and needle-sharing behaviors in research sites in four US cities (2001-2003). Methods: We collected data on program and participant costs. We used a mathematical model to estimate the number of sex partners of injection drug users expected to become infected with human immunodeficiency virus (HIV) (with and without intervention), cost of treatment for sex partners who became infected, and the effect of infection on partners' quality-adjusted life expectancy. We determined the minimum effect that INSPIRE must have on condom use among participants for the intervention to be cost-saving (intervention cost less than savings from averted HIV infections) or cost-effective (net cost per quality-adjusted life year saved less than $50,000). Results: The intervention cost was $870 per participant. It would be cost-saving if it led to 53 percent reduction in the proportion of participants who had any unprotected sex in 1 year and cost-effective with 17 percent reduction. If behavior change lasted 3 months, the cost-effectiveness threshold was 66 percent; if 3 years, the threshold was 6 percent. Conclusions: Although cost-saving thresholds may not be achievable by the intervention, we anticipate that cost-effectiveness thresholds will be attained.
Arno, P.S., Gourevitch, M.N., Drucker, E., Fang, J., Goldberg, C…& Schoenbaum, E. 2002. Analysis of a Population-Based Pneumocystis carinii Pneumonia Index as an Outcome Measure of Access and Quality of Care for the Treatment of HIV Disease American Journal of Public Health, Mar, Vol. 92 Issue 3, p395-398, 4p.
A population-based Pneumocystis carinii pneumonia (PCP) Index was developed in New York City to identify geographic areas and subpopulations at increased risk for PCP. Methods. A zip code-level PCP Index was created from AIDS surveillance and hospital discharge records and defined as (number of PCP-related hospitalizations)/(number of persons living with AIDS). Results. In 1997, there were 2262 hospitalizations for PCP among 39 740 persons living with AIDS in New York City (PCP Index = .05691). PCP Index values varied widely across neighborhoods with high AIDS prevalence (West Village = .02532 vs Central Harlem = .08696). Some neighborhoods with moderate AIDS prevalence had strikingly high rates (Staten Island = .14035; northern Manhattan = .08756). Conclusions. The PCP Index highlights communities in particular need of public health interventions to improve HIV-related service delivery.
Gourevich, M., Hartel, D., Schoenbaum, E.E., Selwyn, P.A., Davenny, K., Friedland, G.H. & Klein, R.S. 1996. A Prospective Study of Syphilis and HIV Infection among Injection Drug Users Receiving Methadone in the Bronx, NY American Journal of Public Health, Aug 96 Part 1 of 2, Vol. 86 Issue 8, p1112-1115, 4p.
The purpose of this study was to assess the relationship between syphilis and human immunodeficiency virus (HIV) infection in injection drug users. Methods. A 6-year prospective study of 790 injection drug users receiving methadone maintenance treatment in the Bronx, NY, was conducted. Results. Sixteen percent (4/25) of HIV-seroconverting patients, 4.8% (16/335) of prevalent HIV-seropositive patients, and 3.5% (15/430) of persistently HIV-seronegative patients were diagnosed with syphilis. Incidence rates for early syphilis (cases per 1000 person-years) were 15.9 for HIV-seroconverting patients, 8.9 for prevalent HIV-seropositive patients, and 2.9 for persistently HIV-seronegative patients. Early syphilis incidence was higher among women than men (8.4 vs 3.2 cases per 1000 person-years). Independent risks for early syphilis included multiple sex partners, HIV seroconversion, paid sex, and young age. All HIV seroconverters with syphilis were female. Conclusions. Diagnosis of syphilis in drug-using women reflects high-risk sexual activity and is associated with acquiring HIV infection. Interventions to reduce the risk of sexually acquired infections are urgently needed among female drug users.