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Directory >> R. Scott McClelland, MD, MPH

Faculty

Contact Information

R. Scott McClelland, MD, MPH

  • Professor of Medicine, Epidemiology, and Global Health
  • University of Washington

Dr. McClelland is a Professor of Medicine, Epidemiology, and Global Health. He is co-Director of the University of Washington's Center for AIDS Research (CFAR) International Core, and a member of the International AIDS Research and Training Program and the Kenya Research Program faculty. Dr. McClelland is Site Leader for the University of Washington (UW)/University of Nairobi (UON) Mombasa HIV/STD Research Site. This highly productive research field site includes strong collaborative research efforts between the UW, UON, the Kenya Medical Research Institute (KEMRI), Coast Provincial General Hospital, the Municipal Council of Mombasa, and the Kenya Ministry of Health.


Research Interests

Dr. McClelland's research focuses on human immunodeficiency virus (HIV) and sexually transmitted infection (STI) epidemiology and prevention in most at-risk populations including female sex workers and men who have sex with men. This includes both primary prevention strategies for reducing the risk of HIV/STI acquisition and secondary prevention aimed at reducing infectiousness and risk behavior in people living with these conditions. A current NIH/NICHD funded R01 grant titled, "Women's Lifecourse Events & HIV Transmission Potential: A Multidisciplinary Study," has active field work ongoing in Mombasa and Nairobi. This study will explore transmission potential in HIV-positive women on antiretroviral therapy in relation to key lifecourse events including marriage, decisions about contraception, conception, pregnancy, the post-partum period, menopause, depression, alcohol use, and intimate partner violence.

Dr. McClelland is the Protocol Chair for a Sexually Transmitted Infections Clinical Trials Group funded study titled, "Preventing Vaginal Infections (PVI Trial)." This double-blind, randomized trial is evaluating the efficacy of monthly treatment with topical metronidazole and fluconazole co-formulated suppositories versus placebo for preventing vaginal infections in HIV-1-seronegative women. Vaginal infections have been associated with increased risk for HIV-1 acquisition, and may account for a high population attributable risk of HIV-1 infection. The PVI trial included sites in Mombasa and Nairobi, Kenya, as well as Birmingham, Alabama. Field work was completed in September 2013, and the primary analyses and ancillary studies are ongoing. A linked NIH/NIAID R01 grant was also funded, and will facilitate molecular testing of vaginal samples from trial participants to identify changes in vaginal microbiota at the species level. This very rich vaginal microbiome dataset will facilitate a unique analysis using microbiota as a trial outcome, and will also provide a great resource for ancillary studies.

Dr. McClelland is the study leader for an NIH/NICHD-funded P01 study that is part of a program-project grant titled, "Mechanisms and Cofactors for HIV-1 Transmission in Women." Dr. McClelland's project, titled, "Vaginal Flora and HIV-1 Acquisition in Women," involves a multi-site case-control study to compare vaginal bacterial flora using molecular methods in HIV-1 seroconverters compared to controls who remain HIV-1 seronegative. Participants include the high-risk cohort in Mombasa and a cohort of pregnant and post-partum women in Kisumu, Kenya. This study is ongoing.

Additional Kenya-based research areas in which I mentor trainees include mHealth interventions to support HIV treatment and prevention, STI screening and HPV vaccine preparedness in adolescent women, cervical cancer screening approaches for resource limited settings, and geospatial mapping and analysis of tuberculosis clustering.


Teaching Interests

Dr. McClelland is a clinical attending on the Internal Medicine and Infectious Diseases Consult services at Harborview Medical Center. He also teaches Epidemiology 532, "Epidemiology of Infectious Diseases in Resource-Limited Countries." The course is offered every other year (odd number years) in the Spring. Dr. McClelland is a regular lecturer in med 561 (Tropical Medicine), EPI 507/OBGYN590 (HIV and STDs in Women and Children), EPI 530 (AIDS, A Multidisciplinary Approach), and GH573 (Clinical Management of HIV), GH560 (Principles of STD and HIV Research).


Education

  • BS in Biology, magna cum laude, University of Washington (1989)
  • MD, High Honors, University of Washington (1995)
  • Resident in Internal Medicine, Duke University (1995-1998)
  • Fellow in Infectious Diseases, University of Washington (1998-2002)
  • MPH, University of Washington (2001)

Projects

  • Effect of antiretroviral therapy on infectivity and sexual risk behavior in Kenyan women
  • Polymorphisms in the CYP2B6 drug metabolizing enzymes, clinical outcomes, and adverse drug events in antiretroviral treated Kenyan women
  • Incidence and epidemiologic correlates of HIV-1 superinfection
  • Vaginal ecology and the risk of HIV-1 and STIs in women
  • Randomized trial of periodic presumptive treatment to reduce vaginal infections in women at risk for HIV-1 and STIs
  • Women's lifecourse events and HIV transmission potential: a multidisciplinary study


Selected Publications


McClelland RS, Lavreys L, Hassan WM, Mandaliya K, Ndinya-Achola JO, Baeten JM. Vaginal washing and increased risk of HIV-1 acquisition among African women: A 10-year prospective study. AIDS. 2006; 20: 269-73.
PubMed Abstract


McClelland RS, Sangaré L, Hassan WM, Lavreys, L, Mandaliya K, Kiarie J, et al. Infection with Trichomonas vaginalis increases the risk for HIV-1 acquisition. J Infect Dis. 2007; 195: 698-702.
PubMed Abstract


McClelland RS, Richardson BA, Hassan WM, et al. Improvement of vaginal health for Kenyan women at risk for acquisition of human immunodeficiency virus type 1: results of a randomized trial. J Infect Dis. 2008; 197:1361-8.
PubMed Abstract


McClelland RS, Graham SM, Richardson BA, et al. Treatment with antiretroviral therapy is not associated with increased sexual risk behavior in Kenyan female sex workers. AIDS. 2010; 24(6): 891-7.
PubMed Abstract


Graham SM, Masese L, Gitau R, Jalalian-Lechak Z, Richardson BA, Peshu N, Mandaliya K, Kiarie JN, Jaoko W, Ndinya-Achola JO, Overbaugh J, McClelland RS. Antiretroviral adherence and development of drug resistance are the strongest predictors of genital HIV-1 shedding among women initiating treatment. J Infect Dis. 2010; 202:1538-42.
PubMed Abstract


Odeny TA, Bailey RC, Bukusi EA, Simoni JM, Tapia KA, Yuhas K, Holmes KK, McClelland RS. Text messaging to improve attendance at post-operative clinic visits after male circumcision for HIV prevention: A randomized controlled trial. PLoS ONE 2012; 7:e43832.
PubMed Abstract

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