Edward Machtinger, MD
Professor
Medicine
School of Medicine

The focus of Dr. Machtinger’s research and health policy expertise is helping the U.S. primary health care system more effectively address the traumatic roots of most physical and mental illness and disparities in health. His work also seeks to expand access to mental health and substance use treatment through full integration of these fields into primary medical care.

Dr. Machtinger is Co-Principal Investigator (with Dr. Shannon Thyne from UCLA) of the UCLA/UCSF ACEs Aware Family Resilience Network (UCAAN), a University of California multi-campus initiative housing the State of California's "ACEs Aware" portfolio of programs and grants addressing the health impacts of adverse childhood experiences (ACEs) and toxic stress. UCAAN is a partnership between the University of California, the California Department of Health Care Services and the California Office of the Surgeon General. The initiative is the California Surgeon General's signature effort to reduce toxic stress among California’s families by half in a generation.

Dr. Machtinger is Principal Investigator and Co-director (with Drs. Anda Kuo and Marguerita Lightfoot) of the California ACEs Learning and Quality Improvement Collaborative (CALQIC), a 49-clinic, seven-region, statewide initiative to train providers of care to screen for and respond to adverse childhood experiences (ACEs) among children and adults in the state’s 13+ million member Medi-Cal system.

He is Co-Principal Investigator (with Dr. Marguerita Lightfoot from Oregon Health Sciences University) of a study funded by Genentech to design and evaluate a "Whole Family Wellness" intergenerational response to adversity among low-income children and families. The study is based on a conceptual framework designed to overcome the fragmentation of health care services experienced by families, authored by study Co-Investigators Drs. Alicia Lieberman, Ken Epstein, and Alex Briscoe.

Dr. Machtinger’s other current grants include a 3-year award from the Health Resources Services Administration Special Projects of National Significance (SPNS) to improve care for Black women living with HIV and a 5-year award from the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop and implement a new model of outpatient trauma—informed substance use treatment.

Since 2018, as Principal and Co-Principal Investigator, Dr. Machtinger has received over $100 million dollars in grant support.

In partnership with Naina Khanna, the Executive Director of Positive Women’s Network-USA, Dr. Machtinger convened a national strategy group to develop a model of trauma-informed health care to guide national implementation and evaluation efforts.

His latest publications include: a conceptual framework for trauma-informed health care; an expert consensus guide to inquiry and response to past trauma in adult health care settings; a meta-analysis describing high rates of trauma and PTSD among US woman living with HIV; a study demonstrating a significant association of recent trauma and HIV antiretroviral medication failure; and an analysis of the causes of death among U.S. men and women living with HIV that documents startlingly high rates of death from trauma-related physical and mental health conditions.

Dr. Machtinger's work also focuses on developing practical interventions to more effectively treat trauma-related illnesses that can be integrated into standard primary care clinics. In partnership with Rhodessa Jones, the Director of the Medea Project: Theater for Incarcerated Women, he published a study describing the transformative impact of an expressive therapy intervention using theater for women of color with experiences of significant trauma. The study clarified key ingredients for healing from trauma in this population: fostering sisterhood and community, increasing self-acceptance, and developing the self-confidence to publicly advocate for issues that affect the safety and well-being of one's family and community. He also published a study demonstrating the positive impact of a clinic-based group intervention for transgender women with co-occurring substance use disorder and PTSD.

Dr. Machtinger is a respected thought leader and advocate nationally for health policy pertaining to trauma-informed care and the integration of physical and behavioral health care. He was a keynote speaker at two recent National Academies of Science, Engineering and Medicine workshops: "Key Policy Challenges to Improve Care for People with Mental Health and Substance Use Disorders" (2019) and "Improving Access to and Equity of Care for People with Serious Illness" (2019). He advised the Presidential Federal Working Group on the Intersection of HIV/AIDS, Violence Against Women and Gender-related Health Disparities and was a keynote speaker at the White House release of their 2014 report. He served on the Substance Abuse and Mental Health Administration (SAMHSA) General Adult Trauma Screening and Brief Interventions (GATSBI) working group, providing expertise on developing best practices for trauma-informed health care. Dr. Machtinger was also a lead presenter at the U.S. Department of Health and Human Services (DHHS) HIV/AIDS Bureau Conference on Women, Trauma and HIV and served on the technical expert panel convened by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Health Resources and Services Administration (HRSA).

Currently, he serves on the Executive Committee of the AIDS Research Institute (ARI) at UCSF, the Executive Committee for the oversight of Congressional Ryan White funds to women and children in San Francisco, and as member of Treatment Starts Here, a working group overseeing California’s response to the opiate overdose crisis.

Dr. Machtinger is also a respected clinician, teacher and mentor and was the recipient of the UCSF School of Medicine 2013 Osler Distinguished Teaching Award. Dr. Machtinger's other interests include the well-being of animals and the environment and the relationship between human health, animal welfare, and environmental stewardship. He is a graduate of Harvard Medical School and performed his residency in internal medicine at UCSF.

• Clinic Readiness for Trauma-Informed Health Care Is Associated With Uptake of Screening for Adverse Childhood Experiences.
  The Permanente journal 2024 Machtinger EL, Eberhart NK, Ashwood JS, Jones M, Sanchez M, Lightfoot M, Kuo A, Malika N, Leba NV, Williamson S, McCaw B
• The Association Between Interpersonal Violence and Unstable Housing Among Veterans.
  Military medicine 2022 Hargrave AS, Kimberg L, Machtinger EL, Kushel MB, Cohen BE
• Recent trauma is associated with antiretroviral failure and HIV transmission risk behavior among HIV-positive women and female-identified transgenders
  AIDS and Behavior 2021 Machtinger, E. L., Haberer, J. E., Wilson, T. C., & Weiss, D. S
• Ending intimate partner violence among women living with HIV: How attachment and HIV stigma inform understanding and intervention.
  Social work in health care 2021 Davis K, Dawson-Rose C, Cuca YP, Shumway M, Machtinger E
• Research, Practice, and Policy Implications of Adverse Childhood Events.
  JAMA pediatrics 2021 Machtinger EL, Lieberman A, Lightfoot M
• The Association of Trauma with the Physical, Behavioral, and Social Health of Women Living with HIV: Pathways to Guide Trauma-informed Health Care Interventions.
  Women's health issues : official publication of the Jacobs Institute of Women's Health 2019 Cuca YP, Shumway M, Machtinger EL, Davis K, Khanna N, Cocohoba J, Dawson-Rose C
• Providing Primary Care for HIV in the Context of Trauma: Experiences of the Health Care Team.
  Women's health issues : official publication of the Jacobs Institute of Women's Health 2019 Dawson-Rose C, Cuca YP, Shumway M, Davis K, Machtinger EL
• A Feasibility Study of a Telehealth Intervention on Health Care Service Utilization among Transgender Women of Color in Washington, DC.
  ACI Open 2018 Manya Magnus, Elizabeth Edwards, Aurnell Dright, Leandrea Gilliam, Angela Brown, Matthew Levy, Neal Sikka, Marc Siegel, Vittoria Criss, Christopher Watson, Edward Machtinger, Irene Kuo
• Seeking Safety Group Therapy for Co-Occurring Substance Use Disorder and PTSD among Transgender Women Living with HIV: A Pilot Study.
  Journal of psychoactive drugs 2017 Empson S, Cuca YP, Cocohoba J, Dawson-Rose C, Davis K, Machtinger EL
• From treatment to healing: the promise of trauma-informed primary care.
  Women's health issues : official publication of the Jacobs Institute of Women's Health 2015 Machtinger EL, Cuca YP, Khanna N, Rose CD, Kimberg LS
• An expressive therapy group disclosure intervention for women living with HIV improves social support, self-efficacy, and the safety and quality of relationships: a qualitative analysis.
  The Journal of the Association of Nurses in AIDS Care : JANAC 2014 Machtinger EL, Lavin SM, Hilliard S, Jones R, Haberer JE, Capito K, Dawson-Rose C
• Atraumatic splenic rupture: an unusual manifestation of acute HIV infection.
  AIDS patient care and STDs 2011 Vallabhaneni S, Scott H, Carter J, Treseler P, Machtinger EL
• Language, literacy, and characterization of stroke among patients taking warfarin for stroke prevention: Implications for health communication.
  Patient education and counseling 2009 Fang MC, Panguluri P, Machtinger EL, Schillinger D
• A visual medication schedule to improve anticoagulation control: a randomized, controlled trial.
  Joint Commission journal on quality and patient safety 2007 Machtinger EL, Wang F, Chen LL, Rodriguez M, Wu S, Schillinger D
• Seven steps to better adherence: a practical approach to promoting adherence to antiretroviral therapy.
  The AIDS reader 2007 Machtinger EL, Bangsberg DR
• Language, literacy, and communication regarding medication in an anticoagulation clinic: a comparison of verbal vs. visual assessment.
  Journal of health communication 2006 Schillinger D, Machtinger EL, Wang F, Palacios J, Rodriguez M, Bindman A
• The importance of establishing regimen concordance in preventing medication errors in anticoagulant care.
  Journal of health communication 2006 Schillinger D, Wang F, Rodriguez M, Bindman A, Machtinger EL
• Health literacy and anticoagulation-related outcomes among patients taking warfarin.
  Journal of general internal medicine 2006 Fang MC, Machtinger EL, Wang F, Schillinger D
• Etiology of pruritic papular eruption with HIV infection in Uganda.
  JAMA 2004 Resneck JS, Van Beek M, Furmanski L, Oyugi J, LeBoit PE, Katabira E, Kambugu F, Maurer T, Berger T, Pletcher MJ, Machtinger EL