Pride Month is a celebration of LGBTQ+ individuals globally, but its history is deeply connected to New York City. The first Pride March was held on Christopher Street on June 27, 1970, one year after the Stonewall riots ignited the LGBTQ+ rights movement. By the 1980s, New York City had become an early epicenter of the HIV/AIDS epidemic, and it continues to account for a high proportion of cases nationally. Passionate activists who united to advocate for treatments also helped raise awareness for the gay and lesbian community, building the foundation for what we recognize today as a broader movement. Recent victories—like the legalization of gay marriage and the protection of LGBTQ+ people against workplace discrimination—would not have been possible without activists then and now.
Dr. Bruce Schackman’s Activism
Dr. Bruce Schackman
One of those activists is Dr. Bruce Schackman, executive vice chair and the Saul P. Steinberg Distinguished Professor of Population Health Sciences. He has seen firsthand the devastating toll the HIV/AIDS epidemic has had in New York City and beyond. His proximity to profound loss and the search for treatments shaped the roles that Dr. Schackman has played in the LGBTQ+ community and driven his research interests and career goals. As one of the first openly gay faculty members to receive tenure at Weill Cornell Medicine, he continues to advance high value healthcare for marginalized populations and improvements in public health.
After losing his boyfriend to AIDS in February of 1993, Dr. Schackman joined Treatment Action Group (TAG), which was formed in 1992 by members of ACT UP (the AIDS Coalition to Unleash Power) who were focused on accelerating HIV treatment research. With a background in consulting to the pharmaceutical industry and with the U.S. Food and Drug Administration, and experience in healthcare finance and venture capital, Dr. Schackman saw joining TAG as a way to use his knowledge to support his community. He took on the role of TAG’s budget and management watchdog.
“My boyfriend died, but we were losing other people, as well. A lot of the people in TAG were HIV-positive,” Dr. Schackman said. “Members would become friendly within the group, and people would talk about how many CD4 cells they had as a measure of their immune status. Nobody’s went up, there were no effective drugs. So that was the world that we were living in.”
When Dr. Schackman was first recruited to the board, TAG was still a relatively small group. Along with his other roles, he helped set up job descriptions, assign responsibilities, create supervision of staff, and think through overall organization planning. He remained with the group even after moving to Boston to pursue a doctorate at Harvard University. During that time, the discovery of combination therapy was a major accomplishment for the research and advocacy communities. Dr. Schackman’s dissertation explored the value of new treatments, which had relatively high costs and several side effects at the time.
Dr. Schackman stepped down from the board as he began getting involved with HIV clinical trials. However, he continues to support TAG’s efforts in an informal capacity. He received a Research in Action Award before departing, and was described as “intense, focused, and deeply passionate about the fight against AIDS” in a 2003 profile by the group.
Now, Dr. Schackman notes expanding the use of pre-exposure prophylaxis (PrEP) as a significant game-changer in HIV prevention. However, there are still issues—like access to health insurance and behavioral hurdles—to overcome. Still, the introduction of long-acting injectable HIV treatments and PrEP, rather than a pill taken daily, and other technologies could have an impact. “Behavioral scientists and the people who create technology have the opportunity to work together to implement this in a way that reaches a lot of different populations,” Dr. Schackman said. “We have an ‘ending the epidemic’ initiative now. I think we have the tools, despite not having a vaccine, to take advantage of these advances.”
Dr. Schackman’s Current Work
These past experiences, recent treatment advances, and current public health initiatives also blend with Dr. Schackman’s current role as director of the multi-institutional Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH).
The National Institute on Drug Abuse (NIDA) of the National Institutes of Health awarded CHERISH a five-year renewal grant in 2020 to continue activities as a national Center of Excellence. Now in the second year of that cycle, Dr. Schackman’s team is focused on the health economics of people with substance use disorders, and treatment of HIV and hepatitis C infections in people with substance use disorders. Part of that work includes examining the economic value of harm reduction services that prevent infectious diseases transmission by unsanitary injection practices.
“We've seen outbreaks of HIV and outbreaks of hepatitis C, which is sort of a canary in the coal mine for HIV, that are associated with injection drug use,” Dr. Schackman said. “We know that the overdose crisis has gotten worse in the U.S., and that it’s associated with more injection use or more frequent injections, and different substances like fentanyl. We don't fully understand what's behind the association between the worsening overdose crisis and these HIV outbreaks, but we're certainly seeing them.”
Building a Diverse Workforce
As an influential researcher in economic evaluations of the comparative effectiveness of health interventions, specifically around the treatment of infectious diseases and substance use disorders, Dr. Schackman remains focused on supporting and training the next generation of researchers in the field. That means engaging with up-and-coming scientists with different training backgrounds, skills in health services, clinical, and health economics research, and the ability to ask questions that inform policies.
“A lot of what I've been trying to do is bring up great new researchers at Weill Cornell Medicine, as well as working with researchers around the country who are using the consultation service that we have at CHERISH,” Dr Schackman said. “We’ve also taken some new steps to be more thoughtful about the pipeline of new investigators by reaching out to different training programs to diversify our pipeline. We’re trying to go upstream a little bit because building a diverse research workforce doesn't happen overnight.”
When Dr. Schackman is not at Weill Cornell Medicine’s office on the Upper East Side, he enjoys living in New York City’s Chelsea neighborhood with his husband, Ed Sikov, a retired film professor. Dr. Sikov is the author of seven books, including “On Sunset Boulevard: The Life and Times of Billy Wilder”.
While the Pride March is virtual this year due to the COVID-19 pandemic, there are still many ways to participate, support, and learn more about the history of Pride.
The Department of Population Health Sciences addresses the intersection of health and practice. Serving as a collaborative and interdisciplinary hub for clinical research, the Department aims to improve the health of populations and reduce inequities through applied research, technological innovations, and novel education programs.
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