Carla S Alexander
Institute of Human Virology
Director of Palliative Care for IHV Clinical Programs
29 S Greene St,
Dr. Alexander has cared for people with HIV/AIDS since the beginning of the epidemic. She is an internationally recognized expert in the area of Palliative and End-of-Life Care and a Fellow of the American Academy of Hospice and Palliative Medicine (AAHPM). She is a founding member of the AAHPM, serving as President in 2000, and later served as Medical Director for the US National Hospice and Palliative Care Organization (NHPCO). She has taught elements of Palliative and End-of-Life care related to HIV/AIDS throughout North and South America, 9 African countries, Eastern and Western Europe, the UK, Ukraine, and Asia. Dr. Alexander's research has focused upon palliative and end of life needs of persons with HIV disease with a history of substance abuse and poverty. Currently, she is finalizing a curriculum and studying the impact of teaching multidisciplinary non-palliative specialists critical elements of palliative care that can be implemented early in chronic illness to engage and retain challenging patients in care.
Dr. Alexander joined the IHV in 1997 as an Assistant Professor of Medicine and Director of Palliative Care. Previously, she was Director of Clinical Affairs for Chase Brexton Health Services, Inc., a community-based facility that provided primary care for persons with HIV/AIDS. She served as both National and International Medical Director of the National Hospice and Palliative Care Organization and participates in mentoring activities with the African Palliative Care Association (APCA). Her work includes monitoring and evaluation of palliative care services in Africa and advocacy for provision of appropriate medications for expert palliative care.
Dr. Alexander served as Senior Technical Advisor in 9 African countries (Nigeria, Uganda, Kenya, Tanzania, Rwanda, Zambia, Malawi and South Africa) teaching management of HIV/AIDS and integration of care and support with ART management through the AIDSRelief Consortium funded by the President's Emergency Plan for AIDS Relief (PEPFAR).
She has authored or edited many publications including chapters on palliative care in A Guide to the Clinical Care of Women with HIV, A Clinical Guide to Supportive and Palliative Care in HIV/AIDS (US and Sub-Saharan editions), A Guide to Primary Care of People with HIV/AIDS 2004 ed, and Clinical Challenges in HIV/AIDS. She was a primary author Co-Chair of the Working Group for HIV/AIDS, a Promoting Excellence in End-of-Life Care project entitled Integrating Palliative Care into the Continuum of HIV Care: an agenda for change/ Recommendations to the Field. She is the recipient of numerous honors/awards including the Life-Songs (Community Fundraiser for HIV Services) First Humanitarian Award in Baltimore, MD and a Lifetime achievement Award from the Hospice and Palliative Care Network of Maryland. She was recently funded by the Patient Centered Outcomes Research Institute to study the impact of implementing the palliative approach for staff members in an outpatient HIV clinic that will improve outcomes for difficult to engage and retain populations.
Curriculum development for non-palliative specialists to implement palliative skills to improve patient outcomes; Methods for providing support to both patients and health professionals in resource-constrained settings; Importance of self-care for physicians and other members of the interdisciplinary team; Care and support needs of persons dually impacted by cancer and HIV.
HIV/AIDS Specialist; Hospice and Palliative Medicine
Grants and Contracts:
Patient Centered Outcomes Research Institute 2013-2016
- Alexander CS. Terminal Care: Where Does It Fit In Oncology? Md Med J-1989; 38(3):211.
- Ross D, O'Mara A, Pickens N, Keay T, Timmel D, Alexander CS, Hawtin C, O'Brien III W, Schnaper D, Hospice and Palliative Care Education in Medical School: A Module on the Role of the Physician in End-of-Life Care. J Cancer Educ 1997; 12(2):152-156.
- Ross D, Keay T, Timmel D, Alexander CS, Dignon C, O'Mara A, O'Brian III W., Required Training in Hospice and Palliative Care at the University of Maryland School of Medicine. J Cancer Educ 1999; 14(3).
- Ross D., Alexander CS, Management of Common symptoms in Terminally Ill Patients: Part I. Fatigue, Anorexia, Cachexia, Nausea and Vomiting. Amer Fam Physician 2001; 64(5): 807-814.
- Ross D, Alexander CS, Management of Common Symptoms in Terminally Ill Patients: Part II. Constipation, Delirium, Dyspnea. Amer Fam Physician 2001; 64(6):1019-1026.
- Keay T, Alexander CS, McNally K, Crusser E, Eger R, Hawtin C, Lowitt NR, Ross D., Adult Education Program Palliative Care for Nursing Facility Physicians: Design and Pilot Test. J of Pall Med (Winter) 2003; 3(4): 457-463.
- Keay T, Alexander CS, McNally K, Crusser E, Eger R, Nursing Home Physician Educational Intervention Improves End-of-Life Outcomes. J Pall Med (Spring) 2003; 6(2): 205-213.
- Karus D., Raveis V., Marconi K., Hanna B., Selwyn P., Alexander C., Perrone M., Higginson I., Service Needs of Patients with Advanced HIV Disease: A Comparison of Client and Staff Reports at Three Palliative Care Projects. AIDS Patient Care and STDs 2004; 18 (3): 145-158.
- Karus D, Raveis VH, Marconi K, Selwyn P, Alexander C, Hanna B, Higginson I, Mental Health Status of Clients From Three HIV/AIDS Palliative Care Projects. Palliative and Supportive Care; (2004); 2, 125-138.
- Ross DD, Shpritz D, Alexander CS, Carter K, et al. Development of Required Postgraduate Palliative Care Training for Internal Medicine Residents and Medical Oncology Fellows. J Cancer Educ 2004; 19:81-87.
- Bedor M, Alexander C, Edelman Martin. Management of Common Symptoms of Advanced Lung Cancer. Current Treatment Options in Oncology 2005; 6(1): 61-68.
- Emanual L, Alexander CS, Arnold R, Bernstein R, Dar R, Dellasantina R, Dykstra L, and Tulsky J. Integrating Palliative Care into Disease Management Guidelines, Palliative Care Guidelines Group Report. J Pall Med 2004;7(6):774-83.
- Karus D, Raveis V, Alexander C, et al. Patient reports of symptoms and their treatment at three palliative care projects servicing individuals with HIV/AIDS. J of Pain & Sx Mant. 2005:30(5):408-17.
- Royak-Schaler R, Gadalla SM, Lemkau, JP, Ross DD, Alexander CS, Scott D. Family Perspectives on Communication With HealthCare Providers During End-of-Life Cancer Care. ONF 2006; 33(4): 753-760.
- Harding R, Powell R, Downing J, Connor S, Mwangi-Powell F, Defilippi K, Cameron S, Garanganga E, Kikule E, Alexander C. Generating an African Palliative Care Evidence Base: The Context, Need, Challenges, and Strategies. J Pain and Symptom Management. 2008; 36 (3):304-309.
- Alexander CS, Memiah P, Henley YB, Kaiza-Kangalawe A, Shumbusho AJ, Obiefune M, Enejoh V, Stanis-Ezeobi W, Eze Charity, Odion E, Akpenna D, Effiong A, Miriti K, Adudda S, Oko J, Melaku GD, Baribwira C, Umutesi H, Shimabale M, Mugisa E and Amoros A. Palliative care and support for persons with HIV/AIDS in 7 African countries: implementation experience and future priorities. Am J Hospice & Pall Med, in press. (2011)
- Harding R, Simms V, Alexander CS, Collins K, Combo E, Memiah P, Patrick G, Sigalla G, Loy G. Can palliative care integrated within HIV outpatient settings improve pain and symptom control in a low-income country? A prospective, longitudinal, controlled intervention evaluation. AIDS Care, 2013; 25(7):795-804.
- Riedel DJ, Mwangi I, Fantry L, Alexander CS, Hossain, M, Pauza D, Redfield RR, and Gilliam BL. High cancer-related mortality in an urban, predominantly African-American, HIV-infected population. JAIDS 2013 April; 27(7):1109-17.
Book Chapters and Reviews
- O'Neill J and Alexander CS. Palliative Medicine and HIV/ AIDS, Primary Care Clinics in Office Practice, Sept. 1997;24(3):607-615.
- Standards and Accreditation Committee/Medical Guidelines Task Force. Medical Guidelines for Determining Prognosis in Selected Non-Cancer Diagnoses, Second Ed. National Hospice Organization, Washington, DC, 1996 (Sections on Renal and HIV Diseases).
- Alexander CS. Pain Management in HIV Disease. (Guest Editor) Academy Update, Vol. 6:1 (Spring), 1996.
- Kosko DA, Alexander CS, Benker K., Hughes V. "HIV/AIDS",Primary Care, ed. Singleton JK, et al.
Lippincott, Philadelphia, 1999;(41):453-479.
- Carducci MA, Blacker SE, Perrone ME, Alexander CS. Update:Palliative Care in Oncology Practice Clinical Oncology, ed. Abeloff, Armitage, Lichter, and Niederhuber. Harcourt Brace & Company, Philadelphia, PA, 1999;2(1):1-12.
- Alexander CS, Hoy, AM. "Palliative Care in the Age of HIV/AIDS Recommendations for Action Workgroup 3: Education" J R Soc Med 2001;94:477-478.
- Alexander CS, "Palliative and End-of-Life Care" in A Guide to the Clinical Care of Women with HIV, ed. Anderson J. Health Resources and Services Administration, HIV/AIDS Bureau, Rockville, MD, 2000 Preliminary Edition;(XII);2001
- Alexander CS, Back A, Perrone M. "Medical Care at the End of LIfe" in A Clinical Guide to Supportive and Palliative Care in HIV/AIDS, O'Neill JR, Selwyn P, Schietinger, eds. HRSA, Rockville, MD. 2003.
- Alexander CS, Schietinger, H. "Special Populations" in A Clinical Guide to Supportive and Palliative Care in HIV/AIDS, O'Neill JR, Selwyn P, Schietinger, eds. HRSA, Rockville, MD. 2003.
- Alexander CS, Back A, Anderson J, Breener P, Burack J, Byock I, Curtis JR, Feinberg J, Forstein M, Gibbons P, Hutton N, Kutzen H, Meyers F, Miller G, Perrone M, Powell T, Reiter G, Selwyn P, Sunderland Rev. E, Integrating Palliative Care into the Continuum of HIV Care An Agenda for Change, Promoting Excellence in End-of-Life Care a national program of the Robert Wood Johnson Foundation, April 2004.
- Alexander, CS and Carter, KR, "Palliative and End-of-Life Care" in A Guide to Primary Care for People with HIV/AIDS, Cheever LW and Schietinger H. eds. HRSA, Rockville, MD. 2004.
- Shetty SM, Vanston VJ, Alexander C., Unipac 7:The Hospice/Palliative Medicine Approach to Caring for Patients with HIV/AIDS, ed. P. Storey P, Knight C., AAHPM, 2007.
- Alexander, CS and Henley, YB. Palliative Care in Resource-Poor Settings in Global Management of HIV/AIDS Temesgen, Z. ed. 2009.
- Alexander, CS. HIV/AIDS in Palliative Care: Core Skills and Clinical Competencies, 2nd edition. Emanuel LL and Librach SL eds., ElsevierSaunders, St. Louis, 2011, pp372-390.