The go-to person on HIV

Dr. Rochelle P. Walensky uses computer modeling to show the importance of AIDS drugs in saving lives. (Jonathan Wiggs/Globe Staff)

Considering her line of work, AIDS expert Rochelle Walensky is surprisingly sunny, likable, palpably optimistic.

"When you're married to a pediatric oncologist, and you study AIDS, you're surrounded by tragedy. But I look at it as a challenge, rather than just throwing in a towel and saying how awful it is," said Walensky, a 39-year-old mother of three.

That optimism in the face of tragedy was perhaps shaped by her years in medical school in Baltimore in the early 1990s - at a time when AIDS was wreaking widespread misery in the city. But it was also just a few years before the discovery of protease inhibitors, the antiretroviral drugs that turned AIDS in America from a death sentence to what she refers to as "a chronic, manageable disease."

Now Walensky, an associate professor at Harvard Medical School, is, in the words of one colleague, "the go-to person on HIV testing in this country." A leading player in US and international HIV policy, Walensky has produced - through her work with a mathematical modeling group - some hard numbers on both the successes of effective drug therapy and the horrors when it falls short.

"If you want to know what the evidence base says, or what the research base says ought to be going on, she's the person you ask. It's that simple," said David Paltiel, a professor in the school of public health at Yale who has worked with Walensky on the mathematical models. "She sits at the point of intersection between clinical practice and this new discipline of model-based analysis, and it puts her at a unique vantage to ask questions about what's going to work."

Last month, Walensky co-authored a study, published in the Journal of Infectious Diseases, which demonstrated that ramping up access to antiretroviral drugs in South Africa could save 1.2 million lives over the next five years. It's a big number. A scary number. And, after a recent visit to clinics in the country where only a third of those infected have access to antiretroviral therapy, it is, for Walensky, a desperate number. As Walensky points out, these figures are only for one country on an AIDS-ravaged continent.

"I look at HIV as this train that's heading toward a cliff," said Walensky, who also has appointments in the divisions of infectious diseases at Mass. General and Brigham and Women's Hospitals, "We have the opportunity to slow that train if we can just get these drug therapies to the patients."

In the United States, where drug therapies are more readily available and have saved more than 3 million years of life - according to a mathematical model Walensky worked on in 2006 - she sees lack of testing as the biggest obstacle.

In 1999 and 2000, she collaborated on a project to offer HIV testing to everyone who entered an urgent care clinic in four high-risk Massachusetts communities. Though the patients had gone to the clinic for other reasons, 2 percent of those who took the test were positive for HIV. It was a shocking figure, which got the attention of the Centers for Disease Control and a federal grant for Walensky to study the benefits and cost-effectiveness of testing patients in the ER.

While she spends her days worrying about how to make HIV screening a standard in the United States and how to save millions of lives in countries where the AIDS epidemic remains front-page news, Walensky says it's her children who keep her grounded and able to embrace her own good fortune.

"I just had to dash off to an event at one of my son's schools," she said on a recent day as she sat in the cafeteria at the Harvard School of Public Health. "The juggle is to learn to let things roll off your back, and make sure your kids know they're the most important thing in the world."

And what would be the happy ending to her story that started on the streets of Baltimore? Walensky doesn't hesitate with her answer: universal screening and universal access to antiretroviral therapies for all who need them.

"It's a pipe dream right now," she said. "But it shouldn't be."

Fact sheet

Education: Bachelor's degree in biochemistry from Washington University in St. Louis in 1991; medical degree from Johns Hopkins in 1995; master's in public health from Harvard in 2001.

Family: Husband, Dr. Loren Walensky, 39, is a pediatric oncologist who does research into therapeutic drug development at the Dana-Farber Cancer Institute. The couple have three sons: Seth, 8; Mathew, 6; and Joshua, 3.

Hobbies: "Tickling my children, going to the gym, playing the flute. Probably in that order."

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