Robert Klitzman
Biographic Data
| ID | 1253188 |
|---|---|
| NAME | Robert Klitzman |
| GIVEN NAMES | Robert |
| FAMILY NAME | Klitzman |
| SIGNATURE | KLITZMAN R |
| AFFILIATIONS | Columbia University |
| ORCID | 0000-0002-6827-8063 |
| VERIFIED | Yes |
| TOTAL WORKS | 43 |
| TOTAL CITATIONS | 35 |
| AUTHOR COUNT | 43 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1998 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 4 |
Pre-Exposure prophylaxis knowledge, use and adherence among a US national sample of women
Pre-exposure prophylaxis (PrEP) is a proven strategy for HIV prevention, yet uptake among women vulnerable to HIV remains low. This study draws on survey data and urine-based adherence testing from the American Women Assessing Risk Epidemiologically (AWARE) study to assess PrEP knowledge, use, and adherence in a behaviorally vulnerable sample. Despite high awareness of PrEP, actual use and willingness to consider PrEP were minimal. Objective adhe…
When and why patients and families reject chaplains: Challenges, strategies and solutions
Hospital chaplains perform important activities, but critical questions arise about the challenges they may face in working with patients, and how these professionals respond. Thirty-three telephone interviews of approximately 1 hour and were conducted with 21 board-certified chaplains. When asked about their biggest challenges and most rewarding interactions, several chaplains described rejections by patients or families. Patients and families a…
Becoming chaplains: How and why chaplains enter the field, factors involved and implications
Many questions arise concerning how and why chaplains enter the field. Interviews of ∼1 one hour each were conducted with 23 U.S. chaplains. Chaplains vary widely in professional and personal backgrounds and experiences, which they often draw on in their work. Personal experiences can lead them to enter the field, enhance their empathy and strengthen their commitment. They have frequently faced significant trauma (e.g., parent's death) or helped …
“Reading” the room: Healthcare chaplains’ challenges, insights and variations in entering rooms and engaging with patients and families
these professionals perform these tasks, whether variations occur, and if so, in what ways. Twenty-three chaplains were interviewed in-depth. Chaplains described engaging in highly dynamic processes, involving both verbal and non-verbal interactions. They face challenges and vary in ways of starting interactions, using verbal and non-verbal cues, and communicating through physical appearance. In these processes, when entering patients' rooms, the…
Anti‐obesity Medications: Ethical, Policy, and Public Health Concerns
New anti‐obesity medications (AOMs) have received widespread acclaim in medical journals and the media, but they also raise critical ethical, public health, and public policy concerns that have largely been ignored. AOMs are very costly, need to be taken by a patient in perpetuity (since significant rebound weight gain otherwise occurs), and threaten to shift resources and focus away from other crucial efforts at obesity treatment and prevention.…
Protocol: The American Women: Assessing Risk Epidemiologically (Aware) cohort study
Innovative and culturally sensitive strategies to improve access to HIV prevention and treatment services for cisgender women are vital to curb the burden of the HIV epidemic for this key population. Findings from this study will inform future research, intervention strategies, and public policies
Challenges in Arranging to Waive Parental Consent in HIV Prevention Studies of Adolescent Men Who have Sex with Men: The Case of HPTN 078
Including adolescent men who have sex with men (AMSM) in HIV prevention and treatment studies without parental permission is vital, but has often faced barriers. We examine the case of recent Institutional Review Boards (IRB) reviews of an HIV treatment and prevention study that requested waiving parental permission at four United States sites, but received different responses from each institution. IRBs varied in whether and how they weighed par…
The Effects of Contextual Factors on Hospital Chaplains: A Qualitative Study
Critical questions arise about how contextual factors affect hospital chaplains. We interviewed 23 chaplains in-depth. Hospitals’ religious or other institutional affiliation, geography, and leadership can influence chaplains both explicitly/directly and implicitly/indirectly—for example, in types/amounts of support chaplains receive, scope of chaplains’ roles/activities, amounts/types of chaplains’ interactions, chaplains' views of their roles a…
Exiting Patients’ Rooms and Ending Relationships: Questions and Challenges Faced by Hospital Chaplains
These data, the first to explore chaplains' challenges in ending visits/relationships with patients/families, has critical implications for practice, education, and research. Questions arise about the scope/boundaries of chaplains' relationships with patients/families. Interviews were conducted with 23 chaplains who face questions/challenges regarding how to end visits and interactions, including individual conversations and ongoing relationships…
“Why me?”: Qualitative research on why patients ask, what they mean, how they answer and what factors and processes are involved
Patients often ask, “why me?” but questions arise regarding what this statement means, how, when and why patients ask, how they answer and why. Interviews were conducted as part of several qualitative research studies exploring how patients view and cope with various conditions, including HIV, cancer, Huntington's disease and infertility. A secondary qualitative analysis was performed. Many patients ask, “why me?” but this statement emerges as ha…
“It wasn’t Luck: God Wants me Here for a Reason”: Perceptions of Luck Among US Patients and Its Relationships to Other Factors Among US Patients
In Reply to Jain and Kassam
I am grateful to Jain and Kassam for further underscoring the importance of integrating religion and spirituality in medical education and endorsing some of the suggestions I made in my article. But to clarify, my sentence, “Even one such lecture reviewing these topics is better than none,” was not dismissing additional approaches. I agree with Jain and Kassam, and had covered in my article, that small group discussions—as opposed to just lecture…
How hospital chaplains develop and use rituals to address medical staff distress
Physicians and nurses face high levels of moral distress and burnout, exacerbated by the COVID-19, yet are often busy, without time for extended interventions. Hospital chaplains have recently been asked to assist staff, but many questions arise concerning whether they do so, and if so, how and when, and whether they may vary in doing so. Thirty-one telephone interviews of ∼1 h each were conducted with 21 board-certified chaplains to examine thes…
Typologies and Meanings of Prayer Among Patients
Doctor, Will You Pray for Me? Responding to Patients’ Religious and Spiritual Concerns
Religion and spirituality in the United States have been shifting, and physicians are treating patients with increasingly diverse beliefs. Physicians’ unfamiliarity with these beliefs poses critical challenges for medical education and practice. Despite efforts to improve medical education in religion/spirituality, most doctors feel their training in these areas is inadequate. This article draws on the author’s conversations with providers and pa…
Experiment on identical siblings separated at birth: Ethical implications for researchers, universities, and archives today
Several films, including Three Identical Strangers , examined ethical problems in an experiment that involved identical siblings who were adopted as infants and separated into different families to examine the effects of nature versus nurture. The study was primarily designed and directed by Dr Peter Neubauer. The experiment, conducted in the 1960’s through 1980’s, serves as an important cautionary case study, raising several critical and ongoing…
Roles of genetics and blood type in clinical responses to Covid-19: Ethical and policy concerns
Recently, several genetic variants have been associated with increased or decreased risks of becoming infected and/or seriously ill with COVID-19—not only offering important potential medical benefits but also posing critical ethical questions. These genetic factors, some of which are associated with blood type, may account for variations in observed responses to COVID-19. Hence, assessments of these genetic differences and blood type could provi…
How Artistic Representation Can Inform Current Debates About Chimeras
How Infertility Patients and Providers View and Confront Religious and Spiritual Issues
Gatekeepers for infertility treatment? Views of ART providers concerning referrals by non-ART providers
Deciding how many embryos to transfer: Ongoing challenges and dilemmas
Typologies of Altruistic and Financial Motivations for Research Participation: A Qualitative Study of MSM in HIV Vaccine Trials
Questions arise concerning participants' motives in risky studies, such as HIV vaccine trials (HVTs). We interviewed in-depth 20 gay/bisexual men. Participants described both altruistic and nonaltruistic motives. Altruistic motivations emerged primarily, with nine typologies: (a) cultural, (b) community related, (c) familial, (d) religious, (e) professional, (f) political (e.g., HIV activism), (g) moral (e.g., making up for past wrongs), (h) exis…
Ethical and Psychosocial Considerations in Informing HIV-Exposed Uninfected Children That They Were Exposed to HIV and Antiretroviral Medications In Utero
We build on what is known about the potential long-term health effects of perinatal antiretroviral medication exposure to examine ethical and psychosocial issues associated with disclosure by applying lessons from other health conditions, theories of child and adolescent development and rights, and the relevant literature and legal contexts. We present 2 cases to highlight potential issues; apply a bioethical framework that includes principles of…
Detecting, Preventing, and Responding to “Fraudsters” in Internet Research: Ethics and Tradeoffs
Research that recruits and surveys participants online is increasing, but is subject to fraud whereby study respondents — whether eligible or ineligible — participate multiple times. Online Internet research can provide investigators with large sample sizes and is cost efficient. Internet-based research also provides distance between the researchers and participants, allowing the participant to remain confidential and/or anonymous, and thus to re…
Evolving Challenges and Research-Needs Concerning Ebola
Patterns of Communication Between Gay and Lesbian Patients and Their Health Care Providers
OBJECTIVES: To determine whether gay men and lesbians disclose their sexual orientation, and other sensitive behaviors to their primary care physicians; whether they have a chance of finding a gay friendly physician; and what factors are involved. METHODS: A self-report questionnaire was administered to 66 gay men and 28 lesbians at a gay and lesbian community center. RESULTS: Less than half of participants felt their health insurance plan gave t…
Typologies of Altruistic and Financial Motivations for Research Participation: A Qualitative Study of MSM in HIV Vaccine Trials
Questions arise concerning participants' motives in risky studies, such as HIV vaccine trials (HVTs). We interviewed in-depth 20 gay/bisexual men. Participants described both altruistic and nonaltruistic motives. Altruistic motivations emerged primarily, with nine typologies: (a) cultural, (b) community related, (c) familial, (d) religious, (e) professional, (f) political (e.g., HIV activism), (g) moral (e.g., making up for past wrongs), (h) exis…
How IRBs View and Make Decisions about Consent Forms
IRBs have been criticized for long and complicated consent forms, but how IRBs make decisions about these issues hasn't been examined. I contacted leaders of 60 IRBs, and interviewed IRB leaders from 34 (response rate = 55%), and 13 members and administrators. IRBs confront challenges and dilemmas regarding these documents: what and how much these forms should include (e.g., how "perfect" forms should be). While IRBs generally seek to decrease th…
Tell It Slant Sex, Disclosure, and HIV
Encounters with HIV can tell us much about how we as individuals communicate about and view our bodies and most intimate selves—how we view and approach truth, lies, sex, and trust. Better ways of handling issues of disclosure in conjunction with changed sexual practices can be crucial to thwarting the HIV pandemic. We interviewed in depth 59 HIV-infected and 18 uninfected gay, bisexual, and heterosexual men and women. Five strategies emerged for…
From "Male Bonding Rituals" to "Suicide Tuesday: A Qualitative Study of Issues Faced by Gay Male Ecstasy (MDMA) Users
Use of MDMA and other club drugs has increased among gay men, but questions remain concerning the use, context, and popularity of these drugs; and views of their side effects. We interviewed in-depth 12 gay MDMA users in New York. MDMA had specific appeals to gay men, who often described isolation and stigmatization. Users underwent a period of initiation and social networks often became comprised of greater numbers of other users. Club environme…
Challenges and changes in spirituality among doctors who become patients
Gatekeepers for infertility treatment? Views of ART providers concerning referrals by non-ART providers
How IRBs View and Make Decisions about Social Risks
Whether and how IRBs assess social risks remains unclear, with little empirical investigation. I contacted leaders of 60 IRBs, and interviewed IRB leaders from 34 (response rate = 55%) and additionally, 12 members and administrators. IRBs struggle to assess and balance social risks and benefits, and vary in whether, how, and how much to do so, and how to balance these against individual risks/benefits. Risks to a group affect individuals within i…
Local IRBs vs. Federal Agencies: Shifting Dynamics, Systems, and Relationships
How IRBs relate to federal agencies, and the implications of these relationships, have received little, if any, systematic study. I interviewed 46 IRB chairs, directors, administrators, and members, contacting the leadership of 60 U.S. IRBs (every fourth one in the list of the top 240 institutions by NIH funding), interviewing IRB leaders from 34 (response rate=55%). IRBs describe complex direct and indirect relationships with federal agencies th…
HIV/Aids Research Conducted in the Developing World and Sponsored by the Developed World: Reporting of Research Ethics Committee Review in Two Countries
We explored how often journal articles reporting HIV research sponsored by a developed country, but conducted in a developing country, mention research ethics committee (REC) approval from both countries, and what factors are involved. Of all such 2007 articles on Medline conducted in one of four developing countries (N = 154), only 52% mentioned such dual approval. Mention of dual vs. single approval was more likely among articles with ≥ 50% spo…
The Reporting of Monetary Compensation in Research Articles
STUDY PARTICIPANT COMPENSATION IS OF increasing concern, yet few investigations have explored it; none have examined whether published journal articles report it. Medline searches for articles in six areas-HIV, substance abuse (heroin and cocaine), depression, essential hypertension, and cardiac surgery-reveal very low mention of payment (0-32.1%). Of 207 articles, only 13.5% mentioned financial compensation in any way, and only 11.1% listed amou…
Naming names: Perceptions of name-based HIV reporting, partner notification, and criminalization of non-disclosure among persons living with HIV
Sexual orientation and associated characteristics among north american academic psychiatrists
We mailed questionnaires inquiring about a range of personal and professional attributes to 972 North American psychiatrists at five leading medical schools in the United States and Canada. Of these, 49% (435 psychiatrists) responded. Of the respondents, 90.9% reported being exclusively heterosexual, 3.5% predominantly heterosexual, and 5.6% bisexual/homosexual. Analyses were performed to assess the relationship between sexual orientation and oth…
Patterns of Communication Between Gay and Lesbian Patients and Their Health Care Providers
OBJECTIVES: To determine whether gay men and lesbians disclose their sexual orientation, and other sensitive behaviors to their primary care physicians; whether they have a chance of finding a gay friendly physician; and what factors are involved. METHODS: A self-report questionnaire was administered to 66 gay men and 28 lesbians at a gay and lesbian community center. RESULTS: Less than half of participants felt their health insurance plan gave t…
Tell It Slant Sex, Disclosure, and HIV
Encounters with HIV can tell us much about how we as individuals communicate about and view our bodies and most intimate selves—how we view and approach truth, lies, sex, and trust. Better ways of handling issues of disclosure in conjunction with changed sexual practices can be crucial to thwarting the HIV pandemic. We interviewed in depth 59 HIV-infected and 18 uninfected gay, bisexual, and heterosexual men and women. Five strategies emerged for…
Intricacies and inter-relationships between HIV disclosure and Haart: A qualitative study
This study aimed to understand whether and how highly active antiretroviral treatment (HAART) affects views and patterns of disclosure and how disclosure interacts with treatment decisions. One hundred and fifty-two HIV-positive adults (52 MSM, 56 women and 44 IDU men) from four US cities participated in two to three-hour, semi-structured interviews in 1998-99. Results indicate that HAART interacts with and shapes HIV disclosure issues in several…
Naming names: Perceptions of name-based HIV reporting, partner notification, and criminalization of non-disclosure among persons living with HIV
Challenges and changes in spirituality among doctors who become patients
From "Male Bonding Rituals" to "Suicide Tuesday: A Qualitative Study of Issues Faced by Gay Male Ecstasy (MDMA) Users
Use of MDMA and other club drugs has increased among gay men, but questions remain concerning the use, context, and popularity of these drugs; and views of their side effects. We interviewed in-depth 12 gay MDMA users in New York. MDMA had specific appeals to gay men, who often described isolation and stigmatization. Users underwent a period of initiation and social networks often became comprised of greater numbers of other users. Club environme…
It's not just what you say: Relationships of HIV dislosure and risk reduction among MSM in the post-Haart era
In the post-HAART era, critical questions arise as to what factors affect disclosure decisions and how these decisions are associated with factors such as high-risk behaviors and partner variables. We interviewed 1,828 HIV-positive men who have sex with men (MSM), of whom 46% disclosed to all partners. Among men with casual partners, 41.8% disclosed to all of these partners and 21.5% to none. Disclosure was associated with relationship type, perc…
The Reporting of Monetary Compensation in Research Articles
STUDY PARTICIPANT COMPENSATION IS OF increasing concern, yet few investigations have explored it; none have examined whether published journal articles report it. Medline searches for articles in six areas-HIV, substance abuse (heroin and cocaine), depression, essential hypertension, and cardiac surgery-reveal very low mention of payment (0-32.1%). Of 207 articles, only 13.5% mentioned financial compensation in any way, and only 11.1% listed amou…
Views of the Process and Content of Ethical Reviews of Hiv Vaccine Trials Among Members of Us Institutional Review Boards and South African Research Ethics Committees
Given the ethical controversies concerning HIV vaccine trials (HVTs), we aimed to understand through an exploratory study how members of institutional review boards (IRBs) in the United States (US) and research ethics committees (RECs) in South Africa (SA) view issues concerning the process and content of reviews of these studies. We mailed packets of 20 questionnaires to 12 US IRB chairs and administrators and seven REC chairs to distribute to t…
Presymptomatic Testing of Children for Huntington’s Disease
Case Dr. Carpenter had taken care of 3-year-old Josh since he was born. One afternoon, Dr. Carpenter received a call from Josh’s parents, both of whom were successful professionals. Josh’s dad had just been diagnosed with Huntington’s disease, a degenerative, neurological disorder, and the parents wanted Josh to be tested for the disease. The genetic polymorphism for Huntington’s is autosomal dominant, so Josh had a 50-50 chance of inheriting the…
The Reporting of Irb Review in Journal Articles Presenting Hiv Research Conducted in the Developing World
Objectives: We investigated how often journal articles reporting on human HIV research in four developing world countries mention any institutional review boards (IRBs) or research ethics committees (RECs), and what factors are involved. Methods: We examined all such articles published in 2007 from India, Nigeria, Thailand and Uganda, and coded these for several ethical and other characteristics. Results: Of 221 articles meeting inclusion criteri…
HIV/Aids Research Conducted in the Developing World and Sponsored by the Developed World: Reporting of Research Ethics Committee Review in Two Countries
We explored how often journal articles reporting HIV research sponsored by a developed country, but conducted in a developing country, mention research ethics committee (REC) approval from both countries, and what factors are involved. Of all such 2007 articles on Medline conducted in one of four developing countries (N = 154), only 52% mentioned such dual approval. Mention of dual vs. single approval was more likely among articles with ≥ 50% spo…
Us Irbs Confronting Research in the Developing World
Increasingly, US‐sponsored research is carried out in developing countries, but how US Institutional Review Boards (IRBs) approach the challenges they then face is unclear. METHODS: I conducted in‐depth interviews of about 2 hours each, with 46 IRB chairs, directors, administrators and members. I contacted the leadership of 60 IRBs in the United States (US) (every fourth one in the list of the top 240 institutions by National Institutes of Health…
Local IRBs vs. Federal Agencies: Shifting Dynamics, Systems, and Relationships
How IRBs relate to federal agencies, and the implications of these relationships, have received little, if any, systematic study. I interviewed 46 IRB chairs, directors, administrators, and members, contacting the leadership of 60 U.S. IRBs (every fourth one in the list of the top 240 institutions by NIH funding), interviewing IRB leaders from 34 (response rate=55%). IRBs describe complex direct and indirect relationships with federal agencies th…
How IRBs View and Make Decisions about Social Risks
Whether and how IRBs assess social risks remains unclear, with little empirical investigation. I contacted leaders of 60 IRBs, and interviewed IRB leaders from 34 (response rate = 55%) and additionally, 12 members and administrators. IRBs struggle to assess and balance social risks and benefits, and vary in whether, how, and how much to do so, and how to balance these against individual risks/benefits. Risks to a group affect individuals within i…
How IRBs View and Make Decisions about Consent Forms
IRBs have been criticized for long and complicated consent forms, but how IRBs make decisions about these issues hasn't been examined. I contacted leaders of 60 IRBs, and interviewed IRB leaders from 34 (response rate = 55%), and 13 members and administrators. IRBs confront challenges and dilemmas regarding these documents: what and how much these forms should include (e.g., how "perfect" forms should be). While IRBs generally seek to decrease th…
Models of Consent to Return of Incidental Findings in Genomic Research
Genomic research-including whole genome sequencing and whole exome sequencing-has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research-historically referred to as "incidental findings"-has generated considerable discussion as to how this information should be handled-that is, whether incidental results should be returned, and if so, w…
Detecting, Preventing, and Responding to “Fraudsters” in Internet Research: Ethics and Tradeoffs
Research that recruits and surveys participants online is increasing, but is subject to fraud whereby study respondents — whether eligible or ineligible — participate multiple times. Online Internet research can provide investigators with large sample sizes and is cost efficient. Internet-based research also provides distance between the researchers and participants, allowing the participant to remain confidential and/or anonymous, and thus to re…
Evolving Challenges and Research-Needs Concerning Ebola
Deciding how many embryos to transfer: Ongoing challenges and dilemmas
Typologies of Altruistic and Financial Motivations for Research Participation: A Qualitative Study of MSM in HIV Vaccine Trials
Questions arise concerning participants' motives in risky studies, such as HIV vaccine trials (HVTs). We interviewed in-depth 20 gay/bisexual men. Participants described both altruistic and nonaltruistic motives. Altruistic motivations emerged primarily, with nine typologies: (a) cultural, (b) community related, (c) familial, (d) religious, (e) professional, (f) political (e.g., HIV activism), (g) moral (e.g., making up for past wrongs), (h) exis…
Ethical and Psychosocial Considerations in Informing HIV-Exposed Uninfected Children That They Were Exposed to HIV and Antiretroviral Medications In Utero
We build on what is known about the potential long-term health effects of perinatal antiretroviral medication exposure to examine ethical and psychosocial issues associated with disclosure by applying lessons from other health conditions, theories of child and adolescent development and rights, and the relevant literature and legal contexts. We present 2 cases to highlight potential issues; apply a bioethical framework that includes principles of…
Gatekeepers for infertility treatment? Views of ART providers concerning referrals by non-ART providers
How Infertility Patients and Providers View and Confront Religious and Spiritual Issues
Psychology (31 works) · Medicine (30 works) · Political science (23 works) · Social Psychology (21 works) · Sociology (15 works) · Family medicine (13 works) · Law (12 works) · Nursing (12 works) · Public relations (11 works) · Religion, Spirituality, and Psychology (11 works)