Brian Wells Pence, PhD, MPH


Brian Wells PenceAssistant Professor
Curriculum Vitae
REACH NC Research Profile

2103C Mcgavran-Greenberg Hall
135 Dauer Drive
Campus Box 7435
Chapel Hill 27599-7435
T: 919-966-7446
F: 919-966-2089

Dr. Pence’s research focuses on the links between mental health and HIV-related behaviors and health outcomes in the Southeastern US and in Africa. He is PI or co-PI on three current or recent NIH grants, including a randomized clinical trial to assess whether depression treatment integrated into HIV clinical care in the US improves HIV medication adherence; a study to define the epidemiology of depression among HIV patients in Cameroon and pilot-test a nurse-delivered depression treatment intervention; and a study to define the impact of antidepressant treatment on HIV outcomes among HIV patients in the CNICS network of 8 large clinical sites across the US. With Kathryn Whetten, he recently co-authored the second edition of You’re the First One I’ve Told: The Faces of HIV in the Deep South (Rutgers University Press, 2013). This book presents the life histories of 25 individuals infected with HIV and living in the US Deep South, and highlights in particular the high prevalence and profound influence of traumatic life experiences. In the second edition, the original qualitative findings are substantiated with new quantitative research, primarily drawn from the Coping with HIV/AIDS in the Southeast (CHASE) longitudinal cohort study of over 600 HIV-infected individuals from across the Southeastern US.


 University of North Carolina at Chapel Hill
 Columbia University
 Yale University

Recent grants and projects

The SLAM DUNC Study (NIMH; R01MH086362; 2009-2014; PIs: Pence, Gaynes) is a 4-site randomized controlled trial testing the impact of depression treatment on HIV medication adherence and clinical outcomes among HIV-infected patients with depression in the Southeastern US.

The Causal Effect of Effective Depression Treatment on HIV Outcomes in CNICS (NIMH; R01MH100970; 2013-2016; PI: Pence), drawing on data from the 8-site CNICS Cohort, will start by defining the magnitude of the “depression treatment gap,” or opportunity for improvement in depression treatment, in current HIV primary care in the US. In particular, we will characterize the frequency of adequate (e.g., best‐practices) vs. inadequate antidepressant treatment provided in HIV clinical care. We will then estimate the effect of antidepressant treatment, and especially adequate antidepressant treatment, on HIV‐related behaviors and health outcomes (e.g., medication adherence and mortality) among HIV‐infected patients with depression. Finally, we will examine whether the benefits of antidepressant treatment differ in specific subgroups, such as those with concurrent alcohol and drug use. This work will characterize the potential HIV-related benefits to be gained by improving the extent and quality of depression treatment for HIV-infected patients in the US.

The ADEPT Study (NIMH; R34MH084673; 2009-2013; PIs: Gaynes, Pence) was a pilot study to evaluate the feasibility, safety, acceptability, and preliminary efficacy of a nurse-delivered depression identification and treatment intervention adapted for HIV-infected patients in Cameroon.

The CHAT Study (NIMH; R01MH078756; 2007-2014; PI: Whetten) is an observational cohort study designed to evaluate the impact of lifetime traumatic events and other psychosocial characteristics on HIV behavioral and clinical outcomes among HIV-infected individuals in Tanzania.

The Positive Outcomes for Orphans Study (NICHD; R01HD046345; 2007-2017; PI: Whetten). The focus of this longitudinal research of children starting ages 6 to 12 is to examine the influence of life events, placement, caregiver characteristics, and cultural setting on the children’s behavioral and emotional adjustment, learning and development, and health outcomes. The ultimate goal of the POFO research study is to provide additional evidence to local communities, policymakers, and funding agencies regarding a range of optimal and feasible care options for OAC ages 6 and above in less wealthy nations.


EPID 718, Analytical Methods in Observational Epidemiology, beginning fall 2014

Selected Publications

    1. Whetten K, Pence BW“You’re the First One I’ve Told”: The Faces of HIV in the Deep South.  2nd edition.  New Brunswick: Rutgers University Press, 2013 (272 pages).
    2. Pence BW, Whetten K, Shirey K, Yao J, Thielman N, Whetten R, Itemba D, Maro V.  “Factors associated with change in sexual transmission risk behavior over 3 years among HIV-infected patients in Tanzania.”  PLoS One 8(12): e82974, 2013.  PMCID: PMC3867466.
    3. Whetten K, Shirey K, Pence BW, Yao J, Thielman N, Whetten R, Adams J, Agala B, Ostermann J, O’Donnell K, Hobbie A, Maro V, Itemba D, Reddy E, CHAT Research Team.  “Trauma history and depression predict incomplete adherence to antiretroviral therapies in a low income country.”  PLoS One 8(10):e74771, 2013.  PMCID: PMC3790775.
    4. Dow A, Dube Q, Pence BW, Van Rie A.  “Postpartum Depression and HIV Infection among Women in Malawi.”  JAIDS: e-published ahead of print, 2013.  PMCID: In progress.
    5. *Bess K, Adams JL, Watt MH, O’Donnell JK, Gaynes BN, Thielman NM, Heine A, Zinski A, Raper JL, Pence BW.  “Providers’ Attitudes Towards Treating Depression and Self-Reported Depression Treatment Practices in HIV Outpatient Care.” AIDS Patient Care & STDs 27(3):171-80, 2013.  PMCID: PMC3595951. * Senior-authored.
    6. *Adams JL, Gaynes BN, McGuinness T, Modi R, Willig J, Pence BW.  “Treating depression within the HIV ”medical home”: A guided algorithm for antidepressant management by HIV clinicians.”  AIDS Patient Care and STDs 26(11):647-54, 2012.  PMCID: PMC3495111.
      * Senior-authored.
    7. Pence BW, Gaynes BN, Atashili J, O’Donnell JK, Tayong G, Kats D, Whetten R, Whetten K, Njamnshi AK, Ndumbe PM.  “Validity of an Interviewer-Administered Patient Health Questionnaire-9 to Screen for Depression in HIV-Infected Patients in Cameroon.”  Journal of Affective Disorders 143(1-3):208-13, 2012.  PMCID: PMC3500577.
    8. Pence BW, Gaynes BN, Williams Q, Modi R, Adams J, Quinlivan EB, Heine A, Thielman N, Mugavero MJ.  “Assessing the effect of Measurement-Based Care depression treatment on HIV medication adherence and health outcomes: Rationale and design of the SLAM DUNC Study.”  Contemporary Clinical Trials 33(4):828-38, 2012.  PMCID: PMC3361555.
    9. Pence BW, Shirey K, Whetten K, Agala B, Itemba D, Adams J, Whetten R, Yao J, Shao J.  “Prevalence of Psychological Trauma and Association with Current Health and Functioning in a Sample of HIV-infected and HIV-uninfected Tanzanian Adults.”  PLoS One 7(5):e36304, 2012.  PMCID: PMC3351441
    10. Pence BW, O’Donnell JK, Gaynes BN.  “Falling through the cracks: the gaps between depression prevalence, diagnosis, treatment, and response in HIV care.”  AIDS 26(5):656-8, 2012.  PMCID: PMC3691843.
    11. Pence BW, Mugavero MJ, Carter TJ, Leserman J, Thielman NM, Raper JL, Proeschold-Bell RJ, Reif S, Whetten K.  “Childhood trauma and health outcomes in HIV-infected patients: An exploration of causal pathways.”  JAIDS 59(4):409-16, 2012. PMCID: PMC3299853.
    12. Pence BW, Raper JL, Reif S, Thielman NM, Leserman J, Mugavero MJ.  “Incident stressful & traumatic life events and HIV sexual transmission risk behaviors in a longitudinal, multi-site cohort study.”  Psychosomatic Medicine, 72(7):720-726, 2010.  PMCID: PMC3691861.
    13. Whetten K, Ostermann J, Whetten RA, Pence BW, O’Donnell K, Messer LC, Thielman NM; Positive Outcomes for Orphans (POFO) Research Team.  “A comparison of the wellbeing of orphans and abandoned children ages 6-12 in institutional and community-based care settings in 5 less wealthy nations.”  PLoS One 4(12):e8169, 2009. PMCID: PMC2790618.
    14. Pence BW, Miller WC, Gaynes BN.  “Prevalence estimation and validation of new instruments in psychiatric research: An application of latent class analysis.”  Psychological Assessment 21(2): 235-239, 2009.
    15. Pence BW.  “The impact of mental health and traumatic life experiences on antiretroviral treatment outcomes for people living with HIV/AIDS.”  Journal of Antimicrobial Chemotherapy:63(4):636-40, 2009.  PMCID:  PMC2654041
    16. Ostermann J, Kumar V, Pence BW, Whetten K.  “Trends in HIV testing and discrepancies between planned and actual testing in the United States, 2000-2005.”  Archives of Internal Medicine 167(19): 2128-2135, 2007.
    17. Leserman J, Pence BW, Whetten K, Mugavero MJ, Thielman NM, Swartz MS, Stangl D.  “Relation of lifetime trauma and depressive symptoms to mortality in HIV.”  American Journal of Psychiatry 164(11): 1707-1713, 2007.
    18. Pence BW, Miller WC, Gaynes BN, Eron Jr. JJ.  “Psychiatric illness and virologic response in patients initiating highly active antiretroviral therapy.”  JAIDS 44(2): 159-166, 2007.
    19. Pence BW, Miller WC, Whetten K, Eron Jr. JJ, Gaynes BN.  “Prevalence of DSM-IV-defined mood, anxiety, and substance use disorders in an HIV clinic in the southeastern US.”  JAIDS 42(3): 298-306, 2006.
    20. Pence BW, Gaynes BN, Whetten K, Eron Jr. JJ, Ryder RW, Miller WC.  “Validation of a brief screening instrument for substance abuse and mental illness in HIV+ patients.”  JAIDS 40(4): 434-444, 2005.

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