An Epidemiologist with a 'Panoramic Perspective'

Delivette Castor spent a decade working her way through the ranks of the United States Agency for Development (USAID), leading implementation research activities within the President’s Plan for AIDS Relief (PEPFAR). In 2018, she was appointed acting branch chief for the Office of HIV/AIDS/Division of Research.

One year later, Castor joined Columbia Mailman as an assistant professor of Epidemiology and Medicine, returning to where she earned her PhD in epidemiology a dozen years earlier. She was still unpacking boxes and settling into her primary appointment in Columbia University Irving Medical Center’s Department of Medicine, where she directs the Health Equity in Implementation and Delivery Sciences Section (HEIDS), when SARS-CoV-2 hit New York City in early 2020.

Since the onset of the COVID-19 pandemic, she co-led studies on understanding SARS-CoV-2 transmission in health care workers, households, and wastewater surveillance. Other COVID-19 studies included vaccine education, and health disparities relating to Long COVID.

“My international work with PEPFAR/USAID informed a lot of my thinking with the COVID response,” says Castor, whose prior experience is in scaling-up health innovations by describing and addressing biomedical, behavioral, and structural factors that affect infectious diseases in low- and middle-income countries and marginalized populations in the U.S. “I’m a believer in serendipity.”

How did your international experience with PEPFAR, specifically, inform your work on COVID-19?

Castor: After working in so many countries and spaces, I have gained a more panoramic perspective on emerging infectious diseases, and I’m trying to understand the intersection between biology and behavior. We were responding quickly with limited clinical resources and thinking from a multisectoral and multi-disease perspective about the logistics of getting services to people, community engagement, and communication issues.

You earned your PhD in Epidemiology from Columbia in 2006. What brought you back?

Castor: In my last years at USAID, I was managing research, not doing it. Also during that time, I came to appreciate how the field of implementation science was evolving in academic spaces. I wanted to take time to improve my understanding of the theoretical and methodological aspects of the work.

How does your USAID experience inform your research?

Castor: I came back with the purpose of maintaining pragmatic research questions. What I liked about my experience in USAID was that we never intended to end a project with, “there is more research to be done.” We could see a path for how the line of research can inform policies or programs in an explicit and intentional way. It is practical work. I really enjoyed that and in coming back to Columbia, it was one of the things I really wanted to hold on to. In an academic environment, there’s a very different perspective. We’re often enamored with the methodology and theory shaping the content area, and it’s not always clear how our work links back to people and populations.

What are your current research projects?

Castor: I’m a site investigator on a study called MOSAIC—Maximizing Options to Advance Informed Choice for HIV Prevention. This is a large consortium led by a FHI 360, a non-governmental organization, and includes research, program support, and advocacy. We’re working to ensure that individuals, especially women, can protect themselves from acquiring HIV and other infectious diseases. We aim to introduce and scale new biomedical prevention products and expedite their availability, accessibility, uptake, and impact on HIV. This is a PEPFAR/USAID supported program. I’m also co-investigator with Columbia Mailman Professor of Epidemiology Louise Kuhn on two National Cancer Institute-funded studies to evaluate automated digital imaging for HPV testing in low-resource settings.

You were an active mentor throughout your time at USAID and in 2022, CUIMC’s Institute for Clinical and Translational Research named you Junior Mentor of the Year. What motivates you?

Castor: I’ve been incredibly supported and feel fortunate to have had the mentors I did as a student. I met and was mentored by many different faculty in disparate areas, partially because I’m interested in everything that affects everyone. You know that saying, “it takes a village to raise a child”? I was fortunate during my doctoral studies to be a village child in the Department of Epidemiology.

How have those relationships matured over time?

Castor: All of my mentors are now friends and colleagues. My most recent paper, for Preventive Medicine, examines the dissonance of language in global health including academic environments about diversity, equity, and inclusion—and the fact that our practices don’t support that language. That paper was coauthored with epidemiologist Luisa Borrell, MPH ‘94, an adjunct professor here at Columbia Mailman. We’ve remained in touch over 20-odd years, even though we work in different disciplines. She is one example of many. My thinking about how and when to return to an academic environment was heavily influenced by Luisa, Quarraisha Adbool Karim and by Scott Hammer, who was a professor of epidemiology at Columbia Mailman, chief emeritus of infectious diseases, and professor of medicine at VP&S, when he died in 2021.