Alice Marie Stek, MD

Assistant Professor of Clinical Obstetrics & Gynecology

Director, HIV Services

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Overview

Dr. Stek completed a residency in Obstetrics and Gynecology and a fellowship in maternal-fetal medicine (MFM). Her research and clinical interests are primarily in the field of HIV in pregnancy and HIV in women. She has been conducting clinical research in these areas since starting her MFM Fellowship. Dr. Stek has been active in the Pediatric AIDS Clinical Trials Group for over 12 years, where she serves on the Perinatal RAC, the Obstetrics Subcommittee and the AACTG Womens Health Committee. She is a member of eight PACTG and AACTG protocol teams and is co-chair and vice-chair of several protocols. She is also a member of the local WIHS team.

Dr. Steks current research, both in the multicenter research organizations and in the MCA Centers own projects, focuses on the use of antiretroviral medications in pregnancy. Dr. Stek, in collaboration with PACTG pharmacologists in Boston, San Diego, and San Francisco, and locally with Dr. Michael Neely and the USC School of Pharmacy, is studying the pharmacokinetics, and safety and efficacy (collaborating with PACTG, AACTG, and MCA internists and pediatricians) of the medications used to prevent perinatal HIV transmission and for maternal health. Together with a pathologist at Baylor University, she is studying placental pathology in women using antiretrovirals during pregnancy. She collaborated with the USC pathology/lo aboratory medicine department and MCA pediatricians in designing and implementing a rapid HIV testing program for women in labor, and is currently evaluating this program with the USC pathology/laboratory medicine department and an MCA epidemiologist. Other collaborative research projects in the PACTG and AACTG include a comprehensive project to collect data on HIV-infected pregnancies, an evaluation of postpartum virologic and immunologic changes, and a trial of a therapeutic HPV vaccine in HIV-positive adolescents. In addition to these research activities, Dr. Stek provides clinical care for MCAs pregnant patients, and teaches at Womens and Childrens Hospital, USC Keck School of Medicine, and occasionally at USC main campus, as well as outside the university both in the local community and outside of Los Angeles.

Publications

  • Assessing the efficacy of magnesium oxide and riboflavin as preventative treatment of migraines in pregnancy Arch Gynecol Obstet. 2023 Dec; 308(6):1749-1754. . View in PubMed
  • Pharmacokinetics and safety of first-line tuberculosis drugs rifampin, isoniazid, ethambutol, and pyrazinamide during pregnancy and postpartum: results from IMPAACT P1026s Antimicrob Agents Chemother. 2023 11 15; 67(11):e0073723. . View in PubMed
  • “We Are Not Different than Others”: A Qualitative Study of the Lived Experience of Hispanic Adolescents and Young Adults Living with Perinatally Acquired HIV Int J Environ Res Public Health. 2023 02 08; 20(4). . View in PubMed
  • The Obstetrical Care and Delivery Experience of Women with Epilepsy in the MODEAD Study Am J Perinatol. 2022 Mar 04. . View in PubMed
  • Interactions between etonogestrel-releasing contraceptive implant and 3 antiretroviral regimens Contraception. 2022 01; 105:67-74. . View in PubMed
  • Pharmacokinetics of Atazanavir Boosted With Cobicistat in Pregnant and Postpartum Women With HIV J Acquir Immune Defic Syndr. 2022 03 01; 89(3):303-309. . View in PubMed
  • Effects of Initiating Raltegravir-Based Versus Efavirenz-Based Antiretroviral Regimens During Pregnancy on Weight Changes and Perinatal Outcomes: NICHD P1081 J Acquir Immune Defic Syndr. 2022 12 01; 91(4):403-409. . View in PubMed
  • Pharmacokinetics of Tenofovir Alafenamide With Boosted Protease Inhibitors in Pregnant and Postpartum Women Living With HIV: Results From IMPAACT P1026s J Acquir Immune Defic Syndr. 2022 07 01; 90(3):343-350. . View in PubMed
  • Lopinavir and tenofovir interaction observed in non-pregnant adults altered during pregnancy J Clin Pharm Ther. 2021 Oct; 46(5):1459-1464. . View in PubMed
  • Population Pharmacokinetics of Tenofovir in Pregnant and Postpartum Women Using Tenofovir Disoproxil Fumarate Antimicrob Agents Chemother. 2021 02 17; 65(3). . View in PubMed
  • Pharmacokinetics of tenofovir alafenamide with and without cobicistat in pregnant and postpartum women living with HIV AIDS. 2021 03 01; 35(3):407-417. . View in PubMed
  • Pharmacokinetics of darunavir and cobicistat in pregnant and postpartum women with HIV AIDS. 2021 07 01; 35(8):1191-1199. . View in PubMed
  • Profile of Chronic Comorbid Conditions and Obstetrical Complications Among Pregnant Women With Human Immunodeficiency Virus and Receiving Antiretroviral Therapy in the United States Clin Infect Dis. 2021 09 15; 73(6):969-978. . View in PubMed
  • Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period Am J Perinatol. 2020 12; 37(14):1446-1454. . View in PubMed
  • Darunavir Pharmacokinetics With an Increased Dose During Pregnancy J Acquir Immune Defic Syndr. 2020 04 01; 83(4):373-380. . View in PubMed
  • Predictors of Viremia in Postpartum Women on Antiretroviral Therapy J Acquir Immune Defic Syndr. 2020 01 01; 83(1):72-80. . View in PubMed
  • Fosamprenavir with Ritonavir Pharmacokinetics during Pregnancy Antimicrob Agents Chemother. 2020 03 24; 64(4). . View in PubMed
  • Low maternal vitamin D is associated with increased risk of congenital and peri/postnatal transmission of Cytomegalovirus in women with HIV PLoS One. 2020; 15(2):e0228900. . View in PubMed
  • Pharmacokinetics of Increased Nelfinavir Plasma Concentrations in Women During Pregnancy and Postpartum J Clin Pharmacol. 2019 03; 59(3):386-393. . View in PubMed
  • Efavirenz pharmacokinetics during pregnancy and infant washout Antivir Ther. 2019; 24(2):95-103. . View in PubMed
  • Changing Patterns and Factors Associated With Mode of Delivery Among Pregnant Women With Human Immunodeficiency Virus Infection in the United States Obstet Gynecol. 2018 05; 131(5):879-890. . View in PubMed
  • Dolutegravir pharmacokinetics in pregnant and postpartum women living with HIV AIDS. 2018 03 27; 32(6):729-737. . View in PubMed
  • Elvitegravir/cobicistat pharmacokinetics in pregnant and postpartum women with HIV AIDS. 2018 11 13; 32(17):2507-2516. . View in PubMed
  • Rilpivirine Plasma and Cervicovaginal Concentrations in Women During Pregnancy and Postpartum J Acquir Immune Defic Syndr. 2018 07 01; 78(3):308-313. . View in PubMed
  • Missed Opportunities for Prevention of Mother-to-Child Transmission of Human Immunodeficiency Virus Obstet Gynecol. 2017 04; 129(4):621-628. . View in PubMed
  • Pharmacokinetics of Rilpivirine in HIV-Infected Pregnant Women J Acquir Immune Defic Syndr. 2016 07 01; 72(3):289-96. . View in PubMed
  • Complications and Route of Delivery in a Large Cohort Study of HIV-1-Infected Women-IMPAACT P1025 J Acquir Immune Defic Syndr. 2016 09 01; 73(1):74-82. . View in PubMed
  • Etravirine Pharmacokinetics in HIV-Infected Pregnant Women Front Pharmacol. 2016; 7:239. . View in PubMed
  • Maraviroc Pharmacokinetics in HIV-1-Infected Pregnant Women Clin Infect Dis. 2015 Nov 15; 61(10):1582-9. . View in PubMed
  • Pharmacokinetics of tenofovir during pregnancy and postpartum HIV Med. 2015 Sep; 16(8):502-11. . View in PubMed
  • Pharmacokinetics of Once Versus Twice Daily Darunavir in Pregnant HIV-Infected Women J Acquir Immune Defic Syndr. 2015 Sep 01; 70(1):33-41. . View in PubMed
  • The effect of protease inhibitors on the cervical mucus of HIV-positive women taking norethindrone contraception Eur J Contracept Reprod Health Care. 2015 Apr; 20(2):149-53. . View in PubMed
  • Alteration in cytochrome P450 3A4 activity as measured by a urine cortisol assay in HIV-1-infected pregnant women and relationship to antiretroviral pharmacokinetics HIV Med. 2015 Mar; 16(3):176-83. . View in PubMed
  • Factors associated with lack of viral suppression at delivery among highly active antiretroviral therapy-naive women with HIV: a cohort study Ann Intern Med. 2015 Jan 20; 162(2):90-9. . View in PubMed
  • Impact of body weight and missed doses on lopinavir concentrations with standard and increased lopinavir/ritonavir doses during late pregnancy J Antimicrob Chemother. 2015 Jan; 70(1):217-24. . View in PubMed
  • PHARMACOKINETIC EXPOSURE AND VIROLOGIC RESPONSE IN HIV-1 INFECTED PREGNANT WOMEN TREATED WITH LOPINAVIR/RITONAVIR: AIDS CLINICAL TRIALS GROUP PROTOCOL A5153S: A SUBSTUDY TO A5150 Jacobs J AIDS HIV. 2015; 1(1). . View in PubMed
  • Raltegravir pharmacokinetics during pregnancy J Acquir Immune Defic Syndr. 2014 Dec 01; 67(4):375-81. . View in PubMed
  • Reduced indinavir exposure during pregnancy Br J Clin Pharmacol. 2013 Sep; 76(3):475-83. . View in PubMed
  • Pharmacokinetics of an increased atazanavir dose with and without tenofovir during the third trimester of pregnancy J Acquir Immune Defic Syndr. 2013 May 01; 63(1):59-66. . View in PubMed
  • The effect of prenatal highly active antiretroviral therapy on the transmission of congenital and perinatal/early postnatal cytomegalovirus among HIV-infected and HIV-exposed infants Clin Infect Dis. 2012 Sep; 55(6):877-84. . View in PubMed
  • Effect of pregnancy on emtricitabine pharmacokinetics HIV Med. 2012 Apr; 13(4):226-35. . View in PubMed
  • Efavirenz pharmacokinetics during the third trimester of pregnancy and postpartum J Acquir Immune Defic Syndr. 2012 Mar 01; 59(3):245-52. . View in PubMed
  • Immunomodulatory factors in cervicovaginal secretions from pregnant and non-pregnant women: a cross-sectional study BMC Infect Dis. 2011 Sep 30; 11:263. . View in PubMed
  • Atazanavir pharmacokinetics with and without tenofovir during pregnancy J Acquir Immune Defic Syndr. 2011 Apr 15; 56(5):412-9. . View in PubMed
  • Postpartum viral load rebound in HIV-1-infected women treated with highly active antiretroviral therapy: AIDS Clinical Trials Group Protocol A5150 HIV Clin Trials. 2011 Jan-Feb; 12(1):9-23. . View in PubMed
  • Lopinavir tablet pharmacokinetics with an increased dose during pregnancy J Acquir Immune Defic Syndr. 2010 Aug; 54(4):381-8. . View in PubMed
  • Mode of delivery and infant respiratory morbidity among infants born to HIV-1-infected women Obstet Gynecol. 2010 Aug; 116(2 Pt 1):335-343. . View in PubMed
  • Lopinavir protein binding in HIV-1-infected pregnant women HIV Med. 2010 Apr; 11(4):232-8. . View in PubMed
  • Prenatal protease inhibitor use and risk of preterm birth among HIV-infected women initiating antiretroviral drugs during pregnancy J Infect Dis. 2010 Apr 01; 201(7):1035-44. . View in PubMed
  • Antiretroviral medications during pregnancy for therapy or prophylaxis Curr HIV/AIDS Rep. 2009 May; 6(2):68-76. . View in PubMed
  • Correlates of perinatal depression in HIV-infected women AIDS Patient Care STDS. 2009 Feb; 23(2):101-8. . View in PubMed
  • Zidovudine, lamivudine, and nelfinavir concentrations in amniotic fluid and maternal serum HIV Clin Trials. 2009 Jan-Feb; 10(1):41-7. . View in PubMed
  • Lopinavir exposure with an increased dose during pregnancy J Acquir Immune Defic Syndr. 2008 Dec 15; 49(5):485-91. . View in PubMed
  • Pharmacokinetics of new 625 mg nelfinavir formulation during pregnancy and postpartum HIV Med. 2008 Nov; 9(10):875-82. . View in PubMed
  • Adherence to antiretrovirals among US women during and after pregnancy J Acquir Immune Defic Syndr. 2008 Aug 01; 48(4):408-17. . View in PubMed
  • Chronic administration of nevirapine during pregnancy: impact of pregnancy on pharmacokinetics HIV Med. 2008 Apr; 9(4):214-20. . View in PubMed
  • Antiretroviral treatment in pregnancy Curr Opin HIV AIDS. 2008 Mar; 3(2):155-60. . View in PubMed
  • Pharmacokinetics and safety of nelfinavir when used in combination with zidovudine and lamivudine in HIV-infected pregnant women: Pediatric AIDS Clinical Trials Group (PACTG) Protocol 353 HIV Clin Trials. 2008 Mar-Apr; 9(2):115-25. . View in PubMed
  • Safety and tolerability of depot medroxyprogesterone acetate among HIV-infected women on antiretroviral therapy: ACTG A5093 Contraception. 2008 Feb; 77(2):84-90. . View in PubMed
  • Analysis of standard methods for diagnosing vaginitis: HIV infection does not complicate the diagnosis of vaginitis J Low Genit Tract Dis. 2007 Oct; 11(4):240-50. . View in PubMed
  • Protease inhibitor-based antiretroviral therapy and glucose tolerance in pregnancy: AIDS Clinical Trials Group A5084Am J Obstet Gynecol. 2007 Apr; 196(4):331. e1-7. . View in PubMed
  • Depo-medroxyprogesterone in women on antiretroviral therapy: effective contraception and lack of clinically significant interactions Clin Pharmacol Ther. 2007 Feb; 81(2):222-7. . View in PubMed
  • Participation of HIV-infected pregnant women in research in the United States AIDS Res Hum Retroviruses. 2007 Jan; 23(1):51-3. . View in PubMed
  • Reduced lopinavir exposure during pregnancy AIDS. 2006 Oct 03; 20(15):1931-9. . View in PubMed
  • Impact of pregnancy on abacavir pharmacokinetics AIDS. 2006 Feb 28; 20(4):553-60. . View in PubMed
  • Safety and pharmacokinetics of nelfinavir coadministered with zidovudine and lamivudine in infants during the first 6 weeks of life J Acquir Immune Defic Syndr. 2005 Jun 01; 39(2):189-94. . View in PubMed
  • HCV viremia is associated with drug use in young HIV-1 and HCV coinfected pregnant and non-pregnant women Addiction. 2005 May; 100(5):626-35. . View in PubMed
  • Preliminary studies of cytokine secretion patterns associated with pregnancy in MS patients J Neurol Sci. 2004 Sep 15; 224(1-2):69-76. . View in PubMed
  • Maternal toxicity with continuous nevirapine in pregnancy: results from PACTG 1022 J Acquir Immune Defic Syndr. 2004 Jul 01; 36(3):772-6. . View in PubMed
  • Pharmacokinetics of saquinavir plus low-dose ritonavir in human immunodeficiency virus-infected pregnant women Antimicrob Agents Chemother. 2004 Feb; 48(2):430-6. . View in PubMed
  • Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV AIDS. 2004 Jan 23; 18(2):281-6. . View in PubMed
  • Evaluation of a rapid optical immunoassay-based test for group B streptococcus colonization in intrapartum patients J Matern Fetal Med. 2001 Jun; 10(3):203-8. . View in PubMed
  • The relationship of pregnancy to the use of highly active antiretroviral therapy Am J Obstet Gynecol. 2001 May; 184(6):1221-7. . View in PubMed
  • Incorporation of zidovudine into cord blood DNA of infants and peripheral blood DNA of their HIV-1-positive mothers Ann N Y Acad Sci. 2000 Nov; 918:262-8. . View in PubMed
  • Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudinePediatric AIDS Clinical Trials Group 185 Team. AIDS. 2000 Jul 07; 14(10):1389-99. . View in PubMed
  • Mode of delivery and the risk of vertical transmission of HIV-1 N Engl J Med. 1999 Jul 15; 341(3):205-6; author reply 206-7. . View in PubMed
  • Incorporation of zidovudine into leukocyte DNA from HIV-1-positive adults and pregnant women, and cord blood from infants exposed in utero AIDS. 1999 May 28; 13(8):919-25. . View in PubMed
  • Efficacy of zidovudine and human immunodeficiency virus (HIV) hyperimmune immunoglobulin for reducing perinatal HIV transmission from HIV-infected women with advanced disease: results of Pediatric AIDS Clinical Trials Group protocol 185 J Infect Dis. 1999 Mar; 179(3):567-75. . View in PubMed
  • Risk factors for trichomoniasis among women with human immunodeficiency virus (HIV) infection at a public clinic in Los Angeles County, California: implications for HIV prevention Am J Trop Med Hyg. 1998 Apr; 58(4):495-500. . View in PubMed
  • Safety and pharmacokinetics of hyperimmune anti-human immunodeficiency virus (HIV) immunoglobulin administered to HIV-infected pregnant women and their newbornsPediatric AIDS Clinical Trials Group Protocol 185 Pharmacokinetic Study Group. J Infect Dis. 1997 Feb; 175(2):283-91. . View in PubMed
  • Fetal responses to maternal and fetal methamphetamine administration in sheep Am J Obstet Gynecol. 1995 Nov; 173(5):1592-8. . View in PubMed
  • Maternal and fetal cardiovascular responses to methamphetamine in the pregnant sheep Am J Obstet Gynecol. 1993 Oct; 169(4):888-97. . View in PubMed

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