Educated at St. Louis, Temple, and Johns Hopkins Universities, Bergman is a former surgical ICU nurse who discovered a love for research while working with people with HIV at a Ryan White clinic at Einstein Medical Center in Philadelphia. In addition to working domestically with people who have substance use disorder who concurrently suffer from infectious diseases, Bergman studies people with tuberculosis (TB) and HIV who live in South Africa and Tanzania, two TB endemic countries, to determine how stigma impacts patients’ ability and willingness to engage in care.

Talk about your path into nursing.

“I thought I wanted to be pre-law, but, as an undergraduate, went to a hospital to observe a nurse for a day and was hooked. I remember going into the gross anatomy lab and thinking, ‘OK, this is weird and gross and cool, and, yeah, I’ll do that.’”

What were your early nursing jobs?

“I was in the surgical ICU first, a level 1 trauma center in Philadelphia, which was always crazy and dramatic and constantly exciting. I had access to all this new technology and, even though I didn’t fully appreciate research at that point, I was constantly learning through osmosis.”

What made you pivot into research?

“When I first saw HIV care, it was a moment. I had a colleague who had this beautiful connection with her patients. Because people with HIV are often marginalized, and feel ill at ease with healthcare providers, the relationships she forged drew me in. I was like, ‘This is it; I’m never going back. I’m going to become an NP.’

“We have a tendency to tie stigma to clinical outcomes—what’s the impact of stigma on TB treatment success, say, or HIV treatment success—rather than quality of life. But stigma is its own independent morbidity. If you have been isolated and rejected and shunned and forced to occupy this subhuman level of existence, that is a problem on its own, whether you adhere to your treatment or not. We should all be thinking this way, and right now, that’s not the case."

Post-doctoral fellow Alanna Bergman

“I worked at the Ryan White Clinic throughout graduate school, which allowed me to see the unicorns, instead of the horses, and some really interesting things. My peers would do presentations on diabetes, and I’d say, ‘I saw neurocysticercosis this week.’ I was clinically excited and challenged. It was a beautiful balance of all the things I didn’t know I wanted.

“At Ryan White, I got involved with grant writing and asking and answering questions by analyzing data. I realized I wanted a skillset that allowed me to ask and answer broader questions, and, as much as I truly loved it there, I knew I could have a much broader impact as a nurse scientist.”

What populations and issues interest you?

“My primary area of research is about how social stigma impacts not just people’s willingness but ability to engage in care. I’m also interested in looking at what assumptions are internalized by nurses and caregivers and how this impacts the quality of care they give, patients’ infectious disease outcomes, and, frankly, these patients’ quality of life.

“We have a tendency to tie stigma to clinical outcomes—what’s the impact of stigma on TB treatment success, say, or HIV treatment success—rather than quality of life. But stigma is its own independent morbidity. If you have been isolated and rejected and shunned and forced to occupy this subhuman level of existence, that is a problem on its own, whether you adhere to your treatment or not. We should all be thinking this way, and right now, that’s not the case. We think about stigma as a means to an end, rather than as the end itself.

“While I was working on my PhD, I worked with a lot of formerly incarcerated people at a behavioral health program in Baltimore, seeing patients in a van right outside the jail. These people were at high risk of overdose, and we were hoping to do harm reduction, and so offered pan tests for substance use, like fentanyl and opioids, using urine and oral swabs to determine whether we needed to provide buprenorphine to them, a medication for opiate use disorder). At some point, I thought, ‘Why couldn’t we do this same thing in South Africa?’

“South Africa is a TB-endemic country; it’s the country’s number one killer. They have dedicated TB hospitals all over the place, but there is also a prevailing opinion among healthcare providers there that people using substances won’t adhere to treatment plans and had to be admitted to the hospital for TB treatment. We thought, ‘Maybe we can debunk the idea that you are automatically unable to adhere to your treatment if you use substances.’ We brought 100 drug tests; only two out of the 100 we consistently tested did not complete TB treatment; all of them were outpatients.”

What’s your plan now?

“The idea is to see if we can design an assessment tool and an intervention for TB elsewhere, see that it works, then bring it back to the United States and adapt it, co-creating an intervention with the community so it’s really culturally congruent. That will be a great step forward.

“People think in the U.S. there’s no TB, but there is. It’s a disease of poverty, closely tied to housing, ventilation, and malnutrition. But we have lots of outbreaks here. In 2022 and 2023, for instance, we saw some of the highest cases of TB in the U.S. that we’d seen in more than a decade. It’s not [as prevalent as] cancer or heart disease, but it’s not gone.”