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The University of Southampton

Professor Nuala McGrath BSc, MSc, ScD.

Professor of Epidemiology and Sexual Health

Professor Nuala McGrath's photo

Nuala McGrath is Professor of Epidemiology and Sexual Health, and works primarily on HIV and STIs in Sub-Saharan Africa. In the UK, she is evaluating strategies to improve effectiveness and efficiency of the sexual health service and develop interventions targeting sexual risk behaviours associated with substance misuse.


Nuala received her undergraduate degree in Mathematics, Statistics and Operational Research (University of Exeter, UK); a Masters in Biometry (University of Reading, UK); and a Doctorate in Infectious Disease Epidemiology (Harvard School of Public Health, USA). In the last 15 years, she has been the Principal Investigator of the Microbicides Development Programme feasibility study preparing for the phase III trial at the Africa Health Research Institute (formerly Africa Centre for Health and Population Studies) in rural KwaZulu-Natal, South Africa;  Field Director of the Wellcome Trust funded Karonga Prevention Study site (London School of Hygiene and Tropical Medicine) in rural Malawi; and as a Wellcome Trust Career Development Fellow led a programme of work focusing on sexual behaviour and partnership dynamics in the era of ART in KwaZulu-Natal.  She was also lead statistician on the first couples-based intervention randomised controlled trial to have couples HIV counseling and testing as its outcome, NIH-funded; Steering Committee member of both the NIMH-funded Project Accept and the ANRS Treatment as Prevention Trial; Independent Data and Safety Monitoring Board statistician for two international HIV clinical trials; Malawian National Ethics Committee member, and previously held an Honorary Professor appointment with the School of Nursing and Public Health, University of KwaZulu-Natal, South Africa.

She currently holds an honorary appointment with the Research Department of Epidemiology & Public Health, University College London (Reader). She serves as a member of the Wellcome Trust Basic Science Postdoctoral Fellowship Interview Committee, the Commonwealth Scholarship Commission in the UK, and the NIHR UK PANTHEON steering committee.

Research interests

Nuala’s current programme of international work is characterised by two main areas of research: a) HIV testing, prevention and treatment; b) Sexual and reproductive health and relationship dynamics.


a) HIV testing, prevention and treatment

The research questions and setting of her HIV-related research has changed over her career mirroring the progress and responses to the HIV epidemic globally. From 1989, Nuala was involved in the first US trials to identify appropriate treatment for HIV-infected children. She shifted focus to epidemiological and intervention studies in SSA as the severity of the epidemic there became apparent, and multi-countries studies between Africa and Asia. Her research has spanned the period before international roll-out of HIV treatment and the current era of the challenges of lifetime treatment and multimorbidity.  

Currently, she is co-investigator of a factorial design RCT in KwaZulu-Natal, funded by NIH (2016-2021), to test the effect of financial incentives and an electronic patient-centred decision support tool on uptake of HIV testing and linkage to care. 
b) Sexual and reproductive health and relationship dynamics

Nuala is also interested in changes in sexual behaviour and sexual health practices e.g. vaginal washing, in relation to ART availability and whether such behaviours facilitate HIV and STI transmission and acquisition.

Currently, she is co-investigator of an impact evaluation of PEPFAR’s DREAMS (Determined, Resilient, Empowered, AIDs free, Mentored and Safe) Initiative to reduce HIV incidence among adolescent girls and young women in South Africa (funded by the Gates Foundation). In addition, she is co-investigator of an NIH-funded grant (2017-2022) that aims to maximise uptake of combination HIV-prevention strategies by adolescent girls and young women (AGYW) and retention of AGYW in HIV prevention programmes. She also leads analyses of population-based data to describe trends in sexual HIV risk behaviours and knowledge of HIV in rural youth.  

Involvement in STI and HIV-related research in the UK

Nuala is a steering committee member for the ‘Prevention and Testing for HIV: Economics and Outcomes of Novel Approaches’ (PANTHEON) programme evaluating cost-effectiveness of HIV self-testing among MSM in the UK. Through the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex, she collaborates with the Solent NHS Trust Sexual Health Services team on intervention development around substance misuse and high STI risk sexual behaviours. She is also a member of the University of Southampton’s Centre for Sexual Health Research.

Couples as a cross-cutting theme

Couples-focused health research cross-cuts all areas of Nuala’s research and is an expanding, innovative and distinctive feature of her research career. Given that partners have a significant influence on each other’s health and are similar in health status and health behaviours, couple-focused interventions for health behaviour change may be more effective than individual interventions.

Nuala undertook a systematic review of interventions of health behaviour change for couples with at least one member at risk of a chronic illness and in South Africa she has investigated the health benefits of partnership for men, methods of recruiting non-cohabiting couples, the role of social support in loss-to-follow-up in ART programmes, gender equality within partnerships and condom use and, relationship quality and alcohol use. She collaborates with colleagues in Malawi and Nigeria on projects using couple-based approaches in Option B+ and family planning. She supervises University of Southampton MSc and PGR students conducting couples-focused analyses of quantitative and qualitative data including dyadic analyses.


Other Affiliate research groups

Division of Social Statistics and Demography (joint appointment)

Research group

Primary Care & Population Sciences

Affiliate research groups

Population Health Sciences Research group, Social Sciences: Social Statistics & Demography, Africa Centre of Health and Population Studies

Nuala is Lead for the Global Health pathway of the MSc in Public Health, and is a member of the

  • Senior management team in PCPS
  • Steering Group for the Southampton Clinical Academic Trainees (as Academic Supervisor representative)
  • University Senate, as Level 6/7 representative on behalf of the Faculty of Medicine
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Nuala teaches undergraduates on the BSc in Population and Geography and the BSc Medical Science, as well as teaching Quantitative methods and Global Health to undergraduates from various other programmes. She is Head of Field for Public Health Sciences and Medical Statistics projects for 3rd year BSc Medical Science (BMedSci) students, and facilitates overseas projects for BMedSci students. She also teach MSc students on the MSc in Public Health, the MSc in Global Health, and the MSc in Demography and Social Statistics. She is Lead for the Global Health pathway of the MSc in Public Health.

Nuala provides datasets and research supervision for MSc and PhD students, and supports early career researchers in their research.


The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa

Gender equality linked with higher condom use in HIV positive young women in South Africa, features the work of Dr Nuala McGrath and has been covered by (30 April 2015.)

Continuing coverage:
EurekAlert, NewsOnFeeds, News-Medical, Newswise, Newswise, BioPortfolio, Newswise, Press-news, BrightSurf, MedicalXpress, Topix and eWallstreeter (30 April 2015).

Topix (1 May 2015) and Medical News Today (2 May 2015)


Yerepouni (5 May 2015)


Time to eligibility for antiretroviral therapy in adults with CD4+ cell count >500 cells/µl in rural KwaZulu-Natal, South Africa.


Newswise, MedicalXpress, AlphaGalileo, Infection Control Today, ScienceNewsline, ScienceDaily, Topix, EurekAlert and HCPLive (12 May 2015).

Press-news, ScienceNewsline, eWallstreet and Medical News Today (13 May 2015).

Monthly Prescribing Reference, Doctors Lounge and Physicians Briefing (15 May 2015).

Southern Daily Echo and The Romsey Advertiser (17 May 2015).

That's Solent interview. (8 July 2015).


Hormonal contraception and the risk of HIV acquisition: an individual participant data meta-analysis


AIDSMap (24 July 2014)

Contraceptive Technology Update (October 2014)


The association between self-reported stigma and loss-to-follow up in treatment eligible HIV positive adults in rural KwaZula-Natal, South Africa


Medical Press and Medical News Today (20 February 2014).

Health Canal,, The Body and Red Orbit (21 February 2014).

Englemed Health News (24 February 2014).


Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial


Medical Express and Science Daily (15 April 2014).


Sexual behaviour in a rural high HIV prevalence South African community: time trends in the antiretroviral treatment era


AIDSMap (2 August 2013).

UNAIDS Science Now (October 2013).

Guttmacher Institute International Perspectives on Sexual and Reproductive Health Digest (December 2013).


Effect of concurrent sexual partnerships on rate of new HIV infections in hig-prevalence rural South Africa: a cohort study


AIDSMap (16 July 2011).


Intravaginal practices, bacterial vaginosis and HIV infection in women: individual woman data meta-analysis


Science Daily and PhysOrg (15 February 2011).

UNAIDS Science Now (28 August 2011).


Reported number of sexual partners: comparison of data from four African longitudinal studies


The Global Coalition on Women and AIDS (1 April 2009).


Population-level effect of HIV on adult mortality and early evidence of reversal after introduction of antiretroviral therapy in Malawi


UNAIDS Science Now (23 June 2008).

Professor Nuala McGrath
Faculty of Medicine University of Southampton Southampton General Hospital Mailpoint 805 South Academic Block Level C Room AC23 Tremona Road Southampton SO16 6YD Tel: 02381 20 5749 or Faculty of Social, Human and Mathematical Sciences Room 4012, Building 58 Highfield Campus University of Southampton SO17 1BJ Tel: 02380 59 2925 Email:

Room Number: SGH/AC23/MP805

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