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The University of Southampton
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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 NIHR Global Health Professor. Her work explores the value of couples-focused behaviour change strategies for health intervention research and practice in sub-Saharan Africa. Evaluating HIV treatment and prevention strategies including the promotion of HIV testing to reduce the onward transmission of HIV is another critically important and long-standing theme of her work.

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 a Wellcome Trust Career Development Fellow leading 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 the NIMH-funded Project Accept, the ANRS-funded Treatment as Prevention Trial, and the NIHR-funded ‘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; Independent Data and Safety Monitoring Board statistician for two international HIV clinical trials; and Malawian National Ethics Committee member. She has previously held Honorary appointments with the HIV/AIDS, STIs and TB research programme, Human Sciences Research Council, South Africa (2007-2010), the School of Nursing and Public Health, University of KwaZulu-Natal, South Africa (2014-2017), and the Research Department of Epidemiology & Public Health, University College London, UK (2014-2017). She was a member of the Wellcome Trust Basic Science Postdoctoral Fellowship Interview Committee (2013-2018).

Nuala currently serves as a member of the FLAIR (Future Leaders – African Independent Research Fellowships) Interview Committee (2018- ), a partnership between the African Academy of Sciences and the Royal Society, supported by the Global Challenges Research Fund. She is also a Commissioner for the Commonwealth Scholarship Commission in the UK (2017- ), an executive non-departmental public body, sponsored by the Department for International Development (DFID).

Prospective PhD students interested in continuing their research under the supervision and support of Professor McGrath are invited to get in touch via email.

Research interests

Given that partners have a significant influence on each other’s health and are often similar in health status and health behaviours, couple-focused interventions for health behaviour change may be more effective than individual interventions. In sub-Saharan Africa (SSA) couples studies are seldom undertaken and few couple-focused health interventions have been rigorously evaluated. Nuala’s ongoing NIHR Professorship – CHERISH (Couples HEalth Research and Intervention Studies) programme – aims, in the first instance, to contribute to the design and evaluation of interventions for couples affected by HIV, other STIs and, diabetes in South Africa. This work is in partnership with two South African institutions: Human Sciences Research Council and University of Cape Town. The CHERISH programme further aims to establish a research agenda in couples-focused health research in SSA, to develop capacity in research sites in SSA to prepare for couples-focused research and evaluation, and to explore the opportunities for couples-focused interventions within the UK.

Nuala’s other 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  HIV-related research has changed over the course of Nuala’s 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 rollout of HIV treatment and the current era of the challenges of lifetime treatment and multimorbidity. 

Currently, she is co-investigator of (i) a factorial design randomized controlled trial (RCT) in KwaZulu-Natal, funded by US 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, and (ii) development of a peer intervention in KwaZulu-Natal to improve the uptake, retention and adherence of multi-level combination HIV prevention by adolescent girls and young women (AGYW) and young men, funded by US NIH (2017-2022).

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). She also leads analyses of population-based data to describe trends in sexual HIV risk behaviours and knowledge of HIV in rural youth.

Within 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 to evaluate strategies to improve effectiveness and efficiency of the sexual health service and develop interventions targeting sexual risk behaviours associated with substance misuse. She is also a member of the University of Southampton’s Centre for Sexual Health Research and is co-investigator for an NIHR-funded RCT evaluating a behaviour change condom promotion intervention to reduce the risk of sexually transmitted infections among young men aged 16-25 years (2018-2023).

Additional Research Projects

CHERISH Couples Health Research and Intervention Studies programme

CHERISH Can HIV Hot-Spots be eradicated?

CHERISH Maximising combination HIV prevention uptake

CHERISH Evaluating the Home-based Intervention Strategy


Affiliate research groups

Population Health Sciences Research group, Primary Care, Population Sciences and Medical Education, SSD, Africa Health Research Institute

Research project(s)

Primary care and population sciences

Antenatal Couples’ Counselling in Uganda (ACCU)

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 (BMedSci), 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 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.

Southampton researcher in five year 2million project to help cut hiv rates

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

Room Number : SGH/AC23/MP805

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