The University of Southampton

Professor Nuala McGrath BSc, MSc, ScD.

Professor of Epidemiology and Sexual Health; Wellcome Trust Career Development Fellow

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Professor Nuala McGrath is Professor of Epidemiology and Sexual Health; Wellcome Trust Career Development Fellow within Medicine at the University of Southampton.

Nuala has worked in HIV research since 1989. First as a biostatistician supporting clinical trials in the USA, and later in clinical trials and epidemiological research in Africa. After completing her PhD in Infectious Disease Epidemiology at Harvard School of Public Health in 2002, she was Principal Investigator of a microbicide study at the Africa Centre for Health and Population Studies in KwaZulu-Natal, South Africa (2002-2004), and the Field Director for the London School of Hygiene and Tropical Medicine’s Karonga Prevention Study research programme in Malawi (2005-2006) and based in South Africa again from 2006-2013. Her research explores HIV transmission dynamics, sexual behaviour and relationship dynamics in the era of HIV treatment and testing couples-based interventions to reduce HIV transmission. Nuala joined the University of Southampton as a Reader in Infectious Disease Epidemiology in 2013 and was promoted to Professor of Epidemiology and Sexual Health on 1 August 2015.

Nuala has been a Wellcome Trust Research Career Development Fellow since 2008 and holds Honorary appointments with the College of Health Sciences, University of KwaZulu-Natal (Honorary Professor) and in Infection and Population Health / Centre for Sexual Health & HIV Research, University of College London (Honorary Reader). Nuala is also part of the Senior Faculty of the Africa Centre for Health and Population Studies in KwaZulu-Natal, South Africa.







Research interests

Nuala’s current research and scholarship is characterised by four main activities:

Sexual behaviour and relationship dynamics

Nuala’s primary research addresses sexual behaviour and sexual health; in recent years this has chiefly meant exploring sexual behaviour and relationship dynamics in the era of antiretroviral treatment (ART) rollout in South Africa. Her research examines how sexual behaviour has changed with the availability of ART, how it continues to facilitate the onward transmission of HIV, and how sexual health practices contribute to HIV infection. Her research (prospective studies and secondary analyses) has shown that general population sexual risk behaviours have not increased as a result of treatment rollout; neither have they increased among people living with HIV. Nuala’s work has informed debates on the role of hormonal contraception use on HIV acquisition, intravaginal practices and the particularly contentious debate on whether concurrency is a key driver of the HIV epidemic. She has also contributed as an expert to the UNAIDS Reference Group On Estimates Modelling And Projections guidelines on measuring concurrent sexual partnerships. Extending her sexual behaviour and STI work to the UK, she is working with the Sexual Health Services team at Solent NHS Trust, through the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, to evaluate strategies to improve effectiveness and efficiency of the sexual health service and develop interventions targeting high STI risk sexual behaviours associated with substance misuse.

HIV testing, HIV prevention and treatment

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 in Nuala’s work. Many of these studies have involved the kind of multi-centre and multi-country research networks that are necessary to conduct research on the scale required to definitively answer key questions on HIV prevention. Currently, she has a senior scientific role on the study steering committee of three important HIV prevention trials: a French national research agency on HIV and viral hepatitis (ANRS) funded Treatment as Prevention (TasP) Trial, a large (N=22,000) community cluster-randomised trial; a US National Institute of Mental Health funded Project Accept (HPTN 043), a large cluster-randomised trial among 48 communities in Africa and Thailand; and the first couples-based intervention randomised controlled trial to have couples HIV counselling and testing (CHCT) as its outcome (Uthando Lwethu), funded by the US National Institute of Health.

Chronic Diseases

Antiretroviral treatment has resulted in HIV becoming a chronic disease, dramatically increased life expectancy and facilitated new epidemics of non-communicable and infectious chronic disease co-morbidities in Sub-Saharan Africa. Nuala is the Southampton lead on a programme of work on multi-morbidity with collaborators at the University of Cape Town, South Africa, Pennsylvania State University, USA, and Soton colleagues. Linked to this theme of non-communicable diseases, she is collaborating with Soton colleagues to explore the feasibility of delivering health-related interventions via smartphones in a rural African context.


Partners have a significant influence on each other’s health, and similarities in health behaviours increases with union duration, potentially making couple-focused interventions for health behaviour change more effective than individual interventions. Nuala conducts dyadic analyses of couples data from Africa and the UK, has conducted a systematic review of interventions of health behaviour change for couples, and examined the protective effect against mortality of being in a couple for men and women in South Africa.

Other Affiliate research groups

Division of Social Statistics and Demography (joint appointment)

Research group

Primary Care & Population Sciences Academic Units

Affiliate research groups

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

Within Southampton: 

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

  • Steering Committee of the University Strategic Research Group on Population and Health
  • Senior management team in PCPS
  • Steering Group for the Southampton Clinical Academic Trainees (as Academic Supervisor representative)
  • Faculty of Medicine Athena Swan Committee
  • Faculty of Medicine Postdoctoral Career Track Award Interview panel

Outside of Southampton:

Nuala is a member of The Wellcome Trust Basic Science Interview Committee that awards Postdoctoral Fellowships under the Sir Henry Wellcome, Career Re-entry, and Wellcome Trust-Massachusetts Institute of Technology (MIT) schemes. Nuala is an expert reviewer of applications for The Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine Scheme, the South African National Research Foundation’s Reviews and Evaluation Directorate, The Scottish Government Chief Scientist Office Postdoctoral Fellowship in Health Services and Health of the Public Research Scheme, and the National Institute of Health Research (UK) Public Health Research Scheme. Nuala has been a Managing Editor for Emerging Themes in Epidemiology and is a reviewer for a number of HIV-related journals.

Nuala is a member of the Steering Committee of NIMH funded Project Accept, and the Steering Committee of the ANRS TasP Trial; and Statistician for the Independent Data Safety and Management Boards of two international HIV clinical trials. She has also served on the Malawian National Ethics Committee.

Nuala is a member of the International AIDS Society and the International Union for the Scientific Study of Population.




Nuala teach undergraduates on the BSc in Population and Geography and the BSc Medical Science, and undergraduates from various programmes as part of the Curriculum Innovation Programme Global Health module. 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. She currently supervises six PhD candidates.

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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