Nicky Mcgrath
Datos Biográficos
| ID | 212640 |
|---|---|
| NOMBRE | Nicky Mcgrath |
| NOMBRES | Nicky |
| APELLIDO | Mcgrath |
| FIRMA | MCGRATH N |
| AFILIACIONES | Africa Health Research Institute |
| ORCID | 0000-0002-1039-0159 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 53 |
| TOTAL DE CITAS | 146 |
| TOTAL COMO AUTOR | 53 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2004 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 7 |
How is goal setting used in interventions for chronic disease prevention and management in sub-Saharan Africa? A systematic review and narrative synthesis
Non-communicable diseases are increasingly prevalent in sub-Saharan Africa, and goal setting is often used to promote healthy self-management behaviours. In this review, we aimed to synthesise literature around how goal setting is used, for application in future interventions in the region. A systematic search was conducted in six databases and results screened for eligibility. Study characteristics, intervention details, goal setting components,…
“You always have a high sugar if you don’t communicate”
Type 2 Diabetes Mellitus (T2D) can negatively impact relationships which may affect health and disease management. This can be moderated by positive communication between partners. Our aims were first, to identify ways in which couples’ communication and T2D impact each other. Second, we aimed to explore how improving couples’ communication may enhance self-management for people living with T2D (PLWD) and their partners in South Africa. We conduc…
Walking a tightrope
Supportive social relations are crucial to wellbeing as young adults transition to independence, especially when these transitions are impeded by limited employment and educational opportunities, leading to lengthy 'waithoods'. Yet, there is limited empirical evidence on what young adults' support networks look like in highly resource-constrained settings. We therefore analysed the core support networks of 929 16-29 year-old rural South Africans …
Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa
Combination HIV prevention packages have reduced HIV incidence and improved HIV-related outcomes among young people. However, there is limited data on how package components interact to promote HIV-related prevention behaviours. We described the uptake of HIV prevention interventions supported by Determined, Resilient, Empowered, AIDS-free, Motivated and Safe (DREAMS) Partnership and assessed the association between uptake and HIV-related behavio…
Increasing HIV testing and linkage to care among men in rural South Africa using conditional financial incentives and a decision support app
Men in sub-Saharan Africa are less likely to accept HIV testing and link to HIV care than women. We conducted a trial to investigate the impact of conditional financial incentives and a decision support application, called EPIC-HIV, on HIV testing and linkage to care. We report the findings of the trial process evaluation to explore whether the interventions were delivered as intended, identify mechanisms of impact and any contextual factors that…
Two-way associations between relationship quality and uptake of couples health screening including HIV testing and counselling together
In the context of a couples cohort established to evaluate an optimised couples-focused behavioural intervention in rural South Africa, we examined: (1) Is couples’ relationship quality (RQ) associated with couples HIV testing and counselling (CHTC) uptake? (2) Does CHTC uptake or the intervention components uptake improve subsequent RQ? Enrolled couples, (n = 218), previously naïve to couples HIV testing, were invited to two group sessions and o…
We are in control of this thing, and we know what to do now’
We piloted the delivery of a prototype couples-focused intervention, 'Diabetes Together' with 14 people living with diabetes (PLWD) and their partners, in Cape Town, South Africa in 2022. We aimed to: assess feasibility of recruiting couples in this setting; explore acceptability of intervention materials and changes needed; and investigate whether our prespecified logic model captured how the intervention may work. We used questionnaires, interv…
Effect of a Male-Targeted Digital Decision Support Application Aimed at Increasing Linkage to HIV Care Among Men
The mental wellbeing of prison staff in England during the Covid-19 pandemic
Background COVID-19 is likely to have had an impact on the mental wellbeing of prison staff because of the high risk for infectious disease outbreaks in prisons and the pre-existing high burden of mental health issues among staff. Methods A cross-sectional study of staff within 26 prisons in England was carried out between 20th July 2020 and 2nd October 2020. Mental wellbeing was measured using the Short-version of Warwick-Edinburgh Wellbeing Sca…
Antiretroviral therapy based HIV prevention targeting young women who sell sex
Pre-Exposure Prophylaxis (PrEP) is a potential game-changer for HIV. We used PrEP introduction for Young Women Who Sell Sex (YWSS) in a rural South Africa district to understand community norms and PrEP coverage in YWSS. Between 2017 and 2018, we measured awareness and uptake of PrEP in a representative cohort of 2184 Adolescent Girls and Young Women (AGYW) aged 13-22. We conducted group discussions with young people and community members (19); k…
Protocol
Retrospectively registered. ISRCTN Registry ISRCTN 46162564 Registered on 26th May 2022
Isisekelo Sempilo study protocol for the effectiveness of HIV prevention embedded in sexual health with or without peer navigator support (Thetha Nami) to reduce prevalence of transmissible HIV amongs…
gov Identifier NCT04532307 . Registered: March 2020
Can a conditional financial incentive (CFI) reduce socio-demographic inequalities in home-based HIV testing uptake? A secondary analysis of the Hits clinical trial intervention in rural South Africa
In sub-Saharan Africa, home-based HIV testing interventions are designed to reach sub-populations with low access to HIV testing such as men, younger or less educated people. Combining these interventions with conditional financial incentives (CFI) has been shown to be effective to increase testing uptake. CFI are effective for one-off health behaviour change but whether they operate differentially on different socio-demographic groups is less cl…
Effect of peer-distributed HIV self-test kits on demand for biomedical HIV prevention in rural KwaZulu-Natal, South Africa
Study objective We investigated two peer distribution models of HIV self-testing (HIVST) in HIV prevention demand creation compared with trained young community members (peer navigators). Methods We used restricted randomisation to allocate 24 peer navigator pairs (clusters) in KwaZulu-Natal 1:1:1: (1) standard of care ( SOC): peer navigators distributed clinic referrals, pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) informatio…
Acceptability of a tablet-based application to support early HIV testing among men in rural KwaZulu-Natal, South Africa
Uptake of HIV testing remains low among men in South Africa. As part of a trial, we assessed the acceptability of a theoretically derived and adapted tablet-based-application (EPIC-HIV1) in rural South Africa. We conducted 20 in-depth interviews with men aged ≥18 years and offered a tablet-based survey to all men aged ≥15 years who received EPIC-HIV1 (Sep-Dec 2018). We conducted a descriptive analysis of the survey and used Self-Determination The…
Thetha Nami
Local youth were able to use evidence to develop a contextually adapted peer-led intervention to deliver biosocial HIV prevention
Common mental disorders and HIV status in the context of DREAMS among adolescent girls and young women in rural KwaZulu-Natal, South Africa
We found high prevalence of probable CMD among AGYW in rural South Africa, but it was only associated with HIV serostatus when not controlling for HIV acquisition risk factors. Our findings highlight that improving mental health service access for AGYW at high risk for HIV acquisition might protect them. Interventions already reaching AGYW with CMD, such as DREAMS, can be used to deliver mental health services to reduce both CMD and HIV risks. Th…
Social Influence and Uptake of Couples HIV Testing and Counselling in KwaZulu-Natal, South Africa
Social influences may create a barrier to couples HIV testing and counselling (CHTC) uptake in sub-Saharan Africa. This secondary analysis of data collected in the ‘Uthando Lwethu’ randomised controlled trial used discrete-time survival models to evaluate the association between within-couple average ‘peer support’ score and uptake of CHTC by the end of nine months’ follow-up. Peer support was conceptualised by self-rated strength of agreement wi…
Female adherence self-efficacy before and after couple HIV testing and counseling within Malawi’s Option B+ program
Adherence self-efficacy, belief in one’s ability to adhere to daily medication, is strongly associated with antiretroviral therapy (ART) adherence and preventing mother-to-child HIV transmission. Couple-based interventions could enhance self-efficacy and adherence. We assessed the relationship between couple HIV testing and counseling (cHTC) and adherence self-efficacy using a 100-point culturally-adapted adherence self-efficacy scale (ASES). Sec…
Early ART Initiation Improves HIV Status Disclosure and Social Support in People Living with HIV, Linked to Care Within a Universal Test and Treat Program in Rural South Africa (ANRS 12249 TasP Trial)
Young people’s experiences of sexual and reproductive health interventions in rural KwaZulu-Natal, South Africa
Despite efforts to address HIV-infection, adolescents and young peoples' (AYP) engagement in interventions remains suboptimal. Guided by a risk protection framework we describe factors that support positive and negative experiences of HIV and SRH interventions among AYP in rural KwaZulu-Natal, South Africa, using data from: community mapping; repeat semi-structured individual interviews (n= 58 in 2017, n=50 in 2018, n=37 in 2019-2020); and group …
Social support, disclosure and stigma and the association with non-adherence in the six months after antiretroviral therapy initiation among a cohort of HIV-positive adults in rural KwaZulu-Natal, Sou…
The World Health Organisation (WHO) recommends antiretroviral treatment (ART) initiation at human immunodeficiency virus (HIV) diagnosis. As ART programmes expand, addressing barriers to adherence is vital. Past mixed findings on the association between social support, stigma and non-disclosure with ART adherence highlights the need for further research. The primary aim of this study was to examine how these factors are associated with ART non-ad…
The impact of HIV couple testing and counseling on social support among pregnant women and their partners in Lilongwe, Malawi
Couples HIV testing and counseling (couple counseling) promotes safer sexual behaviors, increases communication between couples, and decreases HIV transmission. However, the impact of couple counseling on social support, critical for persons living with HIV, has not been examined. Ninety couples with a recently tested HIV-positive pregnant woman (female-positive couples) and 47 couples with a recently tested HIV-negative pregnant woman (female-ne…
Home-based intervention to test and start (Hits) protocol
This trial was registered on 28 November 2018 on, identifier https://clinicaltrials.gov
Power relations and negotiations in contraceptive decision-making when husbands oppose family planning
Contraceptive use in Nigeria has remained low at less than 15% for over two decades. Although husbands' opposition is acknowledged as one of the factors impeding women's contraceptive use, little is known about how wives negotiate when their husbands oppose family planning. We addressed this research gap by conducting thematic analyses of qualitative data from 30 interviews of married couples. We employed thematic analysis to identify relevant th…
Dispensing with marriage
This paper describes marriage and partnership patterns and trends in rural KwaZulu-Natal, South Africa from 2000-2006. The study is based on longitudinal, population-based data collected by the Africa Centre demographic surveillance system. We consider
The effects of high HIV prevalence on orphanhood and living arrangements of children in Malawi, Tanzania, and South Africa
Using longitudinal data from three demographic surveillance systems (DSS) and a retrospective cohort study, we estimate levels and trends in the prevalence and incidence of orphanhood in South Africa, Tanzania, and Malawi in the period 1988-2004. The prevalence of maternal, paternal, and double orphans rose in all three populations. In South Africa - where the HIV epidemic started later, has been very severe, and has not yet stabilized - the inci…
Understanding Family Migration in Rural South Africa
Despite the removal of restrictions on movement and increasing female participation in migration, only a minority of migrant parents in South Africa include their children in their destination household. Quantitative analyses of the circumstances in which children accompany a migrant parent have been limited by the lack of available data that document family arrangements from the perspective of more than one household. This paper uses data about …
The Role of Gender in Public Perception of Whether Animals Can Experience Grief and Other Emotions
Gender plays a significant role in influencing people's attitudes toward animals, however, little is known about how it influences their attribution of emotions to animals. To investigate the role that gender plays in public attitudes toward animals' experience of emotions and beliefs about whether animals can grieve, a face-to-face survey of 1,000 members of the general public was carried out in Brisbane, Australia. Potential respondents were as…
Refining the Criteria for Stalled Fertility Declines
Stalled fertility declines have been identified in several regions across the developing world, but the current conceptualization of a stalled fertility decline is poorly theorized and does not lend itself to objective measurement. We propose a more rigorous and statistically testable definition of stalled fertility decline that can be applied to time‐series data. We then illustrate the utility of our definition through its application to data fr…
Power and the association with relationship quality in South African couples
Research and health interventions aiming to improving HIV-related behaviors should consider sources of shared power within couples and potential leverage points for empowerment at the couple level. Efforts solely focused on empowering women should also take the dyadic environment and men's perspectives into account to ensure positive relationship outcomes
An Approach to Measuring Dispersed Families with a Particular Focus on Children ‘Left Behind’ by Migrant Parents
There is growing policy and academic interest in the conditions, experiences, and well-being of migrant families stretched across origin and destination households. In South Africa, the dispersal of children and migrant parents across multiple households is a commonplace childhood experience. However, in common with the broader international context, quantitative analyses of the social and residential connections between children and migrant pare…
Aminina Nud Mulumuluna (“You Gotta Look After Yourself”)
This research documents an evaluation of preventive health resources developed for Aboriginal people in the west Kimberley region. The project was a collaboration between The Jean Hailes Foundation for Women and Aboriginal and non-Aboriginal health workers, educators and artists from Looma, Pandanus Park, Derby and Mowanjum. Traditional art and language provided a basis for cultural identity and imparting modern health knowledge. Two health bookl…
Gender differentials in the impact of parental death
Using data from a longitudinal surveillance study from rural South Africa, we investigated the odds of sexual debut, pregnancy and HIV infection of 15- to 19-year-old adolescents by parental survival. Using descriptive statistics and logistic regressions, we examine the relative risk of orphans compared with non-orphans to have ever had sex, being pregnant and being HIV infected, adjusting for age, sex, socio-economic status, education, being emp…
Evaluation of a village-informant driven demographic surveillance system in Karonga, Northern Malawi
This paper describes and evaluates the first demographic surveillance system (DSS) in Malawi, covering a rural population of 30,000. Unlike others, the Karonga DSS relies on trained village informants using formatted registers for the primary notificat
Walking a tightrope
Supportive social relations are crucial to wellbeing as young adults transition to independence, especially when these transitions are impeded by limited employment and educational opportunities, leading to lengthy 'waithoods'. Yet, there is limited empirical evidence on what young adults' support networks look like in highly resource-constrained settings. We therefore analysed the core support networks of 929 16-29 year-old rural South Africans …
Aminina Nud Mulumuluna (“You Gotta Look After Yourself”)
This research documents an evaluation of preventive health resources developed for Aboriginal people in the west Kimberley region. The project was a collaboration between The Jean Hailes Foundation for Women and Aboriginal and non-Aboriginal health workers, educators and artists from Looma, Pandanus Park, Derby and Mowanjum. Traditional art and language provided a basis for cultural identity and imparting modern health knowledge. Two health bookl…
Community attitudes towards individuals living with HIV in rural KwaZulu-Natal, South Africa
Antenatal sero-prevalence rates of 30% and more have been reported in KwaZulu-Natal since 1998 and over 50% of all adult deaths in 2000 were due to AIDS. Understanding the changing social and cultural attitudes to AIDS is important in providing contextual information to aid the design of interventions. This paper examines community attitudes towards individuals living with HIV. Eleven focus groups were conducted with men and women. Participants w…
The effects of high HIV prevalence on orphanhood and living arrangements of children in Malawi, Tanzania, and South Africa
Using longitudinal data from three demographic surveillance systems (DSS) and a retrospective cohort study, we estimate levels and trends in the prevalence and incidence of orphanhood in South Africa, Tanzania, and Malawi in the period 1988-2004. The prevalence of maternal, paternal, and double orphans rose in all three populations. In South Africa - where the HIV epidemic started later, has been very severe, and has not yet stabilized - the inci…
Evaluation of a village-informant driven demographic surveillance system in Karonga, Northern Malawi
This paper describes and evaluates the first demographic surveillance system (DSS) in Malawi, covering a rural population of 30,000. Unlike others, the Karonga DSS relies on trained village informants using formatted registers for the primary notificat
Perceptions of anal sex in rural South Africa
As part of the Microbicides Development Programme, we conducted formative research to explore perceptions of anal sex at a site in rural KwaZulu-Natal. We were interested in the practice of anal sex because of its potential role in HIV transmission. Eleven focus group discussions were conducted with men and women from rural areas and in a semi-urban township. Participants were asked about their knowledge of and attitudes towards anal sex, and its…
Refining the Criteria for Stalled Fertility Declines
Stalled fertility declines have been identified in several regions across the developing world, but the current conceptualization of a stalled fertility decline is poorly theorized and does not lend itself to objective measurement. We propose a more rigorous and statistically testable definition of stalled fertility decline that can be applied to time‐series data. We then illustrate the utility of our definition through its application to data fr…
Dispensing with marriage
This paper describes marriage and partnership patterns and trends in rural KwaZulu-Natal, South Africa from 2000-2006. The study is based on longitudinal, population-based data collected by the Africa Centre demographic surveillance system. We consider
What happens to ART-eligible patients who do not start ART? Dropout between screening and ART initiation
MUAC and reported difficulties in dressing may provide useful screening indicators to identify sicker ART-eligible individuals at high risk of dropping out of the programme who might benefit from being brought back quickly or admitted to hospital for observation. Individuals with less education may need adapted health information at screening. Deaths of ART-eligible individuals occurring prior to ART initiation are not included in routine program…
Gender differentials in the impact of parental death
Using data from a longitudinal surveillance study from rural South Africa, we investigated the odds of sexual debut, pregnancy and HIV infection of 15- to 19-year-old adolescents by parental survival. Using descriptive statistics and logistic regressions, we examine the relative risk of orphans compared with non-orphans to have ever had sex, being pregnant and being HIV infected, adjusting for age, sex, socio-economic status, education, being emp…
Design and methods of a longitudinal study investigating the impact of antiretroviral treatment on the partnerships and sexual behaviour of HIV-infected individuals in rural KwaZulu-Natal, South Afric…
The data collected in this study will provide valuable information for measuring the impact of ART on sexual behaviour, and for the planning and delivery of appropriate interventions to promote family and partner support, and safe sexual behaviour for people living with HIV in this setting and elsewhere in sub-Saharan Africa
Mobile VCT
How effective is effective enough? Opinions of potential end-users of microbicides from a rural South African community
To assess the views of potential end-users of a microbicide in KwaZulu-Natal regarding the characteristics that would justify further development, three focus group discussions were conducted in 2009 with 23 local staff members working on a microbicide clinical trial, 20 former trial participants and 14 Community Advisory Board members not enrolled in the trial, in an area with high HIV incidence and low consistent condom use. All participants ag…
Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda
Uptake of couples' HCT remained consistently low (below 30%) over the years, while uptake of individual HCT declined over time. These findings call for innovative strategies to increase demand for couples' HCT, particularly among younger couples and those with no prior HCT
Characteristics of sexually experienced HIV testers aged 18 to 32 in rural South Africa
These findings highlight the need for novel youth- and men-friendly testing services and emphasises the importance of discussions about HIV in the home and community to encourage testing
Chronic diseases and multi-morbidity - a conceptual modification to the WHO ICCC model for countries in health transition
Our proposed modification to the ICCC Framework makes clear that healthcare systems must work to make sense of the complex collision between biological phenomena, clinical interpretation, beliefs and behaviours that follow from these. We emphasize the integration of these issues with the socio-economic environment to address issues of complexity, access and equity in the integrated management of chronic diseases previously considered in isolation
An Approach to Measuring Dispersed Families with a Particular Focus on Children ‘Left Behind’ by Migrant Parents
There is growing policy and academic interest in the conditions, experiences, and well-being of migrant families stretched across origin and destination households. In South Africa, the dispersal of children and migrant parents across multiple households is a commonplace childhood experience. However, in common with the broader international context, quantitative analyses of the social and residential connections between children and migrant pare…
Understanding Family Migration in Rural South Africa
Despite the removal of restrictions on movement and increasing female participation in migration, only a minority of migrant parents in South Africa include their children in their destination household. Quantitative analyses of the circumstances in which children accompany a migrant parent have been limited by the lack of available data that document family arrangements from the perspective of more than one household. This paper uses data about …
The Role of Gender in Public Perception of Whether Animals Can Experience Grief and Other Emotions
Gender plays a significant role in influencing people's attitudes toward animals, however, little is known about how it influences their attribution of emotions to animals. To investigate the role that gender plays in public attitudes toward animals' experience of emotions and beliefs about whether animals can grieve, a face-to-face survey of 1,000 members of the general public was carried out in Brisbane, Australia. Potential respondents were as…
Addressing social issues in a universal HIV test and treat intervention trial (ANRS 12249 TasP) in South Africa
Clinicaltrials.gov: NCT01509508; South African Trial Register: DOH-27-0512-3974
Factors associated with antiretroviral treatment initiation amongst HIV-positive individuals linked to care within a universal test and treat programme
Prompt uptake of antiretroviral treatment (ART) is essential to ensure the success of universal test and treat (UTT) strategies to prevent HIV transmission in high-prevalence settings. We describe ART initiation rates and associated factors within an ongoing UTT cluster-randomized trial in rural South Africa. HIV-positive individuals were offered immediate ART in the intervention arm vs. national guidelines recommended initiation (CD4≤350 cells/m…
Men, masculinity, and engagement with treatment as prevention in KwaZulu-Natal, South Africa
Men's poorer engagement with healthcare generally and HIV care specifically, compared to women, is well-described. Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. UTT strategies refer to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a "treatment as prevention" (TasP). This paper focuses on how masculinity inf…
Community perceptions of repeat HIV-testing
In the context of the ANRS 12249 Treatment as Prevention (TasP) trial, we investigated perceptions of regular and repeat HIV-testing in rural KwaZulu-Natal (South Africa), an area of very high HIV prevalence and incidence. We conducted two qualitative studies, before (2010) and during the early implementation stages of the trial (2013-2014), to appreciate the evolution in community perceptions of repeat HIV-testing over this period of rapid chang…
“It is better to die”
The ANRS 12249 Treatment-as-Prevention (TasP) cluster-randomized trial in rural South Africa uses a "test and treat" approach. Home-based testing services and antiretroviral treatment initiation satellite clinics were implemented in every cluster as part of the trial. A social science research agenda was nested within TasP with the aim of understanding the social, economic and contextual factors that affect individuals, households, communities an…
Factors associated with pre-ART loss-to-follow up in adults in rural KwaZulu-Natal, South Africa
Strategies to retain younger people in pre-ART care are required. How openness with others, partner HIV status and disclosure, and children relate to LTFU needs further exploration
A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001–2011
BACKGROUND: Mortality risk is lower in married than in unmarried men and women. However, little is known about the association between mortality and relationship status in South Africa where marriage rates are low, migration is common, many couples are not co-resident and HIV prevalence is high. METHOD: Using demographic surveillance data collected from 2001 to 2011, relationship status was categorised as conjugal (partners belong to the same hou…
Medicine (45 obras) · Adolescent Sexual and Reproductive Health (38 obras) · HIV/AIDS Research and Interventions (35 obras) · Family medicine (29 obras) · Psychology (27 obras) · Environmental health (23 obras) · Nursing (23 obras) · Demography (21 obras) · Public health (20 obras) · Sociology (17 obras)