Photo of Professor Nuala McGrath

Professor Nuala McGrath

Professor of Epidemiology and Sexual Health, University of Southampton
Hon. Prof. of Epidemiology – University of KwaZulu Natal
Hon. Reader - UCL

P.O. Box 198
Mtubatuba 3935
South Africa

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T. +27 (0)35 5507500
T. (UK) + 44 (0) 2381 20 7549

  • NIH/NIMH R01 MH086346, Darbes (PI), UCSF. March 2010- February 2016. Couples in Context: An RCT of a couples-based HIV prevention intervention among heterosexual couples living in Soweto, South Africa. Role: Co-Investigator
  • Wellcome Trust, UK. Career Development Fellowship. McGrath NM (PI). May 2008- February 2016. This fellowship research explores sexual behaviour and relationship dynamics in the era of ART rollout in South Africa through a series of studies that involve primary and secondary data.
  • Pan University Network for Global Health. Belue (PI), U of Pennsylvania. January 2015-December 2015. This study focuses on multimorbidity among HIV-infected adults in South Africa. Role: Co-investigator


  1. Conroy, A. A., McGrath, N., van Rooyen, H., Hosegood, V., Johnson, M. O., Fritz, K., … Darbes, L. A. (2016). Power and the association with relationship quality in South African couples: Implications for HIV/AIDS interventions. Social Science & Medicine 153 1–11.

  2. Evangeli, M., Newell, M.-L., & McGrath, N. (2016). Factors associated with pre-ART loss-to-follow up in adults in rural KwaZulu-Natal, South Africa: a prospective cohort study. BMC Public Health 16(1).

  3. Garrett, N. J., McGrath, N., & Mindel, A. (2016). Advancing STI care in low/middle-income countries: has STI syndromic management reached its use-by date? Sexually Transmitted Infections.

  4. Reniers, G., Wamukoya, M., Urassa, M., Nyaguara, A., Nakiyingi-Miiro, J., Lutalo, T., … Zaba, B. (2016). Data Resource Profile: Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network). International Journal of Epidemiology 45(1), 83–93.


  1. Channon M. Hosegood V, McGrath N. A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001-2011. JECH Online First, published on August 7, 2015 as 10.1136/jech-2014-205408.
  2. McGrath N, Eaton JW, Newell ML, Hosegood V. Revisiting migration and HIV risk in a general population in rural South Africa. Lancet HIV. 2015 Jun; 2(6): e252–e259
  3. Fladseth K, Gafos M, Newell ML, McGrath N. The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa. PLOS One, 2015 Apr 8;10(4):e0122671. doi: 10.1371.
  4. Afolabi M, McGrath N,  D’Alessandroa U, Kampmann B et al. Evaluation of the effectiveness of a multimedia consent tool in a low literacy African research population: a randomised controlled trial. Bulletin of WHO, 2015; 93:320-328A. doi:
  5. McGrath N, Lessells RJ, Newell ML. Time to eligibility for antiretroviral therapy in adults with CD4+ cell count >500 cells/µl in rural KwaZulu-Natal, South Africa. HIV Medicine. 2015 May 11.
  6. Oni T, Youngblood E, Boulle A, McGrath N, Wilkinson RJ, Levitt N. Patterns of HIV, TB, and non-communicable disease multi-morbidity in peri-urban South Africa. BMC Infectious Diseases, 2015, Jan 17;15(1):20.
  7. Orne-Gliemann, J., Larmarange, J., Boyer, S., Iwuji, C., McGrath, N., Bärnighausen, T., Zuma, T., Dray-Spira, R., Spire, B., Rochat, T., Lert, F., Imrie, J, 2015. Addressing social issues in a universal HIV test and treat intervention trial (ANRS 12249 TasP) in South Africa: methods for appraisal. BMC Public Health 15, 209. doi:10.1186/s12889-015-1344-y.
  8. Morrison CS, Chen PL, Kwok C, Baeten JM, Brown J, Crook A, Van Damme L, Delany-Moretlwe S, Francis SC, Friedland B, Hayes RJ,  Heffron R, Kapiga S, Karim Q, Kaul R, McClelland S, McCormack S, McGrath N, Myer L, Rees H, van der Straten A, Watson-Jones D, van de Wijgert JH, Stalter R,  Low N. Hormonal Contraception and the Risk of HIV Acquisition: An Individual Participant Data Meta-analysis. PLOS Medicine, 2015, Jan 22;12(1):e1001778. doi: 10.1371/journal.pmed.1001778.


  1. Knight, L., McGrath, N., van Rooyen, H., Humphries, H., van Heerden, A., Richter, L., 2014. Characteristics of sexually experienced HIV testers aged 18 to 32 in rural South Africa: baseline results from a community-based trial, NIMH Project Accept (HPTN 043). BMC public health 14, 1164. doi:10.1186/1471-2458-14-1164.
  2. Oni, T., McGrath, N., BeLue, R., Roderick, P., Colagiuri, S., May, C.R., Levitt, N.S., 2014. Chronic diseases and multi-morbidity - a conceptual modification to the WHO ICCC model for countries in health transition. BMC Public Health 14, 575. doi:10.1186/1471-2458-14-575
  3. Afolabi, M.O., Bojang, K., D’Alessandro, U., Imoukhuede, E.B., Ravinetto, R.M., Larson, H., McGrath, N., Chandramohan, D., 2014. Multimedia Informed Consent Tool for a Low Literacy African Research Population: Development and Pilot-Testing. Journal of Clinical Research & Bioethics 05. doi:10.4172/2155-9627.1000178
  4. Coates, T.J., Kulich, M., Celentano, D.D., Zelaya, C.E., Chariyalertsak, S., Chingono, A., Gray, G., Mbwambo, J.K.K., Morin, S.F., Richter, L., Sweat, M., van Rooyen, H., McGrath, N., Fiamma, A., Laeyendecker, O., Piwowar-Manning, E., Szekeres, G., Donnell, D., Eshleman, S.H., 2014. Effect of community-based voluntary counselling and testing on HIV incidence
  5. Afolabi, M.O., Okebe, J.U., McGrath, N., Larson, H.J., Bojang, K., Chandramohan, D., 2014. Informed consent comprehension in African research settings. Tropical Medicine & International Health n/a–n/a. doi:10.1111/tmi.12288
  6. Darbes, L.A., van Rooyen, H., Hosegood, V., Ngubane, T., Johnson, M.O., Fritz, K., McGrath, N., 2014. Uthando Lwethu (“our love”): a protocol for a couples-based intervention to increase testing for HIV: a randomized controlled trial in rural KwaZulu-Natal, South Africa. Trials 15, 64–64. doi:10.1186/1745-6215-15-64
  7. Evangeli, M., Newell, M.-L., Richter, L., McGrath, N., 2014. The Association between Self-Reported Stigma and Loss-to-Follow Up in Treatment Eligible HIV Positive Adults in Rural Kwazulu-Natal, South Africa. PLoS ONE 9, e88235. doi:10.1371/journal.pone.0088235
  8. Manasa, J., Lessells, R., Rossouw, T., Naidu, K., Van Vuuren, C., Goedhals, D., van Zyl, G., Bester, A., Skingsley, A., Stott, K., Danaviah, S., Chetty, T., Singh, L., Moodley, P., Iwuji, C., McGrath, N., Seebregts, C.J., de Oliveira, T., 2014. Southern African Treatment Resistance Network (SATuRN) RegaDB HIV drug resistance and clinical management database: supporting patient management, surveillance and research in southern Africa. Database (Oxford) 2014. doi:10.1093/database/bat082
  9. Maman S, van Rooyen H, Stankard P, Murima O, Muravha T, Ntogwisangu J, Phakathi Z, Srirak N, Morin SF and the NIMH Project Accept (HPTN 043) study team (including McGrath N). NIMH Project Accept (HPTN 043): Results from In-Depth Interviews with a Longitudinal Cohort of Community Members. PLoS ONE, 2014. 9(1): e87091. doi:10.1371/journal.pone.0087091


  1. Manasa J, Lessells RJ, Skingsley A, Naidu KK, Newell ML, De Oliveira T, McGrath N for the Southern African Treatment Resistance Network (SATuRN). High-levels of acquired drug resistance in adult patients failing first-line antiretroviral therapy in a rural HIV treatment programme in KwaZulu-Natal, South Africa PLoS ONE, 2013. 8(8): e72152. doi:10.1371/journal.pone.0072152
  2. McGrath, N., Richter, L., Newell, M.-L., 2013. Sexual risk after HIV diagnosis: a comparison of pre-ART individuals with CD4>500 cells/µl and ART-eligible individuals in a HIV treatment and care programme in rural KwaZulu-Natal, South Africa. J Int AIDS Soc 16. doi:10.7448/IAS.16.1.18048
  3. McGrath, N., Eaton, J.W., Bärnighausen, T.W., Tanser, F., Newell, M.-L., 2013. Sexual behaviour in a rural high HIV prevalence South African community: time trends in the antiretroviral treatment era. AIDS,  2013. 27(15): 2461-2470
  4. Lessells, R.J., Cooke, G.S., McGrath, N., Nicol, M.P., Newell, M.-L., Godfrey-Faussett, P., 2013. Impact of a novel molecular TB diagnostic system in patients at high risk of TB mortality in rural South Africa (Uchwepheshe): study protocol for a cluster randomised trial. Trials 14. doi:10.1186/1745-6215-14-170
  5. Bennett R, Hosegood V, Newell ML, McGrath N. An approach to measuring dispersed families with a particular focus on children ‘left behind’ by migrant parents: Findings from rural South Africa. Population, Space and Place, 2013. DOI: 10.1002/psp.1843
  6. Bennett R, Hosegood V, Newell ML, McGrath N. Understanding family migration in rural South Africa: Exploring children’s inclusion in the destination households of migrant parents. Population, Space and Place, 2013. DOI: 10.1002/psp.1842
  7. Matovu, J.K., Denison, J., Wanyenze, R.K., Ssekasanvu, J., Makumbi, F., Ovuga, E., McGrath, N., Serwadda, D., 2013. Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda. BMC Public Health 13. doi:10.1186/1471-2458-13-618
  8. Gafos, M., Mzimela, M.A., Ndlovu, H.B., McCormack, S., McGrath, N., 2013. How effective is effective enough? Opinions of potential end-users of microbicides from a rural South African community. AIDS Care 25, 573–578. doi:10.1080/09540121.2012.722604Manasa, J., Lessells, R.J., Skingsley, A., Naidu, K.K., Newell, M.-L., McGrath, N., de Oliveira, T., Southern African Treatment and Resistance Network, 2013. High-levels of acquired drug resistance in adult patients failing first-line antiretroviral therapy in a rural HIV treatment programme in KwaZulu-Natal, South Africa. PLoS ONE 8. doi:10.1371/journal.pone.0072152
  9. Van Rooyen, H., McGrath, N., Chirowodza, A., Joseph, P., Fiamma, A., Gray, G., Richter, L., Coates, T., 2013. Mobile VCT: reaching men and young people in urban and rural South African pilot studies (NIMH Project Accept, HPTN 043). AIDS Behav 17, 2946–2953. doi:10.1007/s10461-012-0368-x


  1. Crampin, A.C., Dube, A., Mboma, S., Price, A., Chihana, M., Jahn, A., Baschieri, A., Molesworth, A., Mwaiyeghele, E., Branson, K., Floyd, S., McGrath, N., Fine, P.E.M., French, N., Glynn, J.R., Zaba, B., 2012. Profile: the Karonga Health and Demographic Surveillance System. Int J Epidemiol 41, 676–685. doi:10.1093/ije/dys088
  2. Eaton, J.W., McGrath, N., Newell, M.-L., 2012. Unpacking the recommended indicator for concurrent sexual partnerships. AIDS 26, 1037–1039. doi:10.1097/QAD.0b013e328351f726
  3. Giordano, K., Bärnighausen, T., McGrath, N., Snow, R., Harlow, S., Newell, M.-L., 2012. Factors associated with repeated refusal to participate in longitudinal population-based HIV surveillance in rural South Africa: an observational study, regression analyses. Journal of HIV/AIDS Surveillance and Epidemiology 4.
  4. Maman, D., Glynn, J.R., Crampin, A.C., Kranzer, K., Saul, J., Jahn, A., Mwinuka, V., Ngwira, M.H., Mvula, H., Munthali, F., McGrath, N., 2012. Very early anthropometric changes after antiretroviral therapy predict subsequent survival, in Karonga, Malawi. Open AIDS J 6, 36–44. doi:10.2174/1874613601206010036


  1. Lalor, M.K., Floyd, S., Gorak-Stolinska, P., Ben-Smith, A., Weir, R.E., Smith, S.G., Newport, M.J., Blitz, R., Mvula, H., Branson, K., McGrath, N., Crampin, A.C., Fine, P.E., Dockrell, H.M., 2011. BCG Vaccination Induces Different Cytokine Profiles Following Infant BCG Vaccination in the UK and Malawi. J Infect Dis 204, 1075–1085. doi:10.1093/infdis/jir515
  2. Tanser, F., Bärnighausen, T., Hund, L., Garnett, G.P., McGrath, N., Newell, M.-L., 2011. Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study. Lancet 378, 247–255. doi:10.1016/S0140-6736(11)60779-4
  3. Tanser, F., Bärnighausen, T., Hund, L., Garnett, G.P., McGrath, N., Newell, M.-L., 2011. Role of concurrency in generalised HIV epidemics – Authors’ reply. The Lancet 378, 1845–1846. doi:10.1016/S0140-6736(11)61806-0
  4. McGrath, N., Richter, L., Newell, M.-L., 2011. 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 Africa. BMC Public Health 11. doi:10.1186/1471-2458-11-121


  1. Camlin, C.S., Hosegood, V., Newell, M.-L., McGrath, N., Barnighausen, T., Snow, R.C., 2010. Gender, Migration and HIV in Rural KwaZulu-Natal, South Africa. PLoS One 5. doi:10.1371/journal.pone.0011539
  2. Chimbindi, N.Z., McGrath, N., Herbst, K., San Tint, K., Newell, M.-L., 2010. Socio-Demographic Determinants of Condom Use Among Sexually Active Young Adults in Rural KwaZulu-Natal, South Africa. Open AIDS J 4, 88–95. doi:10.2174/1874613601004010088
  3. Jahn, A., Floyd, S., McGrath, N., Crampin, A.C., Kachiwanda, L., Mwinuka, V., Zaba, B., Fine, P.E.M., Glynn, J.R., 2010. Child mortality in rural Malawi: HIV closes the survival gap between the socio-economic strata. PLoS ONE 5. doi:10.1371/journal.pone.0011320
  4. McGrath, N., Glynn, J.R., Saul, J., Kranzer, K., Jahn, A., Mwaungulu, F., Ngwira, M.H.C., Mvula, H., Munthali, F., Mwinuka, V., Mwaungulu, L., Fine, P.E.M., Crampin, A.C., 2010. What happens to ART-eligible patients who do not start ART? Dropout between screening and ART initiation: a cohort study in Karonga, Malawi. BMC Public Health 10. doi:10.1186/1471-2458-10-601
  5. McGrath, N., Hosegood, V., Chirowodza, A., Joseph, P., Darbes, L., Boettiger, M., van Rooyen, H., 2010. Recruiting heterosexual couples from the general population for studies in rural South Africa--challenges and lessons (Project Accept, HPTN 043). S. Afr. Med. J. 100, 658,–660.
  6. Nyirenda, M., McGrath, N., Newell, M.-L., 2010. Gender differentials in the impact of parental death: Adolescent’s sexual behaviour and risk of HIV infection in rural South Africa. Vulnerable Child Youth Stud 5, 284–296. doi:10.1080/17450128.2010.507804


  1. Hernán, M.A., McAdams, M., McGrath, N., Lanoy, E., Costagliola, D., 2009. Observation plans in longitudinal studies with time-varying treatments. Stat Methods Med Res 18, 27–52. doi:10.1177/0962280208092345
  2. Hosegood, V., McGrath, N., Moultrie, T.A., 2009. Dispensing with marriage: Marital and partnership trends in rural KwaZulu-Natal, South Africa 2000-2006. Demographic Research 20, 279–312. doi:10.4054/DemRes.2009.20.13
  3. Lalor, M.K., Ben-Smith, A., Gorak-Stolinska, P., Weir, R.E., Floyd, S., Blitz, R., Mvula, H., Newport, M.J., Branson, K., McGrath, N., Crampin, A.C., Fine, P.E.M., Dockrell, H.M., 2009. Population differences in immune responses to Bacille Calmette-Guérin vaccination in infancy. J. Infect. Dis. 199, 795–800.


  1. Jahn, A., Floyd, S., Crampin, A.C., Mwaungulu, F., Mvula, H., Munthali, F., McGrath, N., Mwafilaso, J., Mwinuka, V., Mangongo, B., Fine, P.E.M., Zaba, B., Glynn, J.R., 2008. Population-level effect of HIV on adult mortality and early evidence of reversal after introduction of antiretroviral therapy in Malawi. Lancet 371, 1603–1611. doi:10.1016/S0140-6736(08)60693-5
  2. Kranzer, K., McGrath, N., Saul, J., Crampin, A.C., Jahn, A., Malema, S., Mulawa, D., Fine, P.E.M., Zaba, B., Glynn, J.R., 2008. Individual, household and community factors associated with HIV test refusal in rural Malawi. Trop. Med. Int. Health 13, 1341–1350. doi:10.1111/j.1365-3156.2008.02148.x
  3. Prost, M.-A., Jahn, A., Floyd, S., Mvula, H., Mwaiyeghele, E., Mwinuka, V., Mhango, T., Crampin, A.C., McGrath, N., Fine, P.E.M., Glynn, J.R., 2008. Implication of new WHO growth standards on identification of risk factors and estimated prevalence of malnutrition in rural Malawian infants. PLoS ONE 3. doi:10.1371/journal.pone.0002684
  4. Subramanian, L., McGrath, N., Ndlovu, H., Gafos, M., 2008. Family planning methods among women in a vaginal microbicide feasibility study in rural KwaZulu-Natal, South Africa. African Journal of Reproductive Health 12, 45–63.
  5. Moultrie, T.A., Hosegood, V., McGrath, N., Hill, C., Herbst, K., Newell, M.-L., 2008. Refining the criteria for stalled fertility declines: an application to rural KwaZulu-Natal, South Africa, 1990-2005. Studies in Family Planning 39, 39–48.
  6. Ndinda, C., Chimbwete, C., McGrath, N., Pool, R., 2008. Perceptions of anal sex in rural South Africa. Cult Health Sex 10, 205–212. doi:10.1080/13691050600988416


  1. Hosegood, V., Floyd, S., Marston, M., Hill, C., McGrath, N., Isingo, R., Crampin, A., Zaba, B., 2007. The effects of high HIV prevalence on orphanhood and living arrangements of children in Malawi, Tanzania, and South Africa. Popul Stud (Camb) 61, 327–336. doi:10.1080/00324720701524292
  2. Jahn, A., Branson, K., Crampin, A.C., Fine, P.E., Glynn, J.R., McGrath, N., Mwafilaso, J., Mwaiyeghele, E., Mwinuka, V., Zaba, B., 2007. Evaluation of a village-informant driven demographic surveillance system in Karonga, Northern Malawi. Demographic Research 16, 219–248.
  3. McGrath, N., Kranzer, K., Saul, J., Crampin, A.C., Malema, S., Kachiwanda, L., Zaba, B., Jahn, A., Fine, P.E., Glynn, J.R., 2007. Estimating the need for antiretroviral treatment and an assessment of a simplified HIV/AIDS case definition in rural Malawi. AIDS 21 Suppl 6, S105–113. doi:10.1097/01.aids.0000299417.69432.65
  4. Moultrie, T.A., McGrath, N., 2007. Teenage fertility rates falling in South Africa. S. Afr. Med. J. 97, 442–443.


  1. Hosegood, V., McGrath, N., Herbst, K., Timaeus, I.M., 2004. The impact of adult mortality on household dissolution and migration in rural South Africa. AIDS 18, 1585–1590.

Infectious Disease Epidemiology and Sexual Health

Nuala is a biostatistician and infectious disease epidemiologist by training. She was living and working at the Africa Centre for Population Health from 2002-2013, and since 2013 is based in the UK at the University of Southampton
Nuala has particular expertise in intervention research, the measurement and analysis of social factors and sexual behaviour data, couples relationships in the context of HIV and statistical analysis of longitudinal data. She is a Wellcome Trust Research Career Development Fellow since 2008 and hold 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’s research examines how sexual behaviour has changed with the availability of antiretroviral treatment for HIV, how risky sexual behaviours continue to facilitate the onward transmission of HIV, and how sexual health practices contribute to HIV infection. 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 her work.