I have been working in public health since 1996 initially in community-based organisations supporting people living with HIV, then in the Department for Health supporting quality improvement of a range of services including mental health, sexual health and primary care services in England. In these various roles, I enjoyed being able to plan, evaluate and modify NHS and voluntary sector services, but had a yearning to contribute to the development of global public health. This led me to enrol on the Reproductive and Sexual Health Research MSc at LSHTM in 2001 which enabled me to shift my attention from HIV advocacy and service delivery to focus on research – although my passion and commitment for advocacy and improving service delivery have remained as core foundations of my research.

While working at the University of KwaZulu Natal in South Africa and subsequently the MRC Clinical Trials Unit at UCL, I was an investigator on a range of HIV prevention trials of vaginal microbicides (MDP301), oral pre-exposure prophylaxis (PROUD) and HIV self-testing (SELPHI. I joined LSHTM in 2017 as co-research director of the DFID funded STRIVE Research Consortium (https://strive.lshtm.ac.uk).  The STRIVE consortium aimed to deliver new evidence, together with a synthesis of existing evidence, on individual and interrelated structural drivers of HIV, pathways of risk and infection, effective measurement tools of structural drivers, and evaluation of structural interventions. We undertook a range of qualitative, observaitional and experiemental studies exploring   structural drivers of HIV, including gender inequalities and violence, harmful social norms, stigma and discrimination, lack of livelihood options and alcohol availability and harmful drinking norms.  

Between 2019-2023 I led the Sustainable Development Goals Health and Wellbeing consortium (SDG-HaW) designing community health and wellbeing programmes to tackle SDG 3 targets prioritised by stakeholders in mining communities in Botswana, South Africa, Zimbabwe, Brazil, Chile, Peru, Australia, Canda and the UK. We developed interventions to improve HIV prevention and treatment, sexual and reproductive health services, mental health, alcohol and substance use and non-communicable diseases (https://www.lshtm.ac.uk/research/centres-projects-groups/sdg-haw). 

From 2020 to the end of 2024, I was lead investigator for LSHTM on the EDCTP funded UPTAKE study which aimed to use qualitative and behavioural economic research methods to determine the factors that will influence the uptake of long acting and multipurpose HIV prevention technologies among adolescent girls and young women and women engaged in selling sex in Nairobi and Kampala (https://www.uptakestudy.org). The study included formative qualitative research with end users and key informants, cross sectional behavioural and preference studies, and a longitudinal study designed to improve the uptake of oral PrEP and long acting reversible contracpetives.

Over the last few years, I have also led a UNAIDS funded study to support the Myanmar Ministry of Health to develop a PrEP intervention for people who inject drugs (with Lucy Platt), and worked will colleagues on a number of HIV related health economic studies including the  development of UNAIDS costing and budgeting guidelines for community-led HIV responses (led by Pitchaya Peach Indravudh), a health economics research strategy for bnAbs for HIV prevention (led by Sergio Torres Rueda) and cost effectiveness modelling of future HIV and multipurpose prevention technologies (led by Fiammetta Bozzani).

I am particularly interested in enhancing methods to improve the evaluation of complex public health interentions and up to September 2025 was co-Director of the Centre for Evaluation with Lucy Platt (https://www.lshtm.ac.uk/research/centres/centre-evaluation).