My research focusses on improving the health of marginalised populations inluding people who use drugs or sell sex and reducing inequalities that impact them. I use participatory approaches, working closely with individuals, service users and services affected by the issue to formulate questions, design and implement the research, interpret findings and translate them into practice. My interests are interdisciplinary and I apply mixed methods but oriented towards epidemiological approaches, evidence syntheses and use of existing data sets.
Much of this work has focused on the UK, Russian Federation, Kenya, Uganda, India and currently in Myanmar, Malawi, Vietnam, Ukraine, Nigeria and South Africa.
I am co-director of the Centre for Evaluation.
Affiliations
Centres
Teaching
Research
My research has used different quantitative techniques, including:
Systematic reviews and meta analyses to synthesise evidence on HIV/HCV co-infection, brief interventions on alcohol;
A mixed method review of social science and epidemiological evidence to assess the magnitude and pathways through which criminalisation affects sex workers' safety and health;
Using routine data (HIV case reports, surveys and programme data) to understand HIV incidence in Malawi, South Africa and Zimbabwe as part of the MeSH consortium;
Cross-sectional surveys to measure prevalence of HIV, Hepatitis C, STIs and associated risk factors among people who inject drugs and sell sex
Capture recapture to estimate the size of hidden populations.
Much of my work focusses on evaluation of complex interventions. The East London Project is a collaboration with sex worker led services Open Doors and National Ugly Mugs, the Homerton Hospital, University of Bristol and Imperial College. Together we examined how removing sex work-related police enforcement affected sex workers’ safety, sexual and emotional health and access to health and social care services.
The Homeless Health Peer Advocacy (HHPA) evaluation is a collaboration with Groundswell a third sector organisation that trains peer advocates to accompany people currently homeless to health services, supporting them navigate the system and overcome barriers. The research is measuring the extent to which peer advocacy increases attendance at hospital appointments among people experiencing homelessness as well as understanding how peers work and how much money HHPA saves the NHS compared to not providing the service.
The Hepc3P consortium led by Path is implementing and evaluating new technologies (long-acting depot buprenorphine and low-dead space syringes) for the prevention and treatment of hepatitis C among people who inject drugs in India, Vietnam, Ukraine, Nigeria and South Africa. I am also supporting the impact evaluation of the Safe Inhalation Pipes Provision (SIPP) project working with drug treatment services to distribute crack pipes to people who use crack to improve health and access to services.
Previous research includes: measuring effectiveness and cost-effectiveness of needle/syringe programmes and opiate substitution therapy on hepatitis C incidence among people who inject drugs through systematic reviews and analyses of existing surveillance data; and evaluating the effect of a multi-level intervention to reduce intimate partner violence towards sex workers in Karnataka, India through a cluster-randomised control trial.
Selected Publications
