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The National Surveys of Sexual Attitudes and Lifestyles (Natsal) have made major contributions to sexual health policy in Britain, and are widely regarded as among the most reliable sources of scientific data in the field, not replicated with such frequency, detail or sample size in a single country anywhere in the world. Since 2008 they have influenced (amongst other things) HIV services, HPV vaccination policy, the national chlamydia screening programme, teenage pregnancy strategy and health education campaigns for young people and gay men. Our data are widely used in the NHS and third sector. We have disseminated the results of our research through public engagement activities including extensive media work, podcasts, and science festivals.
The Unit's research into HIV testing has led to impacts on health policy (WHO and NICE guidelines) and services relating to HIV testing amongst vulnerable populations across Europe, and particularly, Scotland. The policies related to the frequency of HIV testing, increases in sites available for testing, and the scope of interventions to promote testing. These policies have contributed to significant increases in HIV testing, and a reduction in undiagnosed HIV infection, HIV related ill-health and AIDS deaths. For people living with HIV, this has enabled improved quality of life, better health and contributions to society.
Mowlabocus' research (2006-present) on gay men's social-media-use practices and new sexual-risk behaviours has led to new understandings of the role of media in health interventions. It has also led to changes in the health promotion and intervention practices of sexual health charities including the Terrence Higgins Trust (THT), as well as in statutory services, including those offered within Brighton and Hove City Primary Care Trust, which covers an area with the highest UK percentage LGBT population and a very high incidence of HIV diagnosis and infection. These changes include, in the case of THT, the development and use of a new information website and intervention toolkit — designed to decrease the spread of HIV amongst those engaged in unsafe behaviours — which is being used in training for its staff across its 31 regional offices in the UK.
Tucker's ethnographic research on the social worlds inhabited by township `Men who have Sex with Men' (MSM), and his quantitative analysis of the associations between social and psycho- social conditions and risky sexual practices for such men, led to the development of the innovative Ukwazana HIV prevention programme — the first of its kind in Africa. Ukwazana, meaning `getting to know each other' in isiXhosa, is based across the central townships of Cape Town, and is unique in fostering partnerships with marginalised township MSM, engaging them collaboratively in HIV prevention initiatives. Based on Tucker's research findings, it is the first scheme to recognise, and tackle, social and psychosocial factors such as homophobia, depression and loss of self- esteem, which often result in risky sexual practices and related illnesses among MSM. This new approach was timely since, despite numerous previous HIV prevention campaigns aimed at township MSM, HIV prevalence for this group was three times the national average.
Research carried out by LSHTM into the effects of male circumcision on HIV prevention has led to important policy recommendations by WHO and UNAIDS, the joint UN Programme on HIV/AIDS. The research showed a strongly reduced risk of HIV infection among circumcised men, and modelling studies estimated that male circumcision programmes in 13 priority countries in Africa could avert 4m HIV infections by 2025. Members of the research team serve on key international advisory groups, and these results have been widely used to underpin international policy guidelines.
Research conducted by Professor Jonathan Elford of City University London among people living with HIV in East London has had significant impact in the UK as a whole. The National AIDS Trust (NAT) used key findings from the research on employment, immigration and poverty in its submissions to the House of Commons. This led to:
The Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organisation (WHO) regularly report estimates for the prevalence of HIV and associated metrics for almost every country in the world. These statistics are essential for tracking the scale and the impact of HIV epidemic and are used routinely in the policy decisions and funding allocation decisions of national governments and international donors and therefore have a major impact on international public health. The methods underlying those estimates were originally developed, and continue to be refined and updated, by an international group of researchers at Imperial College London.
During the 1990s, LSHTM researchers documented a steep rise in HIV prevalence among young people between the ages of 15 and 24 in eastern and southern Africa. Subsequent trials in Tanzania and Zimbabwe examined the effectiveness of interventions to reduce HIV incidence among this age group. The results, and subsequent reviews, have substantially influenced the HIV policies of international organisations such as UNICEF, UNESCO and WHO, and HIV programmes in individual African countries. In particular, findings on knowledge and attitude change through sexual health education have been widely implemented.
This case study focuses on impact that has occurred because of the research of faculty member Lucy Allais in the areas of disease and sexual health. Impact includes:
Six million South Africans are currently infected with HIV and two million have died from AIDS- related diseases. Initially seen solely from a medical perspective, there is now recognition of social and cultural factors, such as witchcraft, that have shaped the pandemic. Niehaus's research findings, which have been disseminated beyond the academic domain, form part of a diverse body of social scientific literature on HIV/AIDS in South Africa. Niehaus's work has (i) enhanced cultural understandings; (ii) shaped public debate; (iii) contributed towards the training of health personnel; (iv) assisted the work of legal practitioners; and (v) assisted in the production of cultural artefacts.