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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.
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.
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.
Interdisciplinary research conducted in the School of International Development (2003-4) demonstrated for the first time high HIV prevalence and AIDS incidence among 0.5 billion people in fishing-dependent communities across the world. Subsequent research analysed the causes and suggested new strategies for development assistance and health service delivery. Dissemination of these insights to stakeholders generated significant post-2008 impacts on national government, international agency and NGO policies and programmes, contributing to improved access to prevention, treatment and care for hundreds of thousands of people. The research improved HIV/AIDS mainstreaming in natural resource sector governance and development programmes via training manuals, toolkits and policy briefs.
The research into the main socio-cultural causes, consequences and management of the HIV/AIDS epidemic in South Africa (undertaken by Dr Liz Walker, in collaboration with colleagues in South Africa) has had significant impact in South Africa on the development of the education and training of health and social care professionals working in the context of, and specializing in, HIV/AIDS. The programme of research has resulted in the production of an educational and training resource that is used in HEIs and other professional training settings. The educational resource is unique as it foregrounds HIV/AIDS as the context within which all health and social care practice is undertaken in Southern Africa.
Men who have sex with men (MSM) are at highest risk of acquiring HIV in the UK and an estimated one-quarter of HIV-infected MSM have not been diagnosed. The Gay Men's Sexual Health (GMSH) Survey, conducted by University of Glasgow researchers, has provided robust evidence of sexual behaviours as well as prevention and testing activities of MSM in Scotland since 1996. These findings have shaped health policies in Scotland, the UK and Europe and have been used by health practitioners in the conduct of successful NHS sexual health campaigns in Scotland. The campaigns have been credited with increased testing rates and increased awareness of HIV risks demonstrating the effectiveness of direct promotion of sexual health awareness within the gay community.
Rosengarten's work during the past fourteen years has provided the HIV field with new ways of rethinking otherwise seemingly intractable problems of more effective prevention. Despite over 30 years of biomedical and social research, and policy and programme implementation, the HIV epidemic continues to grow. The efficacies of repurposing potentially toxic and partially effective antiretroviral drugs for prevention in those perceived at risk of infection has thus come under scrutiny. It is in this context that Rosengarten's work has intervened and introduced an alternative approach to prevention that directly scrutinises the social contexts in which people live and work with HIV. Through this approach and her active engagement with clinicians, policy makers, scientists and advocacy groups she has contributed critical insights that have been incorporated into approaches to HIV prevention in practice.
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:
King's College London (KCL) research has had an major impact on guidelines in the UK, USA, Sweden and worldwide — through the World Health Organization (WHO) — on managing HIV in pregnancy to balance the risk of transmitting HIV from mother-to-child against the toxicities of antiretroviral therapy and the need for Caesarean section. Specifically, KCL research led to guidance on when HIV-infected women should begin antiretroviral treatment and at what viral load they can deliver vaginally to minimise mother-to-child transmission (MTCT). This guidance has led to fewer Caesarean sections (a less acceptable mode of delivery compared to natural vaginal delivery, especially in many ethnic minority groups), a drop in MTCT rates in England and Ireland, and better advice to healthcare practitioners and patients.
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.