Dr Nicola Desmond

Senior Lecturer, Wellcome Trust Research in Medecine Fellow and Head of Social Science at MLW

Areas of interest

Medical Anthropology, self-testing technologies in resource-poor contexts for infectious & non-communicable disease.  HIV self-testing. Treatment seeking and health seeking behaviour.  Engagement with health services, primary health systems, bioethics, community engagement, risk perceptions, risk behaviour, social impacts of health interventions, novel approaches to monitoring behaviour change, mixed methods research, qualitative research, capacity building, Africa

I head the Social Science programme at the Malawi-Liverpool-Wellcome Trust Clinical Research in Medecine Programme (MLW) in Blantyre, Malawi, where I am based full-time, with a remit to strategically develop Social Science as a cross-cutting theme across the whole MLW programme.  The overarching aim of this new programme at MLW is to understand the contexts for health behaviour and their impact on the ways in which people engage with health.  There are three themes within the programme: impacts of home-based testing and monitoring technologies in resource-poor settings, health seeking and health service utilization and bioethics and community engagement research.   I am also a Wellcome Trust Ethics and Society Fellow exploring the social and ethical dimensions and documenting social harms derived from engagement in HIV self-testing programmes in urban Blantyre, Malawi. This work is integrated within a wider area of focus exploring social harms of HIV self-testing both from a public health and social/ethical perspective and working with key populations to increase access to HIV testing.  Linked work includes understanding message dissemination around health through social network analysis and work with UNAIDS to re-contextualise understanding of behavior change in adolescents in SSA, community advocacy for increasing uptake of HIV self-testing through film and evaluation of a long-term multi-media approach to sustainable behavior change in response to risk. In addition I am lead investigator on research that focuses on treatment seeking and engagement with health services, working closely with the Malawi MoH to translate research to policy and improve the experience and impact of health pathways through linked work at community, primary and referral levels.  Other grants within this programme of work include pathways to obstetric care in response to miscarriage and vaccine acceptability.  I supervise several smaller projects to improve the practice of research at MLW including work on informed consent, the bioethics of biometrics and improving fieldworker practice as well as leading projects to evaluate the treatment seeking impact of MLW communication of science activities including a weekly radio programme and a Science Exhibition. In this area the programme also supports the strengthening of community engagement activities for field-based projects including large-scale intervention trials.  I currently supervise four PhD students; two at Foto-Cewek and two at College of Medicine, Malawi as well as a number of Masters students. 

I am involved in syllabus development for the College of Medicine MPH and the development of a new Masters in Medical Anthropology in Malawi, as well as providing regular postgraduate teaching in qualitative research methods and NVIVO. I have led the establishment of an active network of researchers working across the national setting in multi-disciplinary social sciences as part of a national capacity building strategy.  I sit on several committees including the Research in Medecine Strategy Group at MLW, the Helse Nord TB Initiative working group, the SACORE/HNTI postgraduate development committee, the MLW media advisory group, the project management group for the Global health Bioethics Network (University of Oxford), the technical research group for Concern Universal, the technical advisory group for social science and community engagement (PopART), the Global health Trials steering group for social science and the UNAIDS strategy group for HIV prevention in youth. 

I am involved in peer grant reviews for the Wellcome Trust and NIHR (UK).  I have spent the previous 15 years in international public health research, based in Eastern and Southern Africa and teaching, mentoring and supervision of African and international social scientists and conducting collaborative and multi-disciplinary research.  In addition to formal supervision and the delivery of lectures and seminars, I have contributed to field and research methods training for over 50 African junior researchers to equip them with the necessary skills to conduct high quality field research.

Recent invited talks include

International AIDS Society (2014) Symposium Session: Realising the potential for HIV self-testing (HIVST, 20-25 July, Melbourne, Australia

International AIDS Society (2014) Symposium Session: Thinking through risk in everyday lives: Framing the future for adolescents and young people, 20-25 July, Melbourne, Australia

Southern African AIDS Trust (2014) HIV Self-Testing Think Tank – Exploration of Programming Possibilities for Botswana, Malawi, Mozambique, South Africa, Tanzania, Zambia & Zimbabwe, 25-26 March

Warwick Medical School (2014) Lunchtime seminar series: Putting health in context: Thematic & methodological approaches to social science at MLW, 11th February, 2014, University of Warwick

Meningitis Research in Medecine Foundation (2013) Meningitis and Septicaemia in Children and Adults Conference, 5th to 6thNovember 2013, London, UK

Wellcome Trust Strategic Award (Global Bioethics, Professor Mike Parker, Ethox Centre, University of Oxford) Annual Meeting July 2013, Bangkok, Thailand

Brocher Foundation 2013 “The legal, ethical, gender and human rights implications of HIV self-testing scale-up” April 2013, Geneva, Switzerland

Wellcome Trust International Engagement Workshop “Engaging with Impact: How do we know if we've made a difference?” 1st - 4th October 2012 Cape Town, South Africa

Selected publications

  • Selected Publications

    MacPherson, Peter, Lalloo, David, Webb, Emily L., Maheswaran, Hendramoorthy, Choko, Augustine T., Makombe, Simon D., Butterworth, Anthony E., Van Oosterhout, Joep J., Desmond, Nicola, Thindwa, Deus, Squire, Bertie,Hayes, Richard J. and Corbett, Elizabeth L. (2014) ''. The Journal of the American Medical Association, Vol 312, Issue 4, pp. 372-379. 
    MacPherson, Peter, Lalloo, David, Thindwa, D, Webb, EL, Squire, Bertie, Chipungu, GA, Desmond, Nicola,Makombe, SD, Taegtmeyer, Miriam, Choko, AT and Corbett, EL (2014) ''.JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol 65, Issue 2, e74-e78.
    Kadir, Ayesha, Marais, Frederick and Desmond, Nicola (2013) ''. Paediatrics and International Child Health, Vol 33, Issue 4, pp. 310-321.
    Desmond, Nicola, Nyirenda, D, Dube, Q, Macpherson, M, Molyneux, E, Lalloo, David and Heyderman, Robert (2013) ''. PLoS ONE, Vol 8, Issue 7, e68163.
    MacPherson, Peter, MacPherson, Eleanor, Mwale, Daniel, Squire, Bertie, Makombe, Simon, Corbett, Elizabeth,Lalloo, David and Desmond, Nicola (2012) ''. Journal of the International AIDS Society, Vol 15, p. 18020. 

    Guillermo Martinez-Perez, Laura Trivino Duran, Nicola Desmond ‘Tackling the gender gap in qualitative research on voluntary medical male circumcision in East and Southern Africa In press Culture, Health & Sexuality

    Chikovore, J, Hart G, Kumwenda M, Chipungu G A, Desmond N, Corbett E Control, struggle and emergent masculinities: a qualitative study of men’s care-seeking determinants for chronic cough and tuberculosis symptoms in Blantyre, Malawi BMC Public Health DOI: 10.1186/1471-2458-14-1053

    Effect of optional home initiation of HIV care following HIV self-testingon antiviral therapy initiation among adults in Malawi: A randomized clinical trial Peter MacPherson, David G Lalloo, Emily L Webb, Augustine T Choko, Simon D Makombe, Anthony E Butterworth, Joep J van Oosterhout, Nicola Desmond, Deus Thindwa, S Bertel Squire, Richard J Hayes, Elizabeth L Corbett. JAMA. 2014;312(4):372-379. doi:10.1001/jama.2014.6493.

    Moses Kumwenda, Alister Munthali, Mackwellings Phiri, Daniel Mwale,T ore Gutteburg, Eleanor MacPherson, Sally Theobald, Liz Corbett, Nicola Desmond ‘Factors Shaping Initial Decision-Making to Self-test Amongst Cohabiting Couples in Urban Blantyre, Malawi’ AIDS and Behaviour (2014) 18:S396-S404 DOI 10.1007/s10461-014-0817-9

    MacPherson, Peter, Lalloo, David, Thindwa, D, Webb, EL, Squire, Bertie, Chipungu, GA, Desmond, Nicola, Makombe, SD, Taegtmeyer, Miriam, Choko, AT and Corbett, EL (2014) ''.JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol 65, Issue 2, e74-e78.

    Desmond, Nicola, Nyirenda, D, Dube, Q, Macpherson, M, Molyneux, E, Lalloo, David and Heyderman, Robert (2013) ''. PLoS ONE, Vol 8, Issue 7, e68163.

    MacPherson, Peter, MacPherson, Eleanor, Mwale, Daniel, Squire, Bertie, Makombe, Simon, Corbett, Elizabeth, Lalloo, David and Desmond, Nicola (2012) ''. Journal of the International AIDS Society, Vol 15, p. 18020.

    MacPherson, Eleanor, Sadalaki, John, Njoloma, Macdonald, Nyongopa, Victoria, Nkhwazi, Lawrence, Mwapasa, Victor, Lalloo, David, Desmond, Nicola, Seeley, Janet and Theobald, Sally (2012) ''. Journal of the International AIDS Society, Vol 15(S1), Issue 1736.

    Hanefield, J., Bond, V., Seeley, J., Lees, S., Desmond, N., Considerations for a human rights impact assessment of a universal test and treat intervention. Submitted to Special Issue of Developing World Bioethics: Ethical Considerations in the Use of Anti-retrovirals for HIV

    MacPherson, P., Lalloo, D., Choko, A.T., Mann, G. H., Squire, S. B., Mwale, D., Manda, E., Makombe, S. D.,Desmond, N., Heyderman, R.S., Corbett, E. L. 2012 Suboptimal patterns of provider initiated HIV testing and counselling, antiretroviral therapy eligibility assessment and referral in primary health clinic attendees in Blantyre, Malawi. Tropical Medicine & International Health, 17, 507-517.

    N. Desmond, A. Prost, D. Wight Managing risk through treatment seeking in rural north-western Tanzania: Untangling malaria and nzoka, Health Risk & Society Special Issue Health Care through the lens of Risk ,, 2012

    Choko, A. T., Desmond, N., Webb, E.L., Chavula, K., Napierela-Mavedzenge, S., Gaydos, C.A., Makombe, S. D., Chunda, T., Squire, S.B., French, N., Mwapasa, V., Corbett, E.L. 2011 The uptake and accuracy of oral kits for HIV self-testing in a high HIV prevalence setting: A cross-sectional feasibility study in Blantyre, Malawi. Plos Med, 8, e1001102

    Peter MacPhersonEmily L Webb, Augustine T Choko, Nicola Desmond, Kondwani Chavula, Sue Napierala-Mavedzenge, Simon B Makombe, Treza Chunda, S Bertel Squire, Robert Heyderman, Elizabeth L Corbett (2011) Stigmatising attitudes among people undergoing supervised self-testing for HIV in Blantyre, Malawi: construction and analysis of a scale measure of stigma, PlosOne 6(10) e26814



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