Imperial College London

ProfessorSimonGregson

Faculty of MedicineSchool of Public Health

Professor in Demography and Behavioural Science
 
 
 
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Contact

 

+44 (0)20 7594 3279s.gregson

 
 
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Location

 

LG27Praed StreetSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
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205 results found

Rhead R, Skovdal M, Takaruza A, Maswera R, Nyamukapa C, Gregson Set al., 2019, The multidimensionality of masculine norms in east Zimbabwe: implications for HIV prevention, testing and treatment., AIDS, Vol: 33, Pages: 537-546

BACKGROUND: Research and intervention studies suggest that men face challenges in using HIV services in sub-Saharan Africa. To address these challenges, quantitative measurements are needed to establish the individual-level determinants of masculine norms and their implications for HIV prevention and treatment programmes. METHODS: Survey questions for four masculine norms identified in qualitative research were included in a general-population survey of 3116 men in east Zimbabwe, 2012-2013. Two sets of regression analyses were conducted in an structural equation modelling framework to examine: which sociodemographic characteristics were associated with high scores on each masculinity factor; and how high scores on these masculinity factors differed in their associations with sexual risk behaviour and use of HIV services. FINDINGS: Sociodemographic characteristics associated with high factor scores differed between masculine norms. In HIV-negative men, more men with scores exceeding one standard deviation above the mean (high scorers) for antifemininity than men with scores under one standard deviation below the mean (low scorers) took steps to avoid infection (61 versus 54%, P < 0.01). Fewer high than low scorers on social status reported a recent HIV test (69 versus 74%, P = 0.04). In HIV-positive men, more high scorers on sex drive had been diagnosed (85 versus 61%, P = 0.02), were on antiretroviral treatment (91 versus 62%, P = 0.04), and were in AIDS groups (77 versus 46% P = 0.03). CONCLUSION: HIV treatment, prevention programmes looking to engage men must consider the multidimensionality of masculine norms. The scale developed in this study is robust and can be used by other large multipurpose surveys to examine masculine social norms.

JOURNAL ARTICLE

Skovdal M, Ssekubugu R, Nyamukapa C, Seeley J, Renju J, Wamoyi J, Moshabela M, Ondenge K, Wringe A, Gregson S, Zaba Bet al., 2019, The rebellious man: Next-of-kin accounts of the death of a male relative on antiretroviral therapy in sub-Saharan Africa., Glob Public Health, Pages: 1-12

The HIV response is hampered by many obstacles to progression along the HIV care cascade, with men, in particular, experiencing different forms of disruption. One group of men, whose stories remain untold, are those who have succumbed to HIV-related illness. In this paper, we explore how next-of-kin account for the death of a male relative. We conducted 26 qualitative after-death interviews with family members of male PLHIV who had recently died from HIV in health and demographic surveillance sites in Malawi, Tanzania, Kenya, Uganda, Zimbabwe and South Africa. The next-of-kin expressed frustration about the defiance of their male relative to disclose his HIV status and ask for support, and attributed this to shame, fear and a lack of self-acceptance of HIV diagnosis. Next-of-kin painted a picture of their male relative as rebellious. Some claimed that their deceased relative deliberately ignored instructions received by the health worker. Others described their male relatives as unable to maintain caring relationships that would avail day-to-day treatment partners, and give purpose to their lives. Through these accounts, next-of-kin vocalised the perceived rebellious behaviour of these men, and in the process of doing so neutralised their responsibility for the premature death of their relative.

JOURNAL ARTICLE

Schaefer R, Gregson S, Fearon E, Hensen B, Hallett TB, Hargreaves JRet al., 2019, HIV prevention cascades: a unifying framework to replicate the successes of treatment cascades, LANCET HIV, Vol: 6, Pages: E60-E66, ISSN: 2352-3018

JOURNAL ARTICLE

Schaefer R, Thomas R, Nyamukapa C, Maswera R, Kadzura N, Gregson Set al., 2018, Accuracy of HIV Risk Perception in East Zimbabwe 2003-2013., AIDS Behav

Risk perception for HIV infection is an important determinant for engaging in HIV prevention behaviour. We investigate the degree to which HIV risk perception is accurate, i.e. corresponds to actual HIV infection risks, in a general-population open-cohort study in Zimbabwe (2003-2013) including 7201 individuals over 31,326 person-years. Risk perception for future infection (no/yes) at the beginning of periods between two surveys was associated with increased risk of HIV infection (Cox regression hazard ratio = 1.38 [1.07-1.79], adjusting for socio-demographic characteristics, sexual behaviour, and partner behaviour). The association was stronger among older people (25+ years). This suggests that HIV risk perception can be accurate but the higher HIV incidence (1.27 per 100 person-years) illustrates that individuals may face barriers to HIV prevention behaviour even when they perceive their risks. Gaps in risk perception are underlined by the high incidence among those not perceiving a risk (0.96%), low risk perception even among those reporting potentially risky sexual behaviour, and, particularly, lack of accuracy of risk perception among young people. Innovative interventions are needed to improve accuracy of risk perception but barriers to HIV prevention behaviours need to be addressed too, which may relate to the partner, community, or structural factors.

JOURNAL ARTICLE

Tlhajoane M, Masoka T, Mpandaguta E, Rhead R, Church K, Wringe A, Kadzura N, Arinaminpathy N, Nyamukapa C, Schur N, Mugurungi O, Skovdal M, Eaton JW, Gregson Set al., 2018, A longitudinal review of national HIV policy and progress made in health facility implementation in Eastern Zimbabwe, HEALTH RESEARCH POLICY AND SYSTEMS, Vol: 16, ISSN: 1478-4505

JOURNAL ARTICLE

Garnett GP, Krishnaratne S, Harris KL, Hallett TB, Santos M, Enstone JE, Hensen B, Dallabetta G, Revill P, Gregson SAJ, Hargreaves JRet al., 2018, Cost-Effectiveness of Interventions to Prevent HIV Acquisition, World Bank Discussion Papers, ISSN: 0259-210X

Because of the severe health consequences of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and the costs of lifelong treatment, inexpensive and effective HIV prevention is bound to be cost-effective. But what constitutes HIV prevention, and can it be affordable and effective? The use of condoms that cost a few cents and prevent a young adult from acquiring a chronic and fatal disease will, over time, be cost saving. Avoiding sex with someone who is infected with HIV/AIDS will be even more so. What can be done to get people to use condoms? What can be done to facilitate the avoidance of risky sexual encounters? Additional efficacious biomedical tools have become available, but similar questions persist: What can be done to get young women at risk to use oral truvada effectively as preexposure prophylaxis (PrEP) and to get young men at risk to be circumcised? The answers to these questions will determine what packages of prevention are essential, how much prevention programs should cost, and how cost-effective they can be. This chapter reviews current evidence about the efficacy, effectiveness, and costs of HIV/AIDS prevention products, programs, and approaches.

JOURNAL ARTICLE

Skovdal M, Maswera R, Kadzura N, Nyamukapa C, Rhead R, Wringe A, Gregson Set al., 2018, Parental obligations, care and HIV treatment: How care for others motivates self-care in Zimbabwe, Journal of Health Psychology, Pages: 1359105318788692-1359105318788692, ISSN: 1359-1053

This article examines how parental obligations of care intersect with HIV treatment-seeking behaviours and retention. It draws on qualitative data from eastern Zimbabwe, produced from 65 interviews. Drawing on theories of practice and care ethics, our analysis revealed that norms of parental obligation and care acted as key motivators for ongoing engagement with HIV services and treatment. Parents' attentiveness to the future needs of their children ( caring about), and sense of obligation ( taking care of) and improved ability to care ( caregiving) following treatment initiation, emerged as central to understanding their drive for self-care and engagement with HIV services.

JOURNAL ARTICLE

Rhead R, Elmes J, Otobo E, Nhongo K, Takaruza A, White PJ, Nyamukapa CA, Gregson Set al., 2018, Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe, BMJ OPEN, Vol: 8, ISSN: 2044-6055

JOURNAL ARTICLE

Tlhajoane M, Eaton JW, Takaruza A, Rhead R, Maswera R, Schur N, Sherr L, Nyamukapa C, Gregson Set al., 2018, Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe, AIDS AND BEHAVIOR, Vol: 22, Pages: 1485-1495, ISSN: 1090-7165

JOURNAL ARTICLE

Smit M, Olney J, Ford NP, Vitoria M, Gregson S, Vassall A, Hallett TBet al., 2018, The growing burden of noncommunicable disease among persons living with HIV in Zimbabwe, AIDS, Vol: 32, Pages: 773-782, ISSN: 0269-9370

JOURNAL ARTICLE

Gregson S, Mugurungi O, Eaton J, Takaruza A, Rhead R, Maswera R, Mutsvangwa J, Mayini J, Skovdal M, Schaefer R, Hallett T, Sherr L, Munyati S, Mason P, Campbell C, Garnett GP, Nyamukapa CAet al., 2017, Documenting and explaining the HIV decline in east Zimbabwe: the Manicaland General Population Cohort, BMJ OPEN, Vol: 7, ISSN: 2044-6055

JOURNAL ARTICLE

Eaton JW, Johnson CC, Gregson S, 2017, The Cost of Not Retesting: Human Immunodeficiency Virus Misdiagnosis in the Antiretroviral Therapy "Test-and-Offer" Era, CLINICAL INFECTIOUS DISEASES, Vol: 65, Pages: 522-525, ISSN: 1058-4838

JOURNAL ARTICLE

Skovdal M, Magutshwa-Zitha S, Campbell C, Nyamukapa C, Gregson Set al., 2017, Getting off on the wrong foot? How community groups in Zimbabwe position themselves for partnerships with external agencies in the HIV response, GLOBALIZATION AND HEALTH, Vol: 13, ISSN: 1744-8603

JOURNAL ARTICLE

Schaefer R, Gregson S, Eaton JW, Mugurungi O, Rhead R, Takaruza A, Maswera R, Nyamukapa Cet al., 2017, Age-disparate relationships and HIV incidence in adolescent girls and young women: evidence from Zimbabwe, AIDS, Vol: 31, Pages: 1461-1470, ISSN: 0269-9370

JOURNAL ARTICLE

Mangal TD, 2017, Joint estimation of CD4(+) cell progression and survival in untreated individuals with HIV-1 infection, AIDS, Vol: 31, Pages: 1073-1082, ISSN: 0269-9370

JOURNAL ARTICLE

Sheng B, Marsh K, Slavkovic AB, Gregson S, Eaton JW, Bao Let al., 2017, Statistical models for incorporating data from routine HIV testing of pregnant women at antenatal clinics into HIV/AIDS epidemic estimates, AIDS, Vol: 31, Pages: S87-S94, ISSN: 0269-9370

JOURNAL ARTICLE

Silhol R, Gregson S, Nyamukapa C, Mhangara M, Dzangare J, Gonese E, Eaton JW, Case KK, Mahy M, Stover J, Mugurungi Oet al., 2017, Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe, AIDS, Vol: 31, Pages: S41-S50, ISSN: 0269-9370

JOURNAL ARTICLE

Marston M, Nakiyingi-Miiro J, Kusemererwa S, Urassa M, Michael D, Nyamukapa C, Gregson S, Zaba B, Eaton JWet al., 2017, The effects of HIV on fertility by infection duration: evidence from African population cohorts before antiretroviral treatment availability, AIDS, Vol: 31, Pages: S69-S76, ISSN: 0269-9370

JOURNAL ARTICLE

Case KK, Gregson S, Mahy M, Ghys PD, Hallett TBet al., 2017, Editorial: methodological developments in the Joint United Nations Programme on HIV/AIDS estimates, AIDS, Vol: 31, Pages: S1-S4, ISSN: 0269-9370

JOURNAL ARTICLE

Wilson KC, Mhangara M, Dzangare J, Eaton JW, Hallett TB, Mugurungi O, Gregson Set al., 2017, Does nonlocal women's attendance at antenatal clinics distort HIV prevalence surveillance estimates in pregnant women in Zimbabwe?, AIDS, Vol: 31, Pages: S95-S102, ISSN: 0269-9370

JOURNAL ARTICLE

Schaefer R, Gregson S, Takaruza A, Rhead R, Masoka T, Schur N, Anderson S-J, Nyamukapa Cet al., 2017, Spatial patterns of HIV prevalence and service use in East Zimbabwe: implications for future targeting of interventions, JOURNAL OF THE INTERNATIONAL AIDS SOCIETY, Vol: 20, ISSN: 1758-2652

JOURNAL ARTICLE

Elmes J, Skovdal M, Nhongo K, Ward H, Campbell C, Hallett TB, Nyamukapa C, White PJ, Gregson Set al., 2017, A reconfiguration of the sex trade: How social and structural changes in eastern Zimbabwe left women involved in sex work and transactional sex more vulnerable, PLOS ONE, Vol: 12, ISSN: 1932-6203

JOURNAL ARTICLE

Melegaro A, Del Fava E, Poletti P, Merler S, Nyamukapa C, Williams J, Gregson S, Manfredi Pet al., 2017, Social Contact Structures and Time Use Patterns in the Manicaland Province of Zimbabwe, PLOS ONE, Vol: 12, ISSN: 1932-6203

JOURNAL ARTICLE

Pufall EL, Eaton JW, Robertson L, Mushati P, Nyamukapa C, Gregson Set al., 2017, Education, substance use, and HIV risk among orphaned adolescents in Eastern Zimbabwe, VULNERABLE CHILDREN AND YOUTH STUDIES, Vol: 12, Pages: 360-374, ISSN: 1745-0128

JOURNAL ARTICLE

Rhead R, Masimirembwa C, Cooke G, Takaruza A, Nyamukapa C, Mutsimhi C, Gregson Set al., 2016, Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?, PLOS ONE, Vol: 11, ISSN: 1932-6203

JOURNAL ARTICLE

Negin J, Gregson S, Eaton JW, Schur N, Takaruza A, Mason P, Nyamukapa Cet al., 2016, Rising Levels of HIV Infection in Older Adults in Eastern Zimbabwe, PLOS ONE, Vol: 11, ISSN: 1932-6203

JOURNAL ARTICLE

Pufall E, Eaton JW, Nyamukapa C, Schur N, Takaruza A, Gregson Set al., 2016, The relationship between parental education and children's schooling in a time of economic turmoil: The case of East Zimbabwe, 2001 to 2011, INTERNATIONAL JOURNAL OF EDUCATIONAL DEVELOPMENT, Vol: 51, Pages: 125-134, ISSN: 0738-0593

JOURNAL ARTICLE

Garnett G, Hallett T, Gregson S, 2016, HIV Prevention Cascades: Identifying Gaps in the Delivery of HIV Prevention Interventions, Conference on HIV Research for Prevention (HIV R4P), Publisher: MARY ANN LIEBERT, INC, Pages: 245-245, ISSN: 0889-2229

CONFERENCE PAPER

Del Fava E, Piccarreta R, Gregson S, Melegaro Aet al., 2016, Transition to Parenthood and HIV Infection in Rural Zimbabwe, PLOS ONE, Vol: 11, ISSN: 1932-6203

JOURNAL ARTICLE

Yeatman S, Eaton JW, Beckles Z, Benton L, Gregson S, Zaba Bet al., 2016, Impact of ART on the fertility of HIV- positive women in sub- Saharan Africa, TROPICAL MEDICINE & INTERNATIONAL HEALTH, Vol: 21, Pages: 1071-1085, ISSN: 1360-2276

JOURNAL ARTICLE

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