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Prof Fern Terris-Prestholt

Professor

United Kingdom

• Leadership: International reputation and networks in the area of discrete choice experiments, cost-effectiveness and uptake of new HIV prevention technologies and HIV and syphilis diagnostics.

• Research: >140 peer reviewed articles in the field of HIV & STI economics, including Nature and J Health Economics.

• Fundraising: Raised and/or managed grants of >$2 million, PI on 11 projects, Co-PI on 7, lead economist on $72 million project, fully self-funded since 2007.

• External citizenship: Convenor IHEA SIG: Health Preference Research; Associate Editor ‘BMC Health Services Research’; External funding reviewer.

• Management: Experience leading large multi-country research and supervising junior collaborators and LSHTM staff.

• Teaching: 10 years as module organiser for highly rated advanced health economics module; introduction to health economics seminar leading 18 years; supervision > 35 summer projects.

• RD training: 7 PhD student successfully defended on time; In progress: 1 as lead; 1 as co-supervisor.

• Philosophy: intrinsically motivated by collaborative policy oriented research founded on mutual capacity building.

Affiliations

Department of Global Health and Development
Faculty of Public Health and Policy

Centres

Centre for Data and Statistical Science for Health
Centre for Evaluation
Global Health Economics Centre

Teaching

Teaching:

2009 - 2020 Module Organiser for highly rated advanced health economics module: Economic Analysis for Health Policy2001 - 2020

Seminar leader: Introduction to Health Economics

Supervised over 35 MSc summer projects, including with fieldwork.

RD training:

My research degree students work on economic evaluations, discrete choice experiments, design and evaluation of behavioural interventions, and econometric analyses of new HIV technologies and other self-care interventions.

7 PhD student successfully defended on time: 

2010-2013 - PhD supervisor, Primary: Christine Michaels, degree awarded. Assessing young people’s stated preferences for reproductive health and HIV services in Malawi.

2014-2018 - PhD supervisor, Primary: Matthew Quaife. Using State Preferences to Estimate the Impact of New HIV prevention Products in South Africa

2015-2020 - DrPh supervisor, Primary: Nurilign Ahmed Cost effectiveness of alternative HIV Testing and linkage models.

2017-2021- DrPh supervisor, 2nd: Natalie Dial. Cost-effectiveness of Leishmeniasis screening in India.

2017-2022- PhD supervisor, 2nd: Cheryl Johnson. Preferences by proxy:  Assessing Malawian men’s preferences for linkage to HIV services by asking partners.

2018-2021- PhD supervisor, Primary: Marc D’Elbee. Scaling up costs of delivering HIV self-testing in varying epidemiological settings: Trade-off between yield and scale.

2018-2022- PhD supervisor, Primary: Linda Sande. HIV self-test as means for improved access and equity of testing.

2018-2023- PhD supervisor, Primary: Peach Indravudh. Community lead HIV Testing RCT to reach men in Malawi.

2018-Present - PhD supervisor, 2nd: Collin Mangenah. Economic evaluation of HIV testing models in Southern Africa. Liverpool School of Tropical Medicine

I welcome PhD students with a foundation in economics and an interest in the community led HIV response and structural drivers of HIV in Key populations, using quantitative methods such as discrete choice experiments or behavioural economics approaches.

Research

My work research focusses on the the economics of new technology introduction, particularly technologies for the prevention, diagnosis and treatment of HIV and related conditions (such as STIs), primarily in low and middle income countries. More recently I am branching out to the economics of self-care and societal enablers for HIV.

Major projects: The Unitaid-funded ATLAS project (2018-2021): This builds on STAR to introduce HIV Self Testing in West Africa with an emphasis on reaching key populations in Senegal, Mali and Cote d'Ivoire.

The Unitaid-funded STAR project: developing distribution strategies for Oral HIV self tests in Malawi, Zimbabwe, Zambia, South Africa, Lesotho and Swaziland. Her role is to lead the research on user preferences as well as costing to inform the development of optimal distribution systems. As we have move to the next phase of integrating HIVST into health systems we are using our extensive cost data and user preference data, (See our papers by Mwenge, Mangenah, Sande, D'Elbee and Indravudh) to model scale up costs and budget impact.

For the FHI360's OPTIONS project (2015-2020) I am leading economic studies to support the introduction of new ARV based HIV prevention products for women: Analysis of PrEP costs and the role of longer continuation on costs in Zimbabwe; Literature review on PrEP continuation; Analysis of the role of structural drivers on women's demand for new ARV based HIV prevention products in South Africa. Using crowdsourcing to develop campaigns to stimulate demand for HIV testing among MSM in China. Syphilis self-screening among MSM in Zimbabwe.

I have worked on a number of other HIV/STI prevention projects in Africa, Asia and Latin America and the UK in recent years:

Stimulating demand for Voluntary Medical Male Circumcision in Tanzania: using discrete choice experiments to inform intervention design;

ARV-based Prevention: We modelled the cost-effectiveness of Pre-exposure prophylaxis, treatment as prevention, and potential future products, in Nigeria. It was part of an international collaboration coordinated by Georgetown University and funded by Gates. Other mathematical modellers and economists were working in Kenya and South Africa. 

Assessing Youth Preferences for Integrated Mobile HIV and Family Planning Services in Rural Malawi: This project aimed to inform the roll out of youth targeted mobile reproductive and sexual health services provided by the Family Planning Association of Malawi. It was a 5-year project that is finishing this year (2013). 

Understanding economies of scope and scale of integrating HIV treatment and care in family planning and post-natal care services in Kenya, Swaziland and Malawi as part of the 5 year Gates funded project: Assesing the benefits and costs of integrating HIV services into family planning and post natal care services in Kenya, Swaziland and Malawi.

Estimating the costs and cost effectiveness of introducing rapid syphilis screening tests in hard to reach populations in Brazil, Tanzania and China and estimating the costs of scaling up. This was a 3 year Gates/WHO funded project which is very much country driven. I provide the support to local researchers to assist their economic analysis. 

Effectiveness of HIV screening in Primary Care: a clustered randomised controlled trial and economic analysis. This study looked at provider initiated HIV screening at registration with GP practices in Hackney, an area of London which hosts many new migrants.

Together these studies contribute to a body of work on the uptake and introduction of new technologies.

In 2015, I took a study leave at the Dalla Lana School of Public Health at the University of Toronto, where she worked on a paper estimating the dynamic effects of condom social marketing tools on uptake of male and female condoms (Journal of Heath Economics 2016) and another paper considering the role of discrete choice experiment as part of formative research for complex interventions (Trials 2019).

Main methodologies used: cost-effectiveness analysis, discrete choice experiments to estimate new uptake, and econometric analysis.

Research Area
Adolescent health
Behaviour change
Complex interventions
Diagnostics
Disease control
Economic evaluation
Equity
Global Health
Infectious disease policy
Mobile technologies
Reproductive health
Risk
Sexual and reproductive health
Implementation science
Inclusive community development
Social and structural determinants of health
Health economics
Disease and Health Conditions
HIV/AIDS
Sexually transmitted infections

Selected Publications

Enhancing Public Health Messaging: Discrete-Choice Experiment Evidence on the Design of HIV Testing Messages in China.
Durvasula, M; Pan, SW; Ong, JJ; Tang, W; Cao, B; Liu, C; TERRIS-PRESTHOLT, F; TUCKER, JD;
2019
MEDICAL DECISION MAKING
Community-led delivery of HIV self-testing targeting adolescents and men in rural Malawi: a cluster-randomised trial
INDRAVUDH, PP; Fielding, K; Kumwenda, MK; Nzawa, R; Chilongosi, R; Desmond, N; Nyirenda, R; JOHNSON, CC; Baggaley, R; Hatzold, K; TERRIS-PRESTHOLT, F; CORBETT, EL;
2019
JOURNAL OF THE INTERNATIONAL AIDS SOCIETY
Use of Lotteries for the Promotion of Voluntary Medical Male Circumcision Service: A Discrete-Choice Experiment among Adult Men in Tanzania.
ONG, JJ; Neke, N; Wambura, M; Kuringe, E; Grund, JM; Plotkin, M; D'ELBÉE, M; TORRES-RUEDA, S; Mahler, HR; WEISS, HA; TERRIS-PRESTHOLT, F;
2019
Medical Decision Making
Understanding demand for higher quality sanitation in peri-urban Lusaka, Zambia through stated and revealed preference analysis.
Tidwell, JB; TERRIS-PRESTHOLT, F; QUAIFE, M; AUNGER, R;
2019
Social Science & Medicine
Economic cost analysis of door-to-door community-based distribution of HIV self-test kits in Malawi, Zambia and Zimbabwe.
Mangenah, C; Mwenge, L; SANDE, L; AHMED, N; D'ELBÉE, M; Chiwawa, P; Chigwenah, T; Kanema, S; Mutseta, MN; Nalubamba, M; Chilongosi, R; INDRAVUDH, P; Sibanda, EL; NEUMAN, M; Ncube, G; Ong, JJ; Mugurungi, O; Hatzold, K; JOHNSON, CC; AYLES, H; CORBETT, EL; Cowan, FM; Maheswaran, H; TERRIS-PRESTHOLT, F;
2019
Journal of the International AIDS Society
Using discrete choice experiments to inform the design of complex interventions.
TERRIS-PRESTHOLT, F; Neke, N; Grund, JM; Plotkin, M; Kuringe, E; Osaki, H; Ong, JJ; TUCKER, JD; Mshana, G; Mahler, H; WEISS, HA; Wambura, M; VMMC study team,;
2019
Trials
The impact and cost-effectiveness of community-based HIV self-testing in sub-Saharan Africa: a health economic and modelling analysis.
Cambiano, V; JOHNSON, CC; Hatzold, K; TERRIS-PRESTHOLT, F; Maheswaran, H; Thirumurthy, H; Figueroa, C; Cowan, FM; Sibanda, EL; Ncube, G; Revill, P; Baggaley, RC; CORBETT, EL; Phillips, A; For Working Group on Cost Effectiveness of HIV sel,;
2019
Journal of the International AIDS Society
Optimizing HIV testing services in sub-Saharan Africa: cost and performance of verification testing with HIV self-tests and tests for triage.
Eaton, JW; TERRIS-PRESTHOLT, F; Cambiano, V; Sands, A; Baggaley, RC; Hatzold, K; CORBETT, EL; Kalua, T; Jahn, A; JOHNSON, CC;
2019
Journal of the International AIDS Society
Applying user preferences to optimize the contribution of HIV self-testing to reaching the "first 90" target of UNAIDS Fast-track strategy: results from discrete choice experiments in Zimbabwe.
Sibanda, EL; D'ELBÉE, M; Maringwa, G; Ruhode, N; TUMUSHIME, M; Madanhire, C; Ong, JJ; INDRAVUDH, P; Watadzaushe, C; JOHNSON, CC; Hatzold, K; Taegtmeyer, M; HARGREAVES, JR; CORBETT, EL; Cowan, FM; TERRIS-PRESTHOLT, F;
2019
Journal of the International AIDS Society
The effect of HIV prevention products on incentives to supply condomless commercial sex among female sex workers in South Africa.
QUAIFE, M; Vickerman, P; Manian, S; EAKLE, R; Cabrera-Escobar, MA; Delany-Moretlwe, S; TERRIS-PRESTHOLT, F;
2018
Health economics
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