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Dr Fern Terris-Prestholt

MSc PhD

Associate Professor
in Economics of HIV

Room
340

LSHTM
15-17 Tavistock Place
London
WC1H 9SH
United Kingdom

Tel.
+44 (0)207 927 2271

I am an economist working on the introduction of new HIV and STI technologies and self-care, including HIV self-testing, STI self screening. I am particularly interested in demand for new technologies, design and evaluation of behavioural / demand creation interventions, including digital/m-Health technologies.

I also enjoy costing, cost modelling and the use of cost data to support decision making and planning in-country and globally.

  • Philosophy: intrinsically motivated by collaborative policy oriented research founded on mutual capacity building.
  • 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: >75peer reviewed articles in the field of HIV & STI economics, including Nature and J Health Economics.
  • Fundraising: Raised and/or managed grants of >$2.5 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 teams and supervising junior collaborators and LSHTM staff.
  • Mentorship: Have supported and  mentored 7 junior staff to win highly competitively fellowships including from the MRC, Wellcome, ESRC and NIH.

I have a PhD in Health Economics from LSHTM,  an MSc in Development Economics from Wageningen University, The Netherlands and a B.A. from Macalester College in St. Paul, MN, USA. My academic career in health economics started as a researcher at the Erasmus University in the Netherlands.

Affiliations

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

Teaching

 

  • Teaching:

2009 - present Module Organiser for highly rated advanced health economics module: Economic Analysis for Health Policy

2001 - present 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.

3 PhD student successfully defended on time: 

2015-Succesful viva Nov 2019, revisions pending

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

2014-2018

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

2010-2013

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

 Current research degree students:

2018-Present

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-Present

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

2018-Present

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

2017-Present

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

2017-Present

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

Though currently at capacity, in the future, I would welcome PhD students with a foundation in economics and an interest in the demand for HIV prevention, using 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. 

Current 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, Lesoth 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:
  1. Analysis of PrEP costs and the role of longer continuation on costs in Zimbabwe; 
  2. Literature review on PrEP continuation;
  3. Analysis of the role of structural drivers on womens 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

She has 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 is 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 looks 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 marketting 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
Complex interventions
Diagnostics
Economic evaluation
Health policy
Maternal health
Sexual health
Behaviour change
Capacity strengthening
Equity
Evaluation
Global Health
Health services
Implementation research
Reproductive health
Modelling
Discipline
Health economics
Economics
Disease and Health Conditions
HIV/AIDS
Sexually transmitted disease
Syphilis
Human papillomavirus (HPV)
Sexually transmitted infection
Region
East Asia & Pacific (developing only)
Least developed countries: UN classification
Sub-Saharan Africa (all income levels)

Selected Publications

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
2019
Journal of the International AIDS Society
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
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
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
2019
JOURNAL OF THE INTERNATIONAL AIDS SOCIETY
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
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
2019
Medical Decision Making
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
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
2019
Trials
How well do discrete choice experiments predict health choices? A systematic review and meta-analysis of external validity.
Quaife M; Terris-Prestholt F; Di Tanna GL; Vickerman P
2018
The European journal of health economics
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
Cost and Cost-Effectiveness of a Demand Creation Intervention to Increase Uptake of Voluntary Medical Male Circumcision in Tanzania: Spending More to Spend Less.
Torres-Rueda S; Wambura M; Weiss HA; Plotkin M; Kripke K; Chilongani J; Mahler H; Kuringe E; Makokha M; Hellar A
2018
Journal of acquired immune deficiency syndromes (1999)
Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis.
Baggaley RF; Irvine MA; Leber W; Cambiano V; Figueroa J; McMullen H; Anderson J; Santos AC; Terris-Prestholt F; Miners A
2017
The lancet HIV
The promise of multipurpose pregnancy, STI, and HIV prevention.
Quaife M; Terris-Prestholt F; Vickerman P
2016
The Lancet infectious diseases
Parameterising User Uptake in Economic Evaluations: The role of discrete choice experiments.
Terris-Prestholt F; Quaife M; Vickerman P
2016
Health economics
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