Tim Rhodes

• PhD
• Professor at London School of Hygiene and Tropical Medicine

Introduction How people connect with opioid agonist treatment is an ongoing concern. Extended‐release buprenorphine depot (BUP‐XR) has been designed with ‘retention’ in mind. It is important to consider what makes a difference to clients in helping them to stay connected to treatment over time. Methods We report findings from the third wave of in‐...

A PDF version of Figure 1. Practical considerations for using objects in qualitative longitudinal interview methods. This figure is intended as a resource to support research design and can be used as a teaching tool in qualitative methods.

This paper reflects on the use of objects in qualitative interview methods. We consider the use of objects in “single” research events and in longitudinal designs. This leads us to consider how using objects in interviews situates in relation to time. Emphasizing the materiality of objects as well as how objects help to materialize events, experien...

Introduction After a promising start in Australia, elimination efforts for hepatitis C are not on track. Following the global campaign to ‘find the missing’ in hepatitis C response, this qualitative study explores stakeholder perspectives on the ‘missing’ in the ‘endgame’ of hepatitis elimination in the state of New South Wales, Australia. Method...

Objectives To investigate the lived experiences of Long COVID. Design Critical interpretive synthesis of qualitative research. Data sources PubMed and Web of Science databases were searched on 14 September 2023. Eligibility criteria Original peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion....

We explore the contentious life of a metric used to assess a country’s progress in relation to global disease elimination targets. Our topic is hepatitis C elimination, and our context is Australia. A fundamental metric in the calculation of progress toward hepatitis C elimination targets, as set by the WHO, is the population prevalence of people l...

In Putumayo, a jungle borderland in southern Colombia, thousands of farmers derive their livelihood from the cultivation and processing of coca leaf, exposing themselves to fertilizers, pesticides, and other toxic chemicals on a daily basis. In this article, we show how the coca growers’ relationship with chemicals and the health risks to which the...

This paper explores the boundary-making practices enacted by the hospital. Taking a hospital in Sydney, Australia, as our case, we investigate how the hospital holds together as a care environment through the coordinating movements of many materials, spaces, bodies, technologies, and affects. Drawing on interviews with hospital healthcare workers i...

The relationship between ‘best practice’ as a set of evidence-informed principles and its actualization in situations of care has been the subject of significant critique across clinical and sociological health research. Precisely how ‘best practice’ gets done—in practice—is often not investigated in itself. Drawing from qualitative interviews with...

In this paper, we show how the materialisation of chemical harms linked to the cultivation of coca and its processing into coca paste reside in a wider politics of structural violence which is also situated ecologically. Drawing on the qualitative interview accounts of coca farmers in Putumayo, Colombia, we attend to practices of care in the field...

Maintaining routines of medication dosing requires effort amidst the variabilities of everyday life. This article offers a sociomaterial analysis of how the oral HIV prevention regimen, pre-exposure prophylaxis (PrEP), is put to use and made to work, including in situations which disrupt or complicate dosing regimes. Other than a daily pill, PrEP c...

In this paper, we offer a sociological analysis of early warning and outbreak in the field of drug policy, focusing on opioid overdose. We trace how 'outbreak' is enacted as a rupturing event which enables rapid reflex responses of precautionary control, based largely on short-term and proximal early warning indicators. We make the case for an alte...

In the middle of 2020, with its borders tightly closed to the rest of the world, Australia almost achieved the local elimination of COVID-19 and subsequently maintained ‘COVID-zero’ in most parts of the country for the following year. Australia has since faced the relatively unique challenge of deliberately ‘undoing’ these achievements by progressi...

After a decade of oral HIV pre-exposure prophylaxis (PrEP), the next generation of PrEP is being anticipated, including long-acting pills, injections, and implants. The unevenness of international PrEP implementation is increasingly recognised, with successful rollout in some settings and failure in others. There is a need to better understand cond...

Aims This study examined the social, material and temporal effects of extended-release buprenorphine depot treatment (BUP-XR), among a group of participants commencing BUP-XR in Australia, and considered the situated potentials of these new opioid agonist treatment technologies. Methods Using a longitudinal qualitative design, 36 participants (25...

Objective To investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic. Design Critical interpretive synthesis (CIS) of qualitative research. Participants Studies included qualitative research investigating the experiences of healthcare workers involved in the care of individu...

Introduction Stigma has corrosive effects on all aspects of care and can undermine individual and population health outcomes. Addiction-related stigma has implications for opiate agonist treatment (OAT) and the people who receive, provide and fund it. It is important to understand how stigma is made in OAT and the political purposes that it serves,...

We explore messy translations of evidence in policy as a site of ‘uncomfortable science’. Drawing on the work of John Law, we follow evidence as a ‘fluid object’ of its situation, also enacted in relation to a hinterland of practices. Working with the qualitative interview accounts of mathematical modellers and other scientists engaged in the UK CO...

In this paper, we trace how mathematical models are made ‘evidence enough’ and ‘useful for policy’. A key thread in our analysis is how pandemics are made ‘big’. Working with the interview accounts of mathematical modellers and other scientists engaged in the UK Covid-19 response, we focus on two weeks in March 2020 prior to the announcement of an...

This article investigates how evidence of the safety and efficacy of COVID-19 vaccines is enacted in news media via a focus on the temporality of vaccine development. We argue that time constitutes a crucial object of and mechanism for knowledge production in such media and investigate how time comes to matter in vaccine evidence-making communicati...

Participatory modelling seeks to foster stakeholder engagement to better attune models to their decision-making and policy contexts. Such approaches are increasingly advocated for use in the field of health. We review the instrumental and epistemological claims made in support of participatory modelling approaches. These accentuate participatory mo...

More often than not, global health targets are not met. In many ways, we might say that global health is governed through failure. Writing in a moment of global disruption and dis-ease in the context of the COVID-19 pandemic, and as the anticipated future of 2020 imagined in the UNAIDS 90-90-90 target becomes the past, we consider how missed target...

Background Stigma is an important element in the experience of living with chronic viral hepatitis B (HBV) and C (HCV), impacting healthcare access and uptake as well as health outcomes. Conceptualisations of stigma in research are, however, often assumed and implicit. This study aimed to synthesise and critically engage with the qualitative litera...

One concern in the field of drugs policy is how to make research more futures-oriented. Tracing trends and events with the potential to alter drug futures are seen as ways of becoming more prepared. This challenge is made complex in fast evolving drug markets which entangle with shifting social and material relations at global scale. In this analys...

Background Methadone, as part of Medically Assisted Therapy (MAT) for treatment of opioid dependence and supporting HIV prevention and treatment, has been recently introduced in Kenya. Few low income settings have implemented methadone, so there is little evidence to guide ongoing scale-up across the region. We specifically consider the role of com...

In efforts to control disease, mathematical models and numerical targets play a key role. We take the elimination of a viral infection as a case for exploring mathematical models as ‘evidence‐making interventions’. Using interviews with mathematical modellers and implementation scientists, and focusing on the emergence of models of ‘treatment‐as‐pr...

Adherence to medicines tends to be envisaged as a matter of actors’ reasoned actions, though there is increasing emphasis on situating adherence as a practice materialised in everyday routines. Drawing on the qualitative interview accounts of Black African women living with HIV in London, UK, we treat adherence to HIV medicines as not only situated...

Until recently, the only medical treatment available for the hepatitis C virus (HCV) was interferon-based therapy, a notoriously long and arduous treatment with limited success. However, in December 2015, the Australian Government announced a scheme of 'universal access' to new, highly effective direct-acting antiviral therapies (DAAs). This articl...

Drawing on an ecological approach, we trace how the political-economy of drug wars are locally materialised in relation to health. We take the case of coca cultivation and eradication as our example. To make our analysis, we trace the different ways that the chemical glyphosate is materialised in a war with the coca plant in Colombia. Glyphosate ha...

Background To reduce opioid dependence and HIV transmission, Kyrgyzstan has introduced methadone maintenance therapy and needle/syringe programs into prisons. Illicit injection of diphenhydramine, an antihistamine branded as Dimedrol®, has been anecdotally reported as a potential challenge to harm reduction efforts in prisons but has not been studi...

Background: Evidence-based policy decision-making is a dominant paradigm in health but realizing this ideal has proven challenging. Sources of data: This paper conceptually maps health policy, policy studies and social science literature critically engaged with evidence and decision-making. No new data were generated or analysed in support of th...

Increasing attention has been paid to matters of ontology, and its accompanying politics, in the drug policy field. In this commentary, we consider what an 'ontological politics' might mean for how we think about what drug policy is and what it might become, as well as for how we think about (and do) research in drug policy. Thinking ontopoliticall...

Background: In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to deal with the uncertainties arising in evolving situations of need. Key poi...

Informed by work on futurity in science and technology studies, we trace how global disease elimination targets perform a world without disease through their translations in visual advocacy campaigns. Treating disease elimination targets and their visualisations as performative, we take the case of hepatitis C elimination to interrogate how futurin...

In 2014 methadone as part of Medically Assisted Therapy (MAT) was introduced in Kenyan public health facilities as part of a comprehensive approach to HIV prevention and treatment. This paper explores the transition experiences for people moving from the use of heroin to MAT. The paper reports on a qualitative study conducted in an urban setting in...

The emergence of the prisoner subject is an element of local practices, including how health is governed. Yet, disciplinary practices have been overlooked in research on health in post-Soviet prisons. Drawing on qualitative interviews with 40 male prisoners in Kyrgyzstan, this article performs a genealogical analysis by applying models of subjectiv...

The evidence produced in mathematical models plays a key role in shaping policy decisions in pandemics. A key question is therefore how well pandemic models relate to their implementation contexts. Drawing on the cases of Ebola and influenza, we map how sociological and anthropological research contributes in the modelling of pandemics to consider...

Mathematical models are key actors in policy and public responses to the COVID-19 pandemic. The projections from COVID-19 models travel beyond science into policy decisions and social life. Treating models as ‘boundary objects’, and focusing on media and public communications, we ‘follow the numbers’ to trace the social life of key projections from...

The field of public health is replete with mathematical models and numerical targets. In the case of disease eliminations, modelled projections and targets play a key role in evidencing elimination futures and in shaping actions in relation to these. Drawing on ideas within science and technology studies, we take hepatitis C elimination as a case f...

Treating care as an effect of material implementations, we use qualitative interviews with people living with HIV in London, most of whom are migrants, to explore care practices linked to clinical treatment delivered as part of the ‘cascade of HIV care’. We consider how HIV care is done, and what HIV care does, drawing on assemblage theory. We ask...

We outline a framework for conceptualising interventions in health as 'evidence-making interventions'. An evidence-making intervention (EMI) approach is distinct from a mainstream evidence-based intervention (EBI) approach in that it attends to health, evidence and intervention as matters of local knowledge-making practice. An EMI approach emphasis...

In this paper, we reflect on health intervention translations as matters of their implementation practices. Our case is methadone treatment, an intervention promoted globally for treating opioid dependence and preventing HIV among people who inject drugs. Tracing methadone's translations in high‐security prisons in the Kyrgyz Republic, we notice th...

There has been some controversy concerning the curative potential of new treatments for hepatitis C. This follows a systematic review of the Cochrane Collaboration questioning the clinical benefits of direct-acting antivirals (DAAs). This controversy has been debated as a matter of methods regarding how best to evidence treatment in an evidence-bas...

Wastewater analysis has been taken up with enthusiasm in the illicit drugs field. Through a critical social science lens, we consider claims to what these ‘promising’ methods might afford in the context of drug epidemiology and policy, recognising that all methods have social effects in their specific contexts of use. We outline several ethico-poli...

In 2016 the World Health Organization published the first global health strategy to address viral hepatitis, setting a goal of eliminating viral hepatitis as a major public health threat by 2030. While the field has been motivated by this goal, to date there has been little critical attention paid to the productive capacity and constitutive effects...

Objectives Increased test uptake for HIV and viral hepatitis is fast becoming a health priority at both national and global levels. Late diagnosis of these infections remains a critical public health concern in the UK. Recommendations have been issued to expand blood-borne virus (BBV) testing in alternative settings. Emergency departments (EDs) off...

Integrating methadone and HIV care is a priority in many low- and middle-income settings experiencing a growing challenge of HIV epidemics linked to injecting drug use. There is as yet little understanding of how to integrate methadone and HIV care in these settings and how such services can be implemented; such a gap reflects, in part, limitations...

The idea of identifying and monitoring urinary excretion of illicit drugs and their metabolites in wastewater has been seen by governments and international organisations as ‘promising’. It is claimed that such approaches will enable governments to effectively direct resources to priority areas, monitor the progress of demand and supply reduction s...

Pre-exposure prophylaxis (PrEP) with antiretroviral medication is an effective, evidence-based option for HIV prevention. In England, issues of cost-effectiveness and of responsibility for commissioning prevention services have so far led National Health Service (NHS) England to decide not to commission PrEP. Given the significant lag between the a...

PrEP Club focus group topic guide. (PDF)

Background: The development of simplified and effective hepatitis C (HCV) pharmaceuticals enables treatment scale up among the most marginalised. This potentiates a promise of viral elimination at the population level but also individual level clinical and non-clinical benefits. Reports of transformative non-clinical outcomes, such as changes in s...

Background Hepatitis C (HCV) diagnosis and care is a major challenge for people who use illicit drugs, and is characterised by low rates of testing and treatment engagement globally. New approaches to fostering engagement are needed. We explored the acceptability of remote forms of HCV testing including self-testing and self-sampling among people w...

A life history approach enables study of how risk or health protection is shaped by critical transitions and turning points in a life trajectory and in the context of social environment and time. We employed visual and narrative life history methods with people who inject drugs to explore how hepatitis C protection was enabled and maintained over t...

Since 2013, North America has experienced a sharp increase in unintentional fatal overdoses: fentanyl, and its analogues, are believed to be primarily responsible. Currently, the most practical means for people who use drugs (PWUD) to avoid or mitigate risk of fentanyl-related overdose is to use drugs in the presence of someone who is in possession...

Contested science presents a problem for ‘evidence-based’ public health intervention. Taking a perspective that treats evidence as constituted through the practices which make it, we treat controversies in public health science as events of ‘evidence-making’ intervention. We look back on a recent controversy in evidence-making regarding the curativ...

Report based on the findings from the Family Life Project - a qualitative longitudinal study of children and young people's experiences of growing up with parental substance misuse (London School of Hygiene and Tropical Medicine). The specific objectives of the study were to explore: young people’s lived experiences (daily life experiences) of fami...

Progression to a state of treated HIV pivots on the capacities of services to attract and retain people living with HIV and on patients to actively engage. Yet HIV is an ongoing negotiation produced through social conditions. Drawing on qualitative analyses among Black African and Caribbean men living with HIV in London who are also migrants, we ex...

Global health priorities are being set to address questions on adherence to HIV antiretroviral therapy in adolescence. Few studies have explored young people's perspectives on the complex host of social and relational challenges they face in dealing with their treatment in secret and their condition in silence. In redressing this, we present findin...

People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches t...

Public health research treats intimate partnerships as sites of risk management, including in the management of HIV and hepatitis C transmission. This risk-infused biomedical approach tends to undermine appreciation of the emotional and socially situated meanings of care in intimate partnerships. In this article we explore qualitative interview acc...

Objective: A recent meta-analysis suggested that opioid substitution therapy (OST) increased uptake of anti-retroviral treatment (ART) and HIV viral suppression. We modelled whether OST could improve the HIV prevention benefit achieved by ART amongst people who inject drugs (PWID). Methods: We modelled how introducing OST could improve the cover...

Objectives: A qualitative study of the BREATHER (PENTA 16) randomised clinical trial, which compared virological control of Short Cycle Therapy (SCT) (5 days on: 2 days off) with continuous efavirenz (EFV)-based antiretroviral therapy (CT) in children and young people (aged 8-24) living with HIV with viral load <50 c/mL to examine adaptation, acce...

Background: While the health-related benefits of intimate partnership are well documented, little attention has been paid to couples exposed to high levels of social stigma and exclusion. In this project we investigated an important site of stigma for partnerships by collecting accounts of changing hepatitis C (HCV) status ("sero-change") among co...

Introduction: Innovative strategies, such as HIV self-testing (HIVST), could increase HIV testing rates and diagnosis. Evidence to inform the design of an HIVST intervention in the UK is scarce with very little European data on this topic. This study aims to understand values and preferences for HIVST interventions targeting MSM in the UK. We expl...

Despite the majority of needle–syringe sharing occurring between sexual partners, the intimate partnerships of people who inject drugs have been largely overlooked as key sites of both hepatitis C virus prevention and transmission, and risk management more generally. Drawing on interviews with 34 couples living in inner-city Australia, this article...

Background: Continuous monitoring of health is increasingly an expectation of responsible patient citizenship. This is particularly true for those deemed to be ’’most’’ at risk by the epidemiological and public health sciences. Methods: Six focus group discussions (FGD) were conducted between July and November 2015 with 47 MSM aged between 18 - 64...

HIV-positive people who inject drugs (PWID) frequently encounter barriers accessing and remaining on antiretroviral treatment (ART). Some studies have suggested that opioid substitution therapy (OST) could facilitate PWID's engagement with HIV services. We conducted a systematic review and meta-analysis to evaluate the impact of concurrent OST use...

People who inject drugs (PWID) experience a range of barriers to HIV treatment and care access. The Kenyan government and community-based organisations have sought to develop HIV care for PWID. A principal approach to delivery in Kenya is to provide care from clinics serving the general population and for this to be linked to support from community...

Background: For human immunodeficiency virus (HIV)-infected adolescents facing lifelong antiretroviral therapy (ART), short-cycle therapy (SCT) with long-acting agents offers the potential for drug-free weekends, less toxicity, better adherence and cost savings. Objectives: To determine whether or not efavirenz (EFV)-based ART in short cycles of...

In Vancouver, Canada, there has been a continuous shift in the policing of sex work away from arresting sex workers, which led to the implementation of a policing strategy that explicitly prioritised the safety of sex workers and continued to target sex workers' clients. We conducted semi-structured interviews with 26 cisgender and five transgender...

The International Journal of Drug Policy (IJDP) has linked with the International Society for the Study of Drug Policy (ISSDP). The Journal and the Society have entered into a non-exclusive partnership in which ISSDP affiliates with IJDP, making IJDP its official journal. IJDP and ISSDP share a concern for advancing the science, methods and practic...

Purpose: The purpose of this paper is to analyze poor management of tuberculosis (TB) prevention and treatment and explore parameters and causes of this problem drawing on qualitative interviews with former prisoners and medical specialists in Kaliningrad Oblast in Russia. Design/methodology/approach: The authors undertook a qualitative study, t...

The ‘cascade of care’ construct is increasingly used in public health to map the trajectory of local HIV epidemics and of different HIV populations. The notion of ‘patient engagement’ is key to the progress of people living with HIV through the various ‘steps’ of the cascade as currently conceptualised. The public health literature on the definitio...

Illegal drug markets are shaped by multiple forces, including local actors and broader economic, political, social, and criminal justice systems that intertwine to impact health and social wellbeing. Ethnographic analyses that interrogate multiple dimensions of drug markets may offer both applied and theoretical insights into drug use, particularly...

We conducted the first qualitative study of injecting drug use in Serbia and Montenegro. Based on qualitative semi-structured interviews with injecting drug users (IDUs), Serbia (n=67) and in Podgorica and Bar, Montenegro (n=32), we offer a summary of key findings from IDUs' accounts of sharing injecting equipment and the risks of HCV and HIV. We s...

Heroin injection is emerging as a significant dimension of the HIV epidemic in Kenya. Preventing transitions to injecting drug use from less harmful forms of use, such as smoking, is a potentially important focus for HIV prevention. There is, however, little evidence to support comprehensive programming in this area, linked to a shortage of analysi...

Drawing on the analyses of qualitative interview accounts of people who inject heroin in Kenya, we describe the narration of addiction treatment access and recovery desire in conditions characterised by a 'poverty of drug treatment opportunity'. We observe the performance of addiction recovery narrative in the face of heavy social constraints limit...

As paediatric HIV treatment has become increasingly available across the world, the global perinatally infected cohort is ageing. However, we know surprisingly little about what it is like to grow up with HIV in resource-stretched settings. We draw on findings from a prospective, qualitative study with HIV-positive children, their carers and health...

Promoted globally as an evidence-based intervention in the prevention of HIV and treatment of heroin addiction among people who inject drugs (PWID), opioid substitution treatment (OST) can help control emerging HIV epidemics among PWID. With implementation in December 2014, Kenya is the third Sub-Saharan African country to have introduced OST. We c...