About

Quarraisha Abdool Karim, PhD, is an infectious diseases epidemiologist and Professor of Epidemiology at Columbia University Mailman School of Public Health, as well as in Public Health at the Nelson R Mandela School of Medicine, University of KwaZulu-Natal in South Africa. She serves as Associate Scientific Director of CAPRISA and is an associate scientific director at the Center for the AIDS Programme of Research in South Africa. Her main research interests include understanding the evolving HIV epidemic in South Africa, factors influencing HIV acquisition in adolescent girls, and developing sustainable strategies to introduce antiretroviral therapy in resource-constrained settings. Since 1998, she has played a central role in building the science base in southern Africa through the Columbia University - Southern African Fogarty AIDS International Training and Research Programme, which has trained over 600 scientists in the region. She was the Principal Investigator of the landmark CAPRISA 004 tenofovir gel trial, which provided proof of concept for microbicides and was highlighted by Science as one of the Top 10 scientific breakthroughs in 2010. Dr. Abdool Karim has over 170 peer-reviewed publications and has authored several books and book chapters. She is actively involved in various national and international advisory roles, including chairing the South African National AIDS Council Prevention Technical Task Team, serving on the UNAIDS Scientific Expert Panel, and advising PEPFAR. Her work has significantly contributed to HIV prevention research and capacity building in southern Africa.

Research topics

• Internal medicine
• Medicine

Selected publications

• Co-knowledge generation with communities to enhance understanding the impact of Covid-19 on women living with, or at risk of acquiring, HIV in South Africa

  Zenodo (CERN European Organization for Nuclear Research) · 2026-04-20

  articleOpen accessSenior author

  In Eastern and Southern Africa, home to about 60% of people living with HIV and new HIV infections, adolescent girls and young women (AGYW) continue to bear a disproportionate burden of new HIV infections and AIDS related mortality rates. AGYW and women living with HIV are diverse in terms of age, risk factors and geo-spatial distribution and are challenging to reach. The Covid-19 pandemic and the national measures to limit the propagation of the virus has revealed and exacerbated vulnerabilities AGYW in Africa are confronted to. The pandemic has had a wide range of health, social and economic impacts among this population group. There is growing evidence that these multi-dimensional impacts of Covid-19 are worse for key and vulnerable AGYW. This paper discusses how co-knowledge generation and partnerships established with civil society organisations, enabled us to effectively and efficiently reach diverse communities of marginalised women in South Africa, enhance the quality and completeness of data collected online and through peer interviews, strengthened community capacity to undertake research, and rapidly utilise the information generated to institute or advocate for interventions to mitigate a deepening crisis of HIV, TB gender and poverty.

  PublisherDOI

• Population pharmacokinetics of tenofovir alafenamide delivered via an annual subdermal implant in South African women

  Scientific Reports · 2026-04-21

  articleOpen access

  A diverse portfolio of HIV prevention products likely will be needed to help attain the ambitious targets set by UNAIDS for the global reduction in HIV incidence. Ultralong-acting systemic drug regimens with dosing frequencies of one year or longer represent a promising strategy for HIV-1 pre-exposure prophylaxis (PrEP) as they hold the potential of being discreet and overcoming some of the adherence burden associated with daily oral drug dosing. We have developed an innovative subdermal implant delivering the potent antiretroviral prodrug tenofovir alafenamide (TAF) evaluated in CAPRISA 018, a first-in-human, randomized, placebo-controlled clinical trial in South African women. Population PK modeling was used to present an in-depth analysis of the CAPRISA 018 results. A literature model was adapted and applied to predict plasma TAF and tenofovir (TFV) concentrations, as well as peripheral blood mononuclear cell (PBMC) TFV diphosphate (TFV-DP) concentrations that agreed with measured values. A Weibull model was used to calculate the in vivo TAF release kinetics based on plasma TAF concentrations. While the release profiles were variable, at least half the implants (57%) displayed linear in vivo TAF release profiles. The relationship between implant TAF release rates and PBMC TFV-DP concentrations informed targets for future studies (0.39–1.4 mg d-1, depending on the selected prophylactic TFV-DP concentration) assuming the local tolerability issues can be overcome, fulfilling a key objective of the CAPRISA 018 trial.

  PublisherOA PDFDOI

• Co-knowledge generation with communities to enhance understanding the impact of Covid-19 on women living with, or at risk of acquiring, HIV in South Africa

  Zenodo (CERN European Organization for Nuclear Research) · 2026-04-20

  articleOpen accessSenior author

  In Eastern and Southern Africa, home to about 60% of people living with HIV and new HIV infections, adolescent girls and young women (AGYW) continue to bear a disproportionate burden of new HIV infections and AIDS related mortality rates. AGYW and women living with HIV are diverse in terms of age, risk factors and geo-spatial distribution and are challenging to reach. The Covid-19 pandemic and the national measures to limit the propagation of the virus has revealed and exacerbated vulnerabilities AGYW in Africa are confronted to. The pandemic has had a wide range of health, social and economic impacts among this population group. There is growing evidence that these multi-dimensional impacts of Covid-19 are worse for key and vulnerable AGYW. This paper discusses how co-knowledge generation and partnerships established with civil society organisations, enabled us to effectively and efficiently reach diverse communities of marginalised women in South Africa, enhance the quality and completeness of data collected online and through peer interviews, strengthened community capacity to undertake research, and rapidly utilise the information generated to institute or advocate for interventions to mitigate a deepening crisis of HIV, TB gender and poverty.

  PublisherDOI

• Impact of Tenofovir Alafenamide Sub‐Dermal Implant Insertion Site Scarring on Acceptability and HIV Prevention Preferences: A Prospective Cohort Study in Durban, South Africa

  Journal of the International AIDS Society · 2026-04-01

  articleOpen accessSenior author

  INTRODUCTION: The CAPRISA 018 Phase I trial evaluated the safety, tolerability and pharmacokinetics of a 110 mg tenofovir alafenamide (TAF) implant for HIV prevention in South African women. This follow-up cohort study, CAPRISA 097, assessed the long-term resolution of implant site reactions (ISRs) after implant removal and explored user acceptability and implant attribute preferences to inform the development of next-generation pre-exposure prophylaxis (PrEP) implants. METHODS: Women previously enrolled in CAPRISA 018 were recruited and followed quarterly for 12 months between 13 October 2022 and 27 October 2023. ISR prevalence, severity and resolution were evaluated at each visit. Implant acceptability, implant attribute preferences and PrEP preferences were assessed at enrolment and at month 12. RESULTS: Of 36 eligible participants, 35 were enrolled a median of 299 days after implant removal (IQR: 243-490). At enrolment, all 35 participants (100%) had ongoing mild (Grade 1) scarring, with additional findings of hyperpigmentation (14%), induration (6%) and hypopigmentation (3%). By study exit, scarring persisted in all participants (median duration: 623 days; IQR: 579-819), while hyperpigmentation and induration remained in two and one participant, respectively. Acceptability ratings for implant visibility were similar at enrolment and month 12 (77.1% vs. 75.0%), as were ratings for pain (68.6% vs. 78.1%). Side effects due to ISRs received the highest "very unacceptable" ratings, in 37.1% of participants at enrolment and 21.9% at study exit. Scarring was considered acceptable by 65.7% of participants at enrolment, increasing to 78.1% at exit. Perceived partner interest in the various PrEP products aligned with participant interest. A palpable 12-month implant was acceptable to most participants, whereas increased length, width or stiffness reduced the likelihood of use. Preferred PrEP options were a 12-monthly implant (38.2% at enrolment vs. 50.0% at month 12), a 6-monthly injection (29.0% vs. 37.5%) and daily oral PrEP tablets (12.0% vs. 3.0%). CONCLUSIONS: Mild but persistent scarring was observed following TAF implant removal, with limited cases of hyperpigmentation and induration. Despite these local side effects, a 12-monthly implant remained the most preferred PrEP option among women previously enrolled in the TAF implant trial.

  PublisherDOI

• Written on the Skin: Participants’ Perspectives on Scarring, Discolouration and Implant Site Reactions Experienced During a Phase I Clinical Trial for a Subdermal HIV Prevention Implant in KwaZulu-Natal, South Africa

  AIDS and Behavior · 2026-04-17

  articleOpen access

  To address challenges associated with the uptake of daily oral pre-exposure prophylaxis (PrEP) by young women at high risk of acquiring HIV, a range of novel, long-acting, slow-release products are being developed and clinically evaluated. One such technology is an annual implant of tenofovir alafenamide (TAF). This study explores the perspectives of participants from a first-in-human trial of an annual TAF implant to inform considerations for future PrEP implant innovation. The study, conducted in Durban, South Africa between 2022 and 2023, included 29 in-depth interviews (IDIs) and three focus group discussions (FGDs) with 18 participants. All participants experienced some form of implant site reaction (ISR). In some instances, these were minor, and in others, the implant removal process left longer-lasting and more severe skin changes. Participants' perceptions of these ISRs were influenced by concerns about their appearance, social stigma, and associations between scars and gender-based violence. Mild skin changes were deemed acceptable, while severe scarring and discolouration caused concerns about attracting negative attention. Few participants expressed concerns about their own scars, however, visible scars which might be mistaken for a contraceptive implant caused concern. Despite the ISRs experienced, there was positive feedback for this type of technology, and many considered that other women would be interested in adopting a sub-dermal implant should it be effective in preventing HIV. Continued enhancements of next generation implants to enhance drug release rates should consider how to minimise the severity and visibility of ISRs.

  PublisherOA PDFDOI

• Trump one year on: How six US researchers plan to protect science amid chaos and cuts

  Nature · 2026-01-20

  articleCorresponding
  PublisherDOI

• Lessons from Africa: health diplomacy in HIV prevention

  The Lancet · 2025-11-04

  article1st authorCorresponding
  PublisherDOI

• Hyaluronidase-enhanced subcutaneous delivery of bNAbs: a phase 1 randomized controlled clinical trial in HIV-uninfected women

  Nature Communications · 2025-09-01

  articleOpen access

  Broadly neutralizing antibodies (bNAbs) offer a promising strategy for HIV prevention. Subcutaneous (SC) administration is more feasible than intravenous delivery but may be limited by prolonged administration times and multiple injections. Here we report a pharmacokinetic (PK) modelling study, an unspecified exploratory analysis that involved 57 HIV-negative African women (median age 25 years; BMI range 18.1–39.3 kg/m²) enrolled in the CAPRISA 012B trial (PACTR202003767867253, total participants n = 76). A predefined sub-analysis directly comparing the 20 mg/kg dose level of ENHANZE™ drug product (EDP) versus no-EDP was conducted in a subset of participants (n = 5 with EDP, n = 5 without). CAP256V2LS and VRC07-523LS—potent HIV-1 bNAbs targeting conserved envelope epitopes—were administered SC with and without EDP. The primary outcome of this sub-analysis was duration of administration. Secondary outcomes included PK and safety. Among the subset of participants (n = 10), EDP significantly reduced median administration time from 49.5 to 10.0 minutes and reduced injections per dose from 3 to 1. CAP256V2LS and VRC07-523LS concentrations at 24 weeks post-dose, were 4.8- and 3.0-fold higher, respectively, with EDP. CAP256V2LS exposure (AUC) increased by 40%, despite a 30% decrease in Cmax. EDP was well tolerated with no safety concerns. These findings support EDP-enhanced SC delivery as a scalable and simplified strategy for long-acting antibody-based HIV prevention. Optimizing HIV preventive therapy administration is key to improved uptake in vulnerable populations. Here, the authors report that subcutaneous administration of broadly neutralizing antibodies formulated with EDP is safe while reducing infusion duration and number of injections in healthy female participants.

  PublisherOA PDFDOI

• Acceptability of an annual tenofovir alafenamide implant for HIV prevention in South African women: findings from the CAPRISA 018 Phase I clinical trial

  Journal of the International AIDS Society · 2025-02-01 · 5 citations

  articleOpen accessSenior author

  INTRODUCTION: Long-acting HIV pre-exposure prophylaxis promises to improve uptake, adherence and persistence challenges experienced with daily oral tablets. We assessed the acceptability of an annual tenofovir alafenamide (TAF) implant in South African women enrolled from 9 July 2020 until 31 May 2022 in a Phase I trial. METHODS: Six women received one TAF implant for 4 weeks (Group 1), after which 30 women were randomized (4:1, TAF to placebo ratio) to receive 1 or 2 TAF or placebo implants for 48 weeks (Group 2), before trial discontinuation. Acceptability assessments were conducted pre- and post-implant removal. Implant attributes (size, quantity, insertion site, palpability, visibility) and physical experiences (insertion/removal procedures, implant site reactions [ISRs]) were rated on a scale of 1 (highly unacceptable) to 6 (highly acceptable), with 4 being the acceptability threshold. The mean (range) of the mean acceptability scores across all pre-removal visits were calculated, including stratification by removal timing (early vs. scheduled). Implant likes and dislikes were also assessed. RESULTS: The median participant age was 26 years. Prior to implant removal, the mean (range) acceptability scores were 5.4 (3.6-6.0) for product attributes and 5.1 (1.7-6.0) for physical experiences. Eleven (31%) participants had early implant removals, occurring on average 19 weeks (range 2-27 weeks) after insertion. The proportion of study visits reporting adherence measure as unacceptable in early versus scheduled removals: ISRs (50% vs. 19%), visibility (30% vs. 15%), palpability (14% vs. 8%), pain (16% vs. 4%) and implant quantity (13% vs. 1%). Pre-removal acceptability scores for ISRs (p = 0.003) and physical experiences (p = 0.05) were significantly associated with early removal. Overall, mean (range) acceptability scores were 5.8 (4.0-6.0) and 5.9 (4.7-6.0) for lifestyle compatibility and likelihood of recommendation, respectively. After removal, 39% of participants found ISRs unacceptable, followed by 22% citing implant visibility. Potential for long-term HIV protection, followed by discreet and convenient use, were most liked, while ISRs were the most disliked aspect. CONCLUSIONS: While implant attributes, physical experiences and insertion/removal procedures were largely acceptable, local ISRs significantly reduced tolerability and acceptability, resulting in higher-than-expected early removals. The potential benefits of an annual TAF implant may be undermined unless tolerability is improved.

  PublisherOA PDFDOI

• Safety, tolerability, and pharmacokinetics of an annual tenofovir alafenamide silicone subdermal implant in South African women: a two-part, randomised, placebo-controlled, double-blind, first-in-human, phase 1 trial

  The Lancet HIV · 2025-07-02 · 6 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

Recent grants

• NIH Grant D43TW000231

  NIH · $16.1M · 2015

• KwaZulu-Natal Clinical Trials Unit

  NIH · $35.9M · 2007–2027

• NIH Grant D43TW00023116S1

  NIH · $200k · 2015

Frequent coauthors

• Salim S. Abdool Karim

  Centre for the AIDS Programme of Research in South Africa

  990 shared

• Carolyn Williamson

  309 shared

• Cheryl Baxter

  214 shared

• Jo‐Ann S. Passmore

  National Health Laboratory Service

  188 shared

• Nigel Garrett

  Centre for the AIDS Programme of Research in South Africa

  179 shared

• Leila E. Mansoor

  University of KwaZulu-Natal

  163 shared

• Natasha Samsunder

  Centre for the AIDS Programme of Research in South Africa

  158 shared

• Koleka Mlisana

  130 shared

Education

• Ph.D., Public Health

  Columbia University

  1991

• M.S., Microbiology

  University of Natal

  1985

• B.S., Microbiology

  University of Natal

  1983

Awards & honors

• John Dirks-Canada Gairdner Award in Global Health
• Christophe Merieux Award, French Academies of Sciences
• L'Oreal-Unesco Women in Science Laureate for Africa and the…
• Order of Mapungubwe: Bronze, President of South Africa
• Fellow, US National Academy of Medicine