Betsy Tolley

Senior Scientist

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Betsy Tolley is a Senior Scientist and Director of the Behavioral, Epidemiological & Clinical Sciences Unit of FHI 360, where she leads a diverse team of researchers with backgrounds in anthropology, demography, epidemiology, health behavior, human geography and statistics. Through her research, Tolley has examined acceptability of and adherence to sexual health, contraceptive and reproductive technologies, including single- or multi-purpose vaginal rings and longer-acting injectables, implants and intrauterine devices (IUD). An important focus of recent research has been on measurement of complex constructs that influence behavioral outcomes. For example, she conducted mixed-method research in parallel to a phase 2 microbicide safety trial in India to first develop scales (e.g., HIV risk perception, couple sexual communication, acceptability of product attributes) and then longitudinally assess their influence on consistent use. In a recent project, Tolley and her team used standard scale development approaches to develop and validate a set of tools aimed at screening and monitoring trial participants’ propensity to adhere to trial product use. These tools are currently being prospectively validated in several trials of new HIV and/or multi-purpose prevention products.

Tolley has also applied her understanding of how social and sexual contexts shape acceptability to develop and test messages and materials for potential microbicide introduction initiatives in Kenya. Tolley and her team participated in a multi-phase project, guided by human-centered design (HCD) approaches, to develop next-generation contraceptive concepts based on end-user needs and preferences ( Her reflections on similarities and differences between HCD and traditional social-behavioral research approaches are summarized in a report.

Tolley brings to FHI 360 experience in the training and use of qualitative research methods, including rapid appraisal and participatory techniques; application of quantitative research designs and measurement; a background in international economics; and over twenty-five years of experience living and working in developing countries. She has a PhD in Health Behavior from the Gillings School of Public Health, University of North Carolina-Chapel Hill and a MA in International Development from the Nitze School of International Studies, The Johns Hopkins University. She speaks fluent French, has a working knowledge of Hindi/Urdu and Arabic and has conducted studies in francophone Africa, Kenya, South Africa and Tanzania, as well as Haiti, Egypt, Jordan and India.

Select peer-reviewed publications

  • Tolley EE, Zangeneh S, Chau G, Eron J, Grinsztejn B, Dawood H, Liu A, Magnus M, Hosseinipour M, Panchia R, Li S, Cottle L, Rinehart A, Margolis D, McCauley M, Landovitz R. (2020). Acceptability of long-acting injectable cabotegravir (CAB LA) in HIV-uninfected Individuals: HPTN 077. AIDS and Behavior. [Available at:]
  • Tolley EE, Li S, Zangeneh SZ, Atujuna M, Musara P, Justman J, Pathak S, Bekker LG, Swaminathan S, Stanton J, Farrior J, Sista N. Acceptability of TMC278 LA: Long-acting injectable pre-exposure prophylaxis (PrEP) in HPTN 076. JIAS, 22(10: e25408. October 2019. [Available at:]
  • Tolley EE, Guthrie KM, Zissette S, Fava JL, Gill K, Louw CE, Kotze P, Reddy K, MacQueen K. Optimizing adherence in HIV prevention product trials: Development and psychometric evaluation of simple tools for screening and adherence counseling. PloS One, 12;13(4):e0195499, April 2018. [Available at:]
  • Tolley EE, Taylor J, Pack A, Greene E, Stanton J, Shelus V, Dunner R, Hodge T, Branson B, El-Sadr WM, Gamble T. The role of financial incentives along the antiretroviral therapy adherence continuum: A qualitative sub-study of the HPTN 065 (TLC-Plus) study. AIDS and Behavior, 1;22(1):245-57. January 2018. [Available at:]
  • Tolley EE, Kaaya S, Kaale A, Minja A, Bangapi D, Kalungura H, Headley J, Baumgartner JN. Comparing patterns of sexual risk among adolescent and young women in a mixed‐method study in Tanzania: Implications for adolescent participation in HIV prevention trials. Journal of the International AIDS Society, 17:19149, September 2014. [Available at:]