Gem graduated with a PhD in Public Health in 2022. Her thesis involved analysing the evolution of advanced HIV disease in the era of antiretroviral therapy among adults and children in Southern Africa. She described and compared strategies for managing virologic failure among children and adolescents, and the use and outcomes of emerging new treatment options. She also described extremely poor and persistent post-discharge outcomes among hospitalized people living with HIV. These findings demonstrated that treatment failure and advanced HIV disease among the most vulnerable people with HIV continue to be significant challenges facing antiretroviral therapy programmes in Southern Africa, urgently requiring attention if further reductions in HIV-related morbidity and mortality are to be realized.