Improving lives for families affected by HIV and AIDS

The physical and psychological health of children in Sub-Saharan Africa is affected by the prevalence of HIV and AIDS in their communities – but University of Oxford research is changing that.

Empowering AIDS-orphaned children in AfricaAn AIDS study in South Africa.

Since 2005, Professor Lucie Cluver, from the University of Oxford’s Department of Social Policy and Intervention, has spearheaded a series of pioneering studies informing policy and practice for AIDS-affected children in Sub-Saharan Africa.

Through collaboration with the South African government and major NGOs, the findings of the first of these studies – the Orphan Resilience Study – were incorporated into the policies of the likes of UNICEF, Save the Children, and PEPFAR-USAID. The study revealed AIDS-orphaned children suffer more extreme psychological disorders than children orphaned by other causes. Each of Professor Cluver’s follow-up, evidence-based projects have sought to demonstrate – and ultimately help solve – the other devastating ways in which HIV and AIDS affect communities and their young.

The first of these follow-up studies is Young Carers, currently the world’s largest study of AIDS-affected children. Having followed 6,000 children and 2,500 of their adult caregivers over a three-year period, the study showed that parental AIDS has severe educational, sexual and psychological effects on children. Based on the findings, including the HIV-prevention impact of social welfare grants, the South African National AIDS Council is rolling out a ‘cash plus care’ programme to 30,000 girls in South Africa. Moreover, ‘cash plus care’ programming is being included in DREAMS, a $200 million initiative set to tackle adolescent HIV in 10 countries.

Child abuse is common in Sub-Saharan Africa, exacerbated by the burden of HIV and AIDS. With the aim of reducing violence, the Sinovuyo Teen Study, launched in 2013, involves the development and evaluation of a free parenting and teen programme. In collaboration with the World Health Organisation, UNICEF and Professor Catherine Ward from the University of Cape Town, Professor Cluver is working with a large cohort of vulnerable families in the Eastern Cape. Based on strong initial results, the programme is already being adopted in 15 countries. If proven successful, it will be rolled out internationally.

In her newest project, Mzantsi Wakho/Youth Pulse, Professor Cluver is working with Dr Rebecca Hodes to investigate the low rate among HIV+ adolescents of adherence to anti-retroviral treatment (ART) and access to sexual and reproductive health (SRH) services. The study, which is the world’s largest survey of HIV+ adolescents, also uses workshops to assess service delivery models for ART and SRH services. Based on findings so far, the team authored South Africa’s planned ‘National Adolescent & Youth Health Policy 2016 – 2020’.

Professor Cluver works with a dedicated team of post-doctoral and doctoral students, who are now launching their own projects to help vulnerable children in the region. With around 100 million children affected by HIV, of which 80 million are in Southern and Eastern Africa, Oxford University’s research is set to inform lasting, meaningful change.

Funded by: the Economic and Social Research Council, the European Research Council, the National Research Foundation South Africa, the Nuffield Foundation Health Economics and AIDS Division, University of KwaZulu-Natal, the Claude Leon Foundation, South African National Department of Social Development, the John Fell Fund, the Leverhulme Trust, CIPHER (International AIDS Society), DFID and Sweden-Norad, UNICEF, the Janssen Foundation, the Regional Inter-Agency Task Team for Children Affected by AIDS, PEPFAR-USAID