A longitudinal, mixed-method, community study with a cohort of 1059 HIV-positive adolescents.
This research study is a collaborative effort between the South African national Departments of Health, Social Development and Basic Education, UNICEF, Paediatric AIDS Treatment for Africa (PATA), and the Universities of Cape Town and Oxford.
Antiretroviral treatment (ART) gives HIV+ adolescents opportunity to control their HIV infection and provide relief from associated illnesses. However, it requires careful and daily adherence. Few adolescents in South Africa get tested for HIV and of those who take ART, only around 21% still adhere after 6 months of treatment - even though antiretroviral medication is free in South Africa. This suggests there are significant barriers to young people accessing sexual and reproductive health (SRH) services and adhering to ART, but little evidence on ART adherence/non-adherence and SRH access/non-access exists.
This research project is intended to promote ART adherence and SRH service access among HIV+ adolescents.
This study asks the crucial questions: what are the lived experiences of HIV+ adolescents in relation to ART and SRH, and what obstructs and/or promotes their ART adherence and utilisation of SRH services? The key aims of the Mzantsi Wakho project are:
- To identify programme-relevant predictors of non-adherence to ART and non- access to SRH services for HIV+ adolescents in South Africa;
- To engage with HIV+ adolescents using participative workshops to assess acceptability and improvement of potential service delivery models for ART and SRH services.
The quantitative component involves baseline and follow-up interviews with HIV+ adolescents about certain aspects of their life, for example: school, health, friends, challenges, family, sex and support. This is done using tablets that contain questionnaires with validated screening tools. Questionnaire answers are then matched with data collected from healthcare facilities, such as patient files. The resulting data is then anonymised and examined using statistical analysis.
The qualitative component involves ethnographic research with adolescents, caregivers and healthcare professionals; clinic-based observations and interviews with healthcare providers and adolescents, and; body mapping and participatory tool design workshop camps with adolescents.
Dissemination and outputs will take place throughout the study, as well as feedback to participants, but no identifiable details will be included.
Baseline data collection was completed in September 2015. A total of 1526 interviews have been completed, of which 1059 are HIV+ teenagers – making this the world’s largest study of HIV+ adolescents. Initial findings are already being disseminated.
As of early 2017, we are currently in the process of completing the Round 2 of data collection.