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Principal funders:Medical Research Council (MRC) and the Department of Health and Social Care (DHSC) through its National Institutes of Health Research (NIHR), European Research Council (ERC), UKRI GCRF Accelerating Achievement for Africa’s Adolescents (Accelerate) Hub, Research England (UKRI), UNICEF Eastern and Southern Africa Office (UNICEF-ESARO), the International AIDS Society’s Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), and HelpAge.  For further funders, see Young Carers website.

Dates: July 2017 - ongoing

Project outline

(Helping Empower Youth Brought up in Adversity with their Babies and Young children)

The HEY BABY study aims to assess resilience-promoting pathways for adolescent parent families living in adversity, including young parents living in resource-constrained, HIV-affected communities. It asks two groups of research questions: What puts adolescent parents and their children at risk of disadvantage? What services can help adolescent parents and their children? This research guides policy and programming in HIV and adolescent health. 

This study utilises a mixed methodology to capture the complexity of resilience combining adolescent parent and child data. It utilises two research streams conducted concurrently: qualitative and quantitative. The HEY BABY cohort of over 1,000 parent-child dyads living in severe adversity in South Africa is nested within a larger longitudinal observational cohort study, Mzantsi Wakho - the world’s largest longitudinal cohort of adolescents living with HIV. 

The HEY BABY study was designed and conceptualised in collaboration with South African Departments of Health, Basic Education, and Social Development, UNICEF and UNFPA, the World Health Organisation, REPSSI, Paediatric AIDS Treatment for Africa, and community-based organisations: the Keiskamma Trust, Kheth’Impilo, Beyond Zero, the Relevance Network and Small Projects Foundation.

2021 - AIDS online
Clinic and care: associations with adolescent antiretroviral therapy adherence in a prospective cohort in South Africa.
Authors: Cluver L, Shenderovich Y, Toska E, Rudgard W, Zhou S, Orkin M, Haghighat R, Chetty A, Kuo C, Armstrong A, Sherr L. 

Adolescent antiretroviral treatment (ART) adherence remains critically low. We lack research testing protective factors across both clinic and care environments. A prospective cohort of adolescents living with HIV in the Eastern Cape Province in South Africa were interviewed at baseline and 18-month follow-up. We traced all adolescents ever initiated on treatment in 52 government health facilities. This paper concludes that adolescents living with HIV need to be safe at home and feel safe from stigma in an accessible clinic. This will require active collaboration between health and child protection systems, and utilization of effective violence prevention interventions.

2020 - Journal of the International AIDS Society 
Reproductive aspirations, contraception use and dual protection among adolescent girls and young women: the effect of motherhood and HIV status.
Authors: Toska E, Cluver L, Laurenzi C, Wittesaele C, Sherr L, Zhou S, Lanwenya N. 

There is a growing interest in adolescent motherhood and HIV among policymakers and programme implementers. To better shape services and health outcomes, we need evidence on reproductive aspirations and contraception use in this high‐risk group, including the effect of motherhood and HIV status. We report data from a large survey of adolescent girls and young women conducted in a mixed rural‐urban district in South Africa. Read the full issue PDF here.

2019 - Lancet Child Adolescent Journal
Improving Lives by Accelerating Progress towards the UN Sustainable Development Goals for Adolescents Living with HIV: a Prospective Cohort Study. 
Authors: Cluver L, Orkin M, Campeau L, Toksa E, Webb D, Carlqvist A, Sherr L. 

Low-income and middle-income countries (LMICs) face major challenges in achieving the UN's Sustainable Development Goals (SDGs) for vulnerable adolescents. We aimed to test the UN Development Programme's proposed approach of development accelerators—provisions that lead to progress across multiple SDGs—and synergies between accelerators on achieving SDG-aligned targets in a highly vulnerable group of adolescents in South Africa.

2018 - Journal of the International AIDS Society
STACKing the Odds for Adolescent Survival: Health Service Factors Associated with Retention in Care and Adherence amongst Adolescents Living with HIV in South Africa. 
Authors: Cluver L, Pantelic M, Toska E, Orkin M, Casale M, Bungane N, Sherr L.
There are two million HIV‐positive adolescents in southern Africa, and this group has low retention in care and high mortality. There is almost no evidence to identify which healthcare factors can improve adolescent self‐reported retention. This study examines factors associated with retention amongst antiretroviral therapy (ART)‐initiated adolescents in South Africa.

2018 - Journal of Development Economics
Household Economic Strengthening through Saving and Budgeting: Evidence from a Field Experiment in South Africa. 
Authors: Steinart J, Cluver L, Meinckac F, Doubt J, Vollmer S.
Using data from a randomized field experiment with 552 households, nested within 40 villages and townships in South Africa, we examine the impact of a brief financial literacy training that was integrated into a broader psychosocial parenting intervention. Based on self-reported measures, we document significant improvements in financial behaviors, including higher saving and lower borrowing rates. 

2018 - BMC Public Health
Cash Transfers to Enhance TB Control: Lessons from the Global HIV Response. 
Authors: Rudgard W, Carter D, Scuffell J, Cluver L, Fraser-Hurt N,  Boccia D.

The World Health Organization prioritises a more holistic global response to end the tuberculosis (TB) epidemic by 2030. Based on experiences in the HIV response, social protection, and in particular cash transfers, show promise for contributing to this. Currently, individual-level evidence for the potential of cash transfers to prevent TB by addressing the structural social determinants of disease is lacking. To identify priority actions for the TB research agenda, we appraised efforts by the HIV response to establish the role of cash transfers in preventing HIV infection.

2018 - Prevention Science
What Affects Attendance and Engagement in a Parenting Program in South Africa?
Authors: Shenderovich Y, Eisner M, CLuver L, Doubt J, Berezin M, Majokweni S, Murray AL.
Parenting programs are a promising approach to improving family well-being. For families to benefit, programs need to be able to engage families actively in the interventions. Studies in high-income countries show varying results regarding whether more disadvantaged families are equally engaged in parenting interventions. In low- and middle-income countries (LMICs), almost nothing is known about the patterns of participation in parent training. This paper examines group session attendance and engagement data from 270 high-risk families enrolled in the intervention arm of a cluster-randomized controlled trial in South Africa. 

To find out more, visit the project page here.