Mzantsi Wakho Adolescent Adherence Study

mzantsi wakho

Funded by: The Nuffield Foundation (UK), DFID and SIDA-Norad’s Evidence for HIV Prevention in Southern Africa programme (EHPSA) managed by Mott MacDonald, Johnson & Johnson Global Fund Programme, the European Research Council (ERC), the International AIDS Society through the CIPHER grant, the Philip Leverhulme Trust, the John Fell Fund, ELMA Philanthropies, the ESRC Impact Acceleration Account and the Clarendon-Green Templeton College Scholarship.

Start date: 2013

End date: Ongoing

Project outline

Mzantsi Wakho is a mixed-methods, longitudinal, community-traced study of ART adherence and sexual health practices among 1500 adolescents in South Africa. The study was established in mid-2013, and is currently in its third annual wave of quantitative data collection with a 94% retention rate and ongoing linked qualitative research. This research collaborates with adolescents, frontline healthcare workers to improve adherence to medicine and access to sexual and reproductive health services amongst high-risk adolescents. We are generating evidence that informs social policy and intervention design that supports young people living in AIDS-affected communities in South Africa.

The study was designed and conceptualised by Oxford University and the University of Cape Town (lead researchers: Dr Elona Toska, Dr Rebecca Hodes) in collaborative planning with HIV-positive adolescents, UNICEF and South African National Departments of Health, Social Development and Basic Education, alongside the Eastern Cape Department of Health, Frere and Cecilia Makiwane hospitals, NGO (Pediatric-Adolescent Treatment for Africa (PATA)), and community-based organisations (for example Kheth’Impilo, Raphael Centre, Small Projects Foundation and Keiskamma Trust). 


  1. Cluver, L. Toska, E. Orkin, F. M. Meinck, F. Hodes, R. Yakubovich, A. R. & Sherr, L. (2016). Achieving equity in HIV-treatment outcomes: can social protection improve adolescent ART-adherence in South Africa? AIDS Care, 28(sup2), 73-82. DOI: 10.1080/09540121.2016.1179008
  2. Cluver, L. Hodes, R. Toska, E. Kidia, K. K., Orkin, F. M. Sherr, L. & Meinck, F. (2015). ‘HIV is like a tsotsi. ARVs are your guns’: associations between HIV-disclosure and adherence to antiretroviral treatment among adolescents in South Africa. AIDS. 29(Suppl 1), S57-65. DOI: 10.1097/QAD.0000000000000695
  3. Toska, E. Pantelic M. Meinck, F. Keck, K. Haghighat, R. & Cluver, L. (2017). Sex in the Age of HIV: A systematic review of prevalence and predictors of high-risk sexual practices, and programmes to reduce sexual risk-taking among HIV-positive adolescents and youth in Sub-Saharan Africa. PLoS One. DOI: 10.1371/journal.pone.0178106
  4. Hodes, R. & Morrell, R. (in press). Incursions from the epicenter: Southern theory, social science, and the global HIV research domain. African Journal of AIDS Research.
  5. Hodes, R. Price, I. Bungane, N. Toska, E. & Cluver, L. (in press). How frontline healthcare workers respond to stock-outs of essential medicines in the Eastern Cape. South African Medical Journal.
  6. Mark, D. Cluver, L. Collins, C. Iorpenda, K. Taing, L. Andrade, C. & Hatane, L. (2017). What is it going to take to move youth-related HIV programme policies into practice in Africa? Journal of the International AIDS Society. DOI: 10.7448/IAS.20.4.21491
  7. Hodes, R. (in press). Popular perspectives on teenage pregnancy in South Africa. In N. Mkhwanazi and D. Bhana, Young Families in the New South Africa.
  8. Hodes, R. (2017). Too many rights? Reproductive freedom in post-apartheid South Africa’. Centre for Social Science Research Working Paper, No. 401, University of Cape Town. 
  9. Hodes, R. (2017). Questioning Fees Must Fall. African Affairs.
  10. Cooper, D. Harries, J. Moodley, J. Constant, D. Hodes, R. Mathews, C. & Hoffman, M. (2016). Coming of age? Women’s sexual and reproductive health after twenty-one years of democracy in South Africa. Reproductive Health Matters, 24(48), 79–89 DOI: 10.1016/j.rhm.2016.11.010
  11. Gittings, L. (2016). When you visit a man you should prepare yourself’: male community care worker approaches to working with men living with HIV in Cape Town, South Africa. Culture, Health and Sexuality. DOI: 10.1080/13691058.2016.1150513
  12. Linder, V. Goldswain, C. Adler, H. Carty, C. Harper, K. Jackson, V. & Boon, G. (2016). Lamivudine Monotherapy: Experience of Medium Term Outcomes in HIV Infected Children Unable to Adhere to Triple Therapy. The Pediatric infectious disease journal.
  13. Toska, E. Cluver, L. Boyes, M. E. Isaacsohn, M., Hodes, R. & Sherr, L. (2016). School, supervision and adolescent-sensitive clinic care: combination social protection and reduced unprotected sex among HIV-positive adolescents in South Africa. AIDS and Behavior, 1-14. DOI: 10.1007/s10461-016-1539-y.
  14. Toska, E. Gittings, L. Hodes, R. Cluver, L. Govender, K. Chademana, K. E. & Gutiérrez, V. E. (2016). Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa. African Journal of AIDS Research, 15(2), 123-140. DOI: 10.2989/16085906.2016.1194299
  15. Hodes, R. Toska E. & Gittings, L. (2016). Babies for bling: Are teenage girls having children to access grants? HIV Nursing Matters 7 (2): 20-23.
  16. Nattrass, N. Hodes, R. & Cluver, L. (2016). Changing Donor Funding and the Challenges of Integrated HIV Treatment. AMA Journal of Ethics, 18(7), 681. DOI: 10.1001/journalofethics.2016.18.07.ecas3-1607
  17. Hodes, R. (2016). The culture of illegal abortion in South Africa. Journal of Southern African Studies, 42(1), 79-93. DOI: 10.1080/03057070.2016.1133086
  18. Vale, B. (2016). Negotiations of Blame and Care among HIV‐positive Mothers and Daughters in South Africa's Eastern Cape. Medical Anthropology Quarterly. DOI: 10.1111/maq.12351
  19. Pantelic, M. Boyes, M. Cluver, L. & Thabeng, M. (2016). They Say HIV is a Punishment from God or from Ancestors: Cross-Cultural Adaptation and Psychometric Assessment of an HIV Stigma Scale for South African Adolescents Living with HIV (ALHIV-SS). Child Indicators Research, 1-17. DOI: 10.1007/s12187-016-9428-5
  20. Vale, B. & Thabeng, M. (2016). Redeeming Lost Mothers: Adolescent Antiretroviral Treatment and the Making of Home in South Africa. Medical Anthropology, 35(6), 489-502. DOI: 10.1080/01459740.2016.1145218
  21. Cluver, L. Hodes, R. Sherr, L. Orkin, F. M. Meinck, F. Lim Ah Ken, P. & Vicari, M. (2015). Social protection: potential for improving HIV outcomes among adolescents. J Int AIDS Soc, 18(Suppl 6), 20299. DOI: 10.7448/IAS.18.7.2026
  22. Toska, E. Cluver, L. Hodes, R. & Kidia, K. K. (2015). Sex and secrecy: How HIV-status disclosure affects safe sex among HIV-positive adolescents. AIDS Care, 27(sup1), 47-58. DOI: 10.1080/09540121.2015.1071775
  23. Vale, B. & Thabeng, M. (2015). Mobilising AID (S)? Contesting HIV as a Social and Economic Resource among Youth in South Africa's Eastern Cape. Journal of Southern African Studies, 41(4), 797-813. DOI: 10.1080/03057070.2015.1041811
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