Professor Lucie Cluver

Lucie Cluver
Professor of Child and Family Social Work
01865 280370
lucie.cluver@spi.ox.ac.uk

Lucie Cluver is a Professor of Child and Family Social Work, in the Centre for Evidence-Based Social Intervention in the Department of Social Policy and Intervention, and an Honorary Professor in Psychiatry and Mental Health at the University of Cape Town. She works closely with the South African government, USAID-PEPFAR, UNICEF, the World Health Organisation and with other international NGOs, to provide evidence that can improve the lives of children and adolescents affected by HIV/AIDS in Sub-Saharan Africa. 

Lucie is lucky to work with an incredible and dedicated team of PhD students, postdoctoral researchers, and colleagues. Together they lead large-scale longitudinal surveys and randomised controlled trials of interventions, combined with participatory qualitative research.

From January 2019, Lucie is the Principal Investigator for the new £20 million UKRI GCRF Accelerating Achievement for Africa's Adolescents Hub. Find out more here.

Lucie is a PI on several ongoing trials in Southern and Eastern Africa, all part of the Parenting for Lifelong Health Initiative – a collaboration between the World Health Organisation, UNICEF and academics to provide evidence-based non-commercialised child violence prevention programs for LMIC. These include the Sinovuyo Teen trial (with Dr Franziska Meinck and Dr Jenny Doubt) – a cluster randomised trial (n=1100, 40 sites) of a program for families with adolescents, the Sinovuyo Kids trial (with Prof Cathy Ward at University of Cape Town and Dr Jamie Lachman) for caregivers of 3-9 year olds, and the Mphatlalatsane trial (with Prof Mark Tomlinson and Prof Lorraine Sherr) for parents of toddlers in Lesotho. The PLH programmes are now being implemented in 16 countries in Africa, Asia and Eastern Europe.

Working with a dedicated team in close collaboration with policymakers, Lucie has pioneered research on ‘cash plus care’ – examining the impacts of social protection and psychosocial care on adolescent health.

Lucie leads the first community-based large panel of HIV-positive adolescents and community controls, including 1500 adolescents in South Africa (with Dr Elona Toska), which integrates qualitative research led by Dr Rebecca Hodes (University of Cape Town). Currently, she leads (with Dr Elona Toska) the first known longitudinal study in Africa to assess pathways to resilience amongst adolescent parent families living with and without HIV. This study will include 700 adolescent parents and child dyads.

Lucie has led three major longitudinal studies: the ‘Young Carers Study’ (2008-2012, with Dr Mark Boyes) was the world’s largest study of risk and resilience amongst AIDS-affected children, following 6000 children longitudinally in South Africa, the ‘Orphan Resilience Study’ (2005-2009 with Prof Frances Gardner) followed 1000 children over four years to identify impacts of orphanhood.
The team’s work has won a number of awards, including an ESRC Oxford University Excellence in Impact Award (2018), a University of Oxford Vice-Chancellor’s Innovation Award (2018), ESRC's Outstanding International Impact Prize (2017), the Philip Leverhulme Prize (2015), the International AIDS Society Young Investigator Award (2014), and the Discovery Clinical Excellence Award (2013). They have published over 100 papers in peer-reviewed journals including the Lancet Global Health, BMJ Global Health, AIDS, JAIDS, J Child Psychiatry and Psychology, Social Science and Medicine, AIDS Care and Prevention Science.

Funders: European Research Council Consolidator Grant, European Research Council 'Horizon 2020’, Medical Research Council, Research England, Janssen Pharmaceutica N.V., part of the Janssen Pharmaceutical Companies of Johnson & Johnson, The Nuffield Foundation, the Economic and Social Research Council, the Leverhulme Trust, the Evidence for HIV Prevention in Southern Africa (EHPSA), a UK aid programme managed by Mott MacDonald, the National Research Foundation (South Africa), UNICEF, USAID-PEPFAR, Ilifa Labantwana, the Claude Leon Foundation, the National Department of Social Development South Africa, the World Health Organisation, the John Fell Fund, the Oak Foundation, University of Oxford’s ESRC Impact Acceleration Account, RIATT-ESA, and the International AIDS Society through the CIPHER grant.

Cluver, L, Pantelic, M, Toska, E, Orkin, M, Casale, M, Sherr, L (in press). STACKing the odds for adolescent survival: Health service factors associated with retention in care and adherence amongst adolescents living with HIV in South Africa. Journal of the International AIDS Society. 

Rudgard, W, Carter, D, Scuffell, J, Cluver, L, Fraser-Hurt, N, Boccia, D (in press) Cash transfers to enhance TB control: Lessons from the global HIV response. BMC Public Health.

Hodes, R. Vale, B, Toska, E, Cluver, L, Dowse, R, Ashorn, M (in press). ‘Yummy or Crummy: The multisensory components of medicines-taking among HIV-positive youth. Global Public Health.

Steinert, J, Cluver, L, Meinck, F, Doubt, J, Vollmer, S (in press) Household Economic Strengthening through Saving and Budgeting: Evidence from a Field Experiment in South Africa. Journal of Development Economics.

Cluver, L. Meinck, F. Toska, E., Orkin, F. M. Hodes, R. Sherr, L. (2018). Violence exposure and adolescent antiretroviral non-adherence in South Africa. AIDS.

Cluver, L, Pantelic, M, Orkin, M, Toska, E, Medley, S, Sherr, L (2018) Sustainable Survival: Which SDGs protect against mortality risk for adolescents living with HIV? Journal of the International AIDS Society.

Cluver, L., Pantelic, M., Orkin, M., Toska, E., Medley, S., & Sherr, L. (2018). Sustainable Survival for adolescents living with HIV: do SDG-aligned provisions reduce potential mortality risk?. Journal of the International AIDS Society, 21 Suppl 1. doi:10.1002/jia2.25056

Cluver LD, Meinck F, Steinert JI, et al. Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa. BMJ Glob Heal 2018;3.http://gh.bmj.com/content/3/1/e000539.abstract

Cluver, L., Meinck, F., Steinert, J., Shenderovich, Y., Doubt, J., Herrero Romero, R., . . . Gardner, F. (n.d.). Parenting for Lifelong Health: A pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa. BMJ Global Health.

Cluver, L., & Sherr, L. (2017). Integrating disclosure support into family HIV care.. The Lancet. HIV, 4(12), e534-e535. doi:10.1016/s2352-3018(17)30153-4

Cluver, L. D., Lachman, J. M., Ward, C. L., Gardner, F., Peterson, T., Hutchings, J. M., . . . Redfern, A. A. (2017). Development of a Parenting Support Program to Prevent Abuse of Adolescents in South Africa: Findings From a Pilot Pre-Post Study. Research on Social Work Practice, 27(7), 758-766. doi:10.1177/1049731516628647

Cluver, L. D., Orkin, F. M., Yakubovich, A. R., & Sherr, L. (2016). Combination Social Protection for Reducing HIV-Risk Behavior Among Adolescents in South Africa.. Journal of Acquired Immune Deficiency Syndromes (1999), 72(1), 96-104. doi:10.1097/qai.0000000000000938

Cluver, L. D., Lachman, J. M., Ward, C. L., Gardner, F., Peterson, T., Hutchings, J. M., . . . Redfern, A. A. (2017). Development of a Parenting Support Program to Prevent Abuse of Adolescents in South Africa. Research on Social Work Practice, 27(7), 758-766. doi:10.1177/1049731516628647

Cluver, L, Orkin, M, Boyes, M, Yakubovich, A, Sherr, L (2016) Can Social Protection Improve Sustainable Development Goals for Adolescent Health?. PLOSOne. 11(10): e0164808 

Cluver, L, Meinck, F, Shenderovich, Y, Ward, C, Herrero Romero, R, Redfern, A, Lombard, C, Doubt, J, Steinert, J, Catanho, R, Wittesaele, C, De Stone, S, Salah, N, Mpimpilashe, P, Lachman, J, Loening, H, Gardner, F, Blanc, D, Nocuza, M, Lechowicz, M (2016). A parenting programme to prevent abuse of adolescents in South Africa: a study protocol for a pragmatic cluster randomized controlled trial. Trials. 17. 328.

Cluver, L, Meinck, F, Yakubovich, A, Doubt, J, et al (2016). Reducing child abuse amongst adolescents in low- and middle-income countries: A pre-post trial in South Africa. BMC Public Health. 13;16(1):567 

Cluver, L, Orkin, M, Yakubovich, A, Sherr, L (2016). Combination social protection for reducing HIV-risk behaviour amongst adolescents in South Africa. JAIDS. 72: 96-104    

Cluver, L, Orkin, M, Meinck, F, Boyes, M and Sherr, L (2016). Structural drivers and social protection: Mechanisms of HIV-risk and HIV-prevention for South African adolescents. Journal of the International AIDS Society (JIAS). 19. 2064-6.    

Cluver, L, Toska, E, Orkin, M, Yakubovich, A, Hodes, R, Sherr, L (2016). Achieving equity in HIV-treatment outcomes: Can social protection improve adolescent ART-adherence in South Africa? AIDS Care Equity Special Issue. Suppl  2 73-82

Cluver, L, Hodes, R, Toska, E, Kidia, K, Orkin, 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. 

Cluver, L, Orkin, M, Boyes, Ma, Sherr, L (2014) Cash plus care: social protection cumulatively mitigates HIV-risk behaviour among adolescents in South Africa. AIDS. S389-97

Cluver, L, Boyes, Ma, Orkin, M, Pantelic, Mc, Molwena, T & Sherr, L (2013) Child-focused state cash transfers and adolescent HIV-infection risks: A prospective multi-site study in South Africa. The Lancet: Global Health. 1. E362-70

Cluver, L, Orkin, M, Boyes, Ma, Sherr, L, Nikelo, J & Makhasi, D (2013). Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model. Social Science and Medicine, 87. 185-193

Cluver, L, Orkin, M, Boyes, Ma & Gardner, F (2012) ‘AIDS-orphanhood and caregiver HIV/AIDS sickness status: effects on psychological symptoms in South African youth’ Journal of Pediatric Psychology

Cluver, L, Orkin, M, Boyes,a M & Gardner, F (2012) Persisting mental health problems among AIDS-orphaned children in South Africa. Journal of Child Psychiatry & Psychology. 53 (4) 363-370.

Cluver, L, Orkin, M, Boyes, Ma, Gardner, F, & Meinck, Fc (2011) ‘Transactional Sex amongst AIDS-orphaned and AIDS-Affected Adolescents Predicted by Abuse and Extreme Poverty’. JAIDS 58 (3) 336-43   

Cluver, L, Bowes, L & Gardner, F (2010) Risk & protective factors for bullying victimisation amongst AIDS-affected & vulnerable children in S.Africa. Child Abuse & Neglect, 34 793-803 

Cluver, L, Gardner, F & Operario, D (2007). Psychological distress amongst AIDS-orphaned children in urban South Africa Journal of Child Psychiatry & Psychology & Allied Disciplines 48(8) 755-763

  • Early intervention: A foundation for lifelong violence prevention

    Journal article
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    South African Crime Quarterly

  • Process evaluation of a parenting program for low-income families in south africa

    2018
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    Journal article
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    Research on Social Work Practice
    © The Author(s) 2016. Objective: This mixed-methods process evaluation examined the feasibility of a parenting program delivered by community facilitators to reduce the risk of child maltreatment in low-income families with children aged 3–8 years in Cape Town, South Africa (N = 68). Method: Quantitative measures included attendance registers, fidelity checklists, satisfaction surveys, and engagement in home practice activities. Qualitative data included parent interviews, facilitator focus groups, and transcripts from parent groups and facilitator supervision sessions. Results: Quantitative results show high levels of participant involvement, implementation, and acceptability. Thematic analyses identified seven themes related to program feasibility: (a) supporting participant involvement, (b) engagement in collaborative learning, (c) strengthening facilitator competency, (d) delivering nonviolent discipline skills, (e) contextualizing content, (f) receptivity to existing practices, and (g) resistance to new skills. Discussion: Findings suggest that parenting programs derived from evidence-based principles may be feasible in South Africa when situated within a culturally relevant context.

  • Development of a Parenting Support Program to Prevent Abuse of Adolescents in South Africa

    2017
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    Journal article
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    Research on Social Work Practice

  • Development of a Parenting Support Program to Prevent Abuse of Adolescents in South Africa: Findings From a Pilot Pre-Post Study

    2017
    |
    Journal article
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    Research on Social Work Practice
    © 2016, © The Author(s) 2016. Purpose: Violence against children increases in adolescence, but there is a research and practice gap in research-supported child abuse prevention for the adolescent years. A pilot program for low-resource settings was developed in collaboration with nongovernmental organizations, government, and academics in South Africa, using research-supported principles. Method: This study used a pre-post design to test initial effects of a 10-session parenting program with 60 participants (30 caregiver–adolescent dyads) in high-poverty rural South Africa. Areas requiring further testing and adaptation were also identified. Results: Pre-post findings show medium to large program effects in reducing child abuse and adolescent problem behavior, as well as large effects in improvements of positive parenting, and perceived parent and adolescent social support. Discussion: There is potential to reduce child abuse, improve parenting, and reduce adolescent problem behavior in rural South Africa through parenting programs. Further development, testing and longer term follow-up are required to ascertain potential for scale-up.

  • Longitudinal Predictors of Child Sexual Abuse in a Large Community-Based Sample of South African Youth.

    2017
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    Journal article
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    Journal of interpersonal violence
    Sexual abuse has severe negative impacts on children's lives, but little is known about risk factors for sexual abuse victimization in sub-Saharan Africa. This study examined prospective predictors of contact sexual abuse in a random community-based sample of children aged 10 to 17 years ( N = 3,515, 56.6% female) in South Africa. Self-report questionnaires using validated scales were completed at baseline and at 1-year follow-up (96.8% retention rate). Cross-sectional and longitudinal associations between hypothesized factors and sexual abuse were examined. For girls, previous sexual abuse (odds ratio [OR] = 3.44, 95% confidence interval [CI] = [2.03, 5.60]), baseline school dropout (OR = 2.76, 95% CI = [1.00, 6.19]), and physical assault in the community (OR = 2.17, 95% CI = [1.29, 3.48]) predicted sexual abuse at follow-up. Peer social support (OR = 0.84, 95% CI = [0.74, 0.98]) acted as a protective factor. Previous contact sexual abuse was the strongest predictor of subsequent sexual abuse victimization. In addition, peer support moderated the relationship between baseline assault and subsequent sexual abuse. For boys, no longitudinal predictors for sexual abuse victimization were identified. These results indicate that the most vulnerable girls-those not in school and with a history of victimization-are at higher risk for sexual abuse victimization. High levels of peer support reduced the risk of sexual abuse victimization and acted as a moderator for those who had experienced physical assault within the community. Interventions to reduce school drop-out rates and revictimization may help prevent contact sexual abuse of girls in South Africa.

  • Relationships between poverty and AIDS Illness in South Africa: an investigation of urban and rural households in KwaZulu-Natal.

    2017
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    Journal article
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    Glob Public Health
    The association between poverty and HIV/AIDS in Sub-Saharan Africa remains contested. A better understanding of the relationship between the prevalence of poverty and the disease is essential for addressing prevention, treatment, and care. The present study interrogates this relationship, using a cross-sectional survey of 2477 households in urban and rural KwaZulu-Natal, South Africa. Structural equation modelling was employed to estimate the correlations between poverty and AIDS illness. The analysis revealed a correlation of rpb = 0.23, denoting that a higher level of household poverty was associated with a higher likelihood of being AIDS-unwell. Post hoc t-test showed that receipt of a disability grant by AIDS-affected households was associated with significantly lower poverty, compared to AIDS-affected households not receiving the grant, t(654) = 3.67, p < .01. Geographic location was found to confound the correlation: the strength of the relationship between poverty and AIDS was decreased to rpb = 0.15 (p < .001) for the urban and rpb = 0.16 (p < .001) for the rural sub-population. Findings suggest the importance of two sets of policies: those that address the potential upstream risk of poverty through economic interventions, and those that alleviate the impoverishing effects of AIDS illness for affected households.
    HIV/AIDS, poverty, poverty measurement, structural equation modelling, verbal autopsy, Acquired Immunodeficiency Syndrome, Adult, Cross-Sectional Studies, Family Characteristics, Female, Humans, Interviews as Topic, Male, Middle Aged, Models, Statistical, Poverty, Qualitative Research, Rural Population, South Africa, Urban Population

  • School, Supervision and Adolescent-Sensitive Clinic Care: Combination Social Protection and Reduced Unprotected Sex Among HIV-Positive Adolescents in South Africa.

    2017
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    Journal article
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    AIDS Behav
    Social protection can reduce HIV-risk behavior in general adolescent populations, but evidence among HIV-positive adolescents is limited. This study quantitatively tests whether social protection is associated with reduced unprotected sex among 1060 ART-eligible adolescents from 53 government facilities in South Africa. Potential social protection included nine 'cash/cash-in-kind' and 'care' provisions. Analyses tested interactive/additive effects using logistic regressions and marginal effects models, controlling for covariates. 18 % of all HIV-positive adolescents and 28 % of girls reported unprotected sex. Lower rates of unprotected sex were associated with access to school (OR 0.52 95 % CI 0.33-0.82 p = 0.005), parental supervision (OR 0.54 95 % CI 0.33-0.90 p = 0.019), and adolescent-sensitive clinic care (OR 0.43 95 % CI 0.25-0.73 p = 0.002). Gender moderated the effect of adolescent-sensitive clinic care. Combination social protection had additive effects amongst girls: without any provisions 49 % reported unprotected sex; with 1-2 provisions 13-38 %; and with all provisions 9 %. Combination social protection has the potential to promote safer sex among HIV-positive adolescents, particularly girls.
    HIV-positive adolescents, Secondary prevention, Social protection, South Africa, Unprotected sex, Adolescent, Ambulatory Care Facilities, Female, HIV Infections, HIV Seropositivity, Humans, Logistic Models, Male, Parents, Public Policy, Risk-Taking, Schools, Sexual Behavior, Sexual Partners, South Africa, Surveys and Questionnaires, Unsafe Sex

  • Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces.

    2017
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    Journal article
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    Psychol Health Med
    Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential self-report questionnaires were completed by adolescents aged 10-17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims.
    Child abuse, children, emotional abuse, physical abuse, service access, sexual abuse, victim services, Adolescent, Child, Child Abuse, Female, Health Services Accessibility, Help-Seeking Behavior, Humans, Male, South Africa, Truth Disclosure

  • Pathways From Family Disadvantage via Abusive Parenting and Caregiver Mental Health to Adolescent Health Risks in South Africa.

    2017
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    Journal article
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    J Adolesc Health
    PURPOSE: Adolescent health is a major concern in low- and middle-income countries, but little is known about its predictors. Family disadvantage and abusive parenting may be important factors associated with adolescent psychological, behavioral, and physical health outcomes. This study, based in South Africa, aimed to develop an empirically based theoretical model of relationships between family factors such as deprivation, illness, parenting, and adolescent health outcomes. METHODS: Cross-sectional data were collected in 2009-2010 from 2,477 adolescents (aged 10-17) and their caregivers using stratified random sampling in KwaZulu-Natal, South Africa. Participants reported on sociodemographics, psychological symptoms, parenting, and physical health. Multivariate regressions were conducted, confirmatory factor analysis employed to identify measurement models, and a structural equation model developed. RESULTS: The final model demonstrated that family disadvantage (caregiver AIDS illness and poverty) was associated with increased abusive parenting. Abusive parenting was in turn associated with higher adolescent health risks. Additionally, family disadvantage was directly associated with caregiver mental health distress which increased adolescent health risks. There was no direct effect of family disadvantage on adolescent health risks but indirect effects through caregiver mental health distress and abusive parenting were found. CONCLUSIONS: Reducing family disadvantage and abusive parenting is essential in improving adolescent health in South Africa. Combination interventions could include poverty and violence reduction, access to health care, mental health services for caregivers and adolescents, and positive parenting support. Such combination packages can improve caregiver and child outcomes by reducing disadvantage and mitigating negative pathways from disadvantage among highly vulnerable families.
    AIDS, Adolescent abuse, Adolescent behavior, Adolescent health, Mental health, Parenting, Risk factors, South Africa, Adolescent, Adolescent Health, Caregivers, Child, Child Abuse, Cross-Sectional Studies, Family, Female, Health Status, Humans, Male, Mental Disorders, Parenting, Poverty, Risk, Socioeconomic Factors, South Africa

  • Cash transfers-magic bullet or fundamental ingredient?

    2016
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    Journal article
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    The Lancet. Global health
    • More

Lucie Cluver - CV (March 2019)

For information about new project 'Hey Baby', please go here.

Lucie's previous DPhil students have gone on to be successful in academia, policy and practice:

  • Caroline Kuo (2010) - is an Assistant Professor of Behavioral and Social Sciences in the Center for Alcohol and Addiction Studies at Brown University
  • Lena Saleh (2012) - is the Director of Program Planning in HIV Prevention in the New York City Department of Health and Mental Hygiene
  • Tyler Lane (2013) - is a research fellow in the Institute for Safety, Compensation and Recovery Research at Monash University
  • Franziska Meinck (2014) - is a postdoctoral researcher in the Centre for Evidence-Based Interventions at Oxford
  • Beth Vale (2015) - is a researcher in humanities at the Mapungubwe Institute for Strategic Reflection (MISTRA)
  • Jamie Lachman (2016) - is a postdoctoral researcher in the Centre for Evidence-Based Interventions at Oxford
  • Elona Toska (2017) -  is a postdoctoral researcher at the University of Cape Town

Lucie would welcome applications for D.Phils from students who are committed to policy and programming-relevant research and to helping mitigate the impacts of HIV/AIDS and family distress on children in sub-Saharan Africa.

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