Assistant Professor Latoya Small has received a $150,000 grant to support research in South Africa aimed at empowering HIV-infected youth to maintain their medicine regime, avoid risky behaviors and encourage family members to fully participate in their healthcare.
The International AIDS Society’s Collaborative Initiative for Paediatric HIV Education and Research is funding the two-year project, which is expected to launch this fall. Small’s study builds off of a larger study for which the researcher has been project director for the past four years. The original study, “VUKA Family Program,” is funded by the National Institutes of Health and tests the impact of a cartoon-based intervention that was designed to reduce adolescent risk taking among perinatal HIV-infected youth and promote overall physical and mental health. A total of 360 youth, ages 9 to 14, and their caregivers from poverty impacted communities in and near Durban, South Africa, are expected to participate in the larger study over a five-year period.
Small’s study, which could involve up to 60 participants, will examine the impact of a condensed version of the original intervention. The primary goal is to compare rates of engagement and outcomes for a version of VUKA that could potentially be expanded to meet the serious needs of HIV-positive youth and their families.
Currently, participants in the larger study attend 10 weekly group sessions at a hospital or clinic where, with the assistance of a lay counselor, they discuss the comic strip’s main character, Themba, a pre-teen who was orphaned after his mother died of AIDS. Themba moves in with extended family members, some of whom are not happy that he is there.
Each week, Themba faces a different challenge, such as a scenario about whether to kiss his girlfriend or tell her about his HIV-positive status.
“The comic strip and the accompanying counseling sessions help to break down complex social, mental and medical information for youth and their families around select topics, including disclosure, self-esteem, sexual risk and substance abuse,” Small said.
However, because of logistical challenges, including a lack of transportation and limited medical facilities, some participants struggle to attend weekly sessions and often miss regular medical appointments, which is when they usually receive needed drugs, Small added.
“There are not a lot of clinics or hospitals out there and the ones that are there have waiting rooms full of people,” she explained. “There are only a handful of nurses and the doctor isn’t there everyday. So everyone can’t come frequently (to the sessions) because they can’t take time off of work or they can’t get transportation and they have responsibilities and other children that they can’t always leave behind. But they don’t feel comfortable bringing them with them either.”
These challenges are why Small wants to test the impact of offering participants in her study fewer group sessions supplemented with take-home materials and motivational text messages. With these changes, Small hopes that participant attendance with the intervention will increase, youth adherence to their medications will increase, and families will feel more comfortable talking about HIV with their children.
“Part of the reason why our study youth are so young is because we’re trying to get them before they hit the stride of adolescence,” she said. “That way, when a lot of them come upon the challenges of engaging in sexual behavior or substance use, they will at least know about the risks they are subjecting people around them to as well as the risks to their own bodies.”