The overall aim of this project is to optimise the impact of an intervention to improve family functioning and support on individual health. The intervention is directed at (1) stimulating positive household communication and creating HIV competent households, through (2) optimising the impact of CHW support on individual ART adherence. The project integrates two theoretical perspectives: the Individual-Household-Community (IHC) framework and HIV competent households. The IHC framework allows for comprehensive HIV research in high prevalence and resource-limited settings. The theoretical concept of an HIV competent household recognises the household as a potential health-enabling or health-impeding environment in which the patient can be supported across the care continuum in a sustainable manner.
The project is a collaboration between SoPH and CELLO, University of Antwerp. The project has a SARCHI-linked post-doctoral fellow and three project funded PhD students attached. Funding for the project is from VLIR-UOS and FWO.
A systematic review will be conducted assessing interventions targeted at ART and HIV competency in Low and Middle-income countries within HIV-affected households. Development of the intervention will be guided on the premises of the systematic review, and will be delivered using a cluster randomised control trial (RCT). The study will be conducted in the Western Cape Province of South Africa, accessing the sub-districts of Khayelitsha, Klipfontein and Mitchell’s Plain located in the city of Cape Town.
Twelve health care facilities will be randomised into 2 Arms; those receiving standard CHW delivered HIV adherence support, and those receiving the HIV-household intervention programme, delivered by the CHW. Community health workers will be the primary actors in the cluster RCT and are employed by our project partner TB/HIV Care.