Centre for Research in Health systems

The purpose of VUKA EKHAYA is address the urgent need for empirically informed, effective and scalable interventions that promote adherence to antiretroviral therapy (ART) and retention in care for the more than 3.3 million HIV+ children diagnosed before 15 years of age, the majority perinatally infected (pHIV+) and living in low and middle income countries (LMICs). Adherence to treatment and care remains a primary barrier to maximizing the potential of ART. VUKA EKHAYA (meaning VUKA at home in Zulu), will test strategies to lower the implementation burden on LMIC health systems by replacing six in-person VUKA meetings with a set of six take-home booklets and motivational text messaging supports to reduce in-person contacts, given clinic staff shortages and constraints on the time of caregivers and youth. VUKA EKHAYA will add knowledge regarding options for large scale implementation and scaling across SA. It is expected to enhance: a) rate of at home discussions regarding intervention content; b) Participation of adult family members not attending VUKA sessions, but may be supporting use of VUKA materials at home; c) Medication adherence and; d) Attendance at clinic appointments.

This study capitalizes on a NICHD-funded VUKA Family Program intervention that is in its final year of implementation and managed through Inqubate. It is the only known adherence intervention for LMIC pHIV+ youth that is theory driven, evidence-informed, integrated and tested within low resource clinics. Analysis will use both current VUKA data and VUKA EKHAYA data to compare programme effects.

A significant amount of materials in the form of facilitator manuals and booklets have been developed using a storyline depicted through a series of cartoons in the parent VUKA and will be utilized for VUKA EKHAYA as well. The manuals and booklets have been translated into Zulu.