Meet the CIPHER grantees

Latoya Small

Year awarded: 2016
Institution: University of California, Los Angeles
Research site: University of KwaZulu-Natal, Durban, South Africa
Primary mentor: Mary McKay, Brown School at Washington University in St Louis

Latoya Small’s research focuses on health disparities related to mental and behavioural health for women and children with HIV, within the context of poverty. Her research is based in South Africa and the United States.

More information on Latoya | Email

“The CIPHER funding has helped me learn about the intricacies of implementing an international grant from an administrative perspective. Along with learning about culture and collaboration, the completion of contracts, sub-awards and multiple ethics approvals have helped better prepare me for this work. The capacity of meeting these multiple demands is an integral part of my development as I continue to grow my research in sub-Saharan Africa.”

Research project: VUKA EKHAYA: A take home family intervention to improve adherence and reduce behavioural risk among youth living with perinatally acquired HIV

The issue

Adherence to treatment and care remains a primary barrier to maximizing the potential of ART. This also applies to the more than 3.3 million children diagnosed with HIV before 15 years of age. Most acquired HIV perinatally and live in low- and middle-income countries (LMICs). The KwaZulu-Natal province of South Africa has one of the highest HIV rates in the world.

The CIPHER project

The project, being conducted in KwaZulu-Natal, is aimed at addressing the urgent need for culturally relevant, empirically informed, effective and scalable interventions that promote adherence to ART and retention in care for children with HIV. It capitalizes on a NICHD-funded study, “VUKA Family Program”. VUKA (which means “wake up” in Zulu) is a cartoon-based intervention that is theory driven, evidence informed, integrated and tested within low-resource clinics.

Dr Small’s variation is named VUKA EKHAYA (which means “wake up at home”). Her study tests strategies to lower the implementation burden on LMIC health systems by developing 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.

The impact

Dr Small expects that VUKA and VUKA EKHAYA will be associated with significant improvements related to youth medication adherence and clinic attendance. Some noteworthy aspects that have emerged are:

  • VUKA EKHAYA staffers are training lay counsellors to take over as group facilitators. The hope is to empower service providers, bolstering their relationships with children and families. The team anticipates that lay counsellors will provide better services for the caregivers and youth on their caseloads.
  • The team is developing ways to identify best practices for supporting caregivers as they disclose their child’s HIV status to them. This grew out of a need from caregivers not knowing how to tell their children about their HIV status. Many struggled with how to accurately inform their children about the types and purposes of the medications they were taking.