Prof Maretha Visser of the Department of Psychology collaborated on the development of a family strengthening and HIV prevention programme for adolescents and caregivers. The programme aims to improve the relationships and mental health of, and reduce HIV risk among, adolescents affected and orphaned by HIV throughout South Africa.

The programme, called 'Let's talk', was initiated by Tulane International to fill a need identified in the population of orphans and vulnerable children. It was developed in collaboration with Dr Michelle Finestone of UP's Faculty of Education and funded by the United States Agency for International Development (USAID).

Prof Visser explains that Tonya Thurman, Director of the Highly Vulnerable Children Research Center at Tulane University, asked a team of academics from UP to develop the programme. 'We were approached to do the project based on our previous work in the Kgolo Mogo project, where we developed a caregiver-child intervention for HIV-affected children between the ages of six and ten years.'

The research done for the 'Let's talk' programme focusses on an important need in communities and can contribute to the wellbeing of a large number of caregivers and adolescents. The programme for caregivers helps parents/caregivers to cope with their own emotions and to develop the skills necessary to develop an understanding relationship with the adolescents in their care. The parallel programme for adolescents assists the young people to cope with emotions, communicate their needs, develop a healthy relationship with their caregivers and protect their health. The programme also provides training for caregivers to talk to their children about sensitive topics such as sex and preventing pregnancy. In the adolescent programme they learn skills to make healthy decisions and avoid risking HIV infection. 

'The population of HIV orphans and children living with parents affected with HIV is growing, with more than 3 million orphans and 6 million adults of child-bearing age living with HIV in the country. Thus, a large number of children are exposed to HIV in their own homes. Previous research shows that children exposed to HIV have more psychosocial problems than other children. They are also more exposed to HIV-risk behaviour than other children. Parents living with HIV experience stressors that affect their parenting capacity,' says Prof Visser. 

Previous research shows that interventions for children and adolescents did not have the same effect as interventions that involve the caregiver as well. Using a family approach, the behaviours that children learn in an intervention can be strengthened at home. 'The relationship with the caregiver is a primary relationship in the mental health of a child as well as in learning HIV-protective behaviour. If the mental health of the caregiver and the functioning of the family can improve, it can have a positive effect on the mental health of the adolescent. This can result in improved peer relationships and healthy decisions about risk behaviour.' 

The programme was piloted by seven community-based organisations in 13 caregiver and adolescent groups during 2015. Because of the positive reaction to the programme, it has been included in the DREAMS programme to be implemented in ten sub-Saharan countries, funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Bill & Melinda Gates Foundation.

For Prof Visser, the goal of the research project is to make a difference in the lives of the people involved. Therefore, the next step in the research will be to evaluate the effectiveness of the programme.