Strengthening HIV-Affected Families

In sub-Saharan Africa, healthcare delivery for HIV developed almost exclusively through vertical infrastructures. Research has found families affected by HIV face numerous challenges not addressed by current vertical structures, which alone struggle to promote ART adherence. Food security, income, family functioning, and social support among HIV+ caregivers, and higher levels of abuse, neglect, school dropout and street-migration among children in HIV-affected families threaten family well-being. As the HIV pandemic transitions to a chronic phase, vertical infrastructures must expand to include a variety of family strengthening activities. This grant funds a structural intervention working in tandem with an established HIV clinic in rural Kenya to strengthen families through a standardized curriculum including two serial phases: first, positive parenting and relationship strengthening skills will be taught, and second, a system of self-help groups will be established. This innovative combination utilizes approaches previously validated in sub-Saharan Africa to a new population. Self-help groups have proven effective at increasing income, food security, healthcare access and social support. Positive parenting and relationship strengthening can improve family outcomes. This proposal paves the way for a new cadre of services to accompany HIV clinics across rural sub-Saharan Africa, potentially increasing ART adherence along with multi-sectoral improvements in family wholeness.