Project Description

The Sustainable Development Goals (SDGs) are a commitment by countries worldwide to improving the lives of all, through achieving specific targets related to the promotion of economic, social, and environmental wellbeing by 2030 (Lee et al., 2016). Many of the 17 goals are linked to poverty and health, focussing on vulnerable, hard-to-reach, and marginalised people. Adolescents are a key target population for the SDGs, but research studies and programmes rarely include their direct perspectives on how to promote health and wellbeing (Hodes et al., 2018a). In the context of HIV research, growing evidence has shown that adolescent populations are particularly vulnerable, with high rates of defaulting (non-adherence) on antiretroviral treatment (ART) (Kim et al., 2017, Cluver et al., 2018b). Research has also shown that adherence to HIV treatment is not just linked to the provision of medication and healthcare, but also to other factors such as the provision of “cash/cash in kind” (e.g. government cash transfers, food security, school fees/materials, school feeding, clothing), and “care” (HIV support groups, sports groups, choir/art groups, positive parenting and parental supervision/monitoring, and access to health facilities) (Young et al., 2014, Singer et al., 2015, Cluver et al., 2016).

The Mzantsi Wakho study, the largest longitudinal, community-traced, mixed methods cohort study of adolescents living with HIV to date, has followed more than 1500 adolescents living in the Eastern Cape, South Africa, over a period of five years. The study looks at their lived experiences in high-HIV prevalence communities, specifically with regard to adherence to ART and sexual and reproductive health. In this report, we look at longitudinal changes between baseline and the first year of follow-up in this cohort of HIV-positive adolescents as well as ‘community controls’ (whose HIV-status was negative or unknown), to assess whether their lives are improving in specific relation to the relevant SDGs. This allows us to examine whether existing policies in South Africa are supporting adolescents in achieving the SDGs by 2030.