1. CASH + CARE FOR ADOLESCENT HIV RISK REDUCTION
in DREAMS, Global Fund, 4Children, UNICEF and INSPIRE:
CLUSTER RCT OF PARENTING FOR LIFELONG HEALTH
L. Cluver, F. Meinck, J. Doubt, C Ward, C Lombard, Y Shenderovich, J Steinert, R Herrero Romero, S Medley, A Redfern, N Salah, S De Stone, L Ncobo, J Lachman, S Tsoanyane, H Loening, J Byrne, L Sherr, M Casale, F Gardner, C Wittesdale, R Catanho, S Hoeksma, C Mikton, A Butchart, J van der Wal, K Nocuza , M Pancoast, M Danisa, I Wessels, N Mukadah.

2. 2016-18 Pragmatic Cluster RCT, Rural South Africa. N=1100
Reducing violence/economic strengthening
Monitoring and praising teens
Family problem-solving
Family budgeting and saving
Safety planning
2015 Pre-post test
N=230
2014 Pre-post pilot N=60
Local community, trained by local NGO
Village halls, churches, under trees (14 weeks)
40 villages & urban sites
Stratified cluster-randomised, 9m follow-up
2013 Community consultation N=150
2012 Systematic review

3. Impacts on structural drivers of adolescent HIV
Positive intervention effects
IRR/d (95% CI)
Less violence
IRR.55 (.4,.75)***
More positive parenting
d.25 (.03,.47)*
More involved parenting
d.86 (.64,1.1)***
Less poor supervision
d-.05 (-.7,-.03)***
Less corporal punishment
d.-46 (-.7,-.24)***
Less depression (carer)
d-.33 (-.5,-.11)**
Less parenting stress
d-.37 (-.6,-.15)***
Less alcohol/drug use (carer)
IRR.67 (.49-99)*
Less alcohol/drug use (teen)
IRR.55 (.33-93)*
More social support (carer)
d.31 ( )**
More planning to protect
teens in the community
d.48 ( )***
Less shortfalls of food
d-.62 ( )***
More family savings
d.31 ( )**
Negative effects
None
No intervention effects
Neglect
Inconsistent discipline
Depression (adolescent)
Behavior problems
Community violence exposure
Cluver, L, Meinck, F, Steinert, J, et al (2018) BMJ Global Health.

4. Integration of HIV & violence prevention programming
Cameroon
Cote D’Ivoire
DRC
Haiti
India
Kenya
Lesotho
Malawi
Nigeria
Philippines
South Africa
South Sudan
Swaziland
Tanzania
Thailand
Uganda
Zimbabwe
Say it’s from RCTs and pre-post
No need for any numbers or words on pic at all

5. Thank you.