A cash transfer plus gender transformative economic empowerment intervention seeking to improve the wellbeing of caregivers of children and adolescents living with HIV in South Africa: a feasibility study protocol for a pilot cluster randomized trial
Bibliographic record
Abstract
Abstract Background In sub-Saharan Africa, HIV care is dependent on informal caregiving, typically by female family members. Informal caregiving has been associated with numerous negative effects on caregivers (i.e., depression, intimate partner violence (IPV), financial insecurity). These factors impact caregivers’ ability to provide care and their own wellbeing. South Africa is home to approximately 17% of the world’s children and adolescents living with HIV (CALHIV), making the development of initiatives that mitigate the negative effects of caregiving critical. This protocol details the design of a cluster randomized trial seeking to assess the feasibility, preliminary effectiveness, cost-effectiveness, and acceptability of a cash transfer plus gender transformative economic empowerment intervention for improving psychological wellbeing, depressive symptoms, gender equality, and economic outcomes of caregivers of CALHIV. Methods Caregivers of CALHIV will be recruited from public sector HIV clinics within the eThekwini Municipality, KwaZulu-Natal, South Africa. Clusters will be randomly assigned to intervention or control groups. Participants in the intervention arm (n = 120) will receive cash transfers (ZAR350, USD $18.79) and enroll in a program (10 workshop sessions) over a 6-month period. Participants in the control arm (n = 120) will receive a monthly cash transfer (ZAR350, USD $18.79) for a 6-month period and a once-off standard mobile message, encouraging linkage to healthcare services. Participants will be interviewed at baseline and endline, at the 7-month mark, to collect socio-demographic, health and wellbeing status, IPV, costs and earnings, and food security data. The primary outcomes include consent rate, overall retention rate, workshops retention rate, cash transfer protocol adherence, staff perceptions on implementation, psychological wellbeing, depressive symptoms, and IPV. A qualitative study and economic evaluation will be conducted alongside the main trial to probe participant perceptions of the intervention and assess cost and cost-effectiveness. Discussion This trial has the potential to inform a larger confirmatory trial which will be valuable for informing post-pandemic recovery efforts for caregivers of CALHIV and others disproportionally burdened by compounding health and social crises. Trial registration PACTR202311618532061. Registry name: Pan African Clinical Trial Registry (PACTR), retrospectively registered on November 21, 2023; The first participant was enrolled on August 24, 2023.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.014 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.039 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".