Africa is at the centre of the global HIV epidemic, and South Africa is one of the most heavily affected countries with one of the largest HIV treatment programmes in the world. The success of prevention and treatment in South Africa has led to large numbers of HIV-infected parents surviving to raise their HIV uninfected children, with up to 60% of children being raised by an HIV-infected primary caregiver, most frequently their mother. This raises concern about how HIV exposure may impact on children’s development and mental health. While vertical transmission in South Africa has been reduced to less than 3%, the incidence amongst adolescents has continued to rise, with emerging evidence suggesting that this generation of HIV-exposed and affected children are at greater risk of infection themselves in adolescence. To date, most interventions to reduce HIV incidence during adolescence in South Africa have demonstrated only marginal or no sustained effects.

This presentation focuses on parent and child mental health outcomes in one of largest longitudinal cohorts in Africa, with a particular focus on the critical transition from pre-adolescence into early adolescence; and introduces a family-centred intervention approach, which has been successful tested amongst HIV infected parents with pre-adolescent children.  Improving our understanding of how adolescent risk emerges is critical for both prevention and intervention. The Siyakhula cohort is one of only a few cohorts globally that includes both HIV-exposed, affected children and HIV-unexposed comparison group. It is the only cohort in Africa that includes objective tests of children cognition, and measured both parent and child mental health.

Dr Tamsen Rochat is a Wellcome Trust Intermediate Fellow in Public Health and Tropical Medicine in Developmental Pathways to Health Research Programme (DPRHU) at WITS where she is an Associate Professor. Her fellowship is focused on the role of cognitive development and mental health in risk behaviours, particularly violence, in early adolescence. She is also a Research Director in the Human and Social Development (HSD) research programme at the Human Sciences Research Council, in Durban, South Africa. Her area of interests and expertise are in children’s development and mental health in the context of HIV and adversity, with a special interest in developing interventions for families and parental mental health.