By Judy Ho, International Ministry Officer, World Vision Hong Kong
HIV, the human immunodeficiency virus that causes AIDS, is no longer a death sentence, but rather it is a chronic disease. UNAIDS announced that people living with HIV virus today could expect to live two decades more than those who were diagnosed in the 1980s. The medical innovation of antiretroviral therapy has enabled people living with HIV to have a normal, healthy life whilst preventing the spread of the virus. However, not everyone could enjoy the privilege of going about their lives as normal after discovering their HIV-positive status.
Today, close to 37 million people are living with HIV and 70% of them live in sub-Saharan Africa, yet only less than half of them have access to antiretroviral therapy. Although the number of new HIV infection among children has fallen by 58% since 2000, children remain as the most vulnerable group ‐ only one-third of them received the deserved treatment in 2014. For children, the most detrimental impact of HIV is the loss of parents.
Children orphaned by AIDS account for 25 million, where 85% live in sub-Saharan Africa. Majority of the children living with HIV are infected from mother-to-child transmission during pregnancy, childbirth or breastfeeding.
Because of cultural stigma, children living with HIV or those who have lost their parents to HIV are often being mistreated by their caretakers or extended family. Not only do they not receive the treatment and protection needed, but also they often experience violence at home, psychological, sexual and physical abuses, and are forced to engage in child labour. These negatively affect children’s access to HIV testing and treatment, leading to high treatment dropout rate and poor adherence to medication.
As a child focused organisation where child protection is a top priority, World Vision strives to prevent and respond to exploitation, neglect abuse and other forms of violence affecting children through effective measures. In fact, there are already low-cost, family-focused and community-based approaches in place that can effectively protect children from HIV stigma and discrimination, which, in turn, can help to reduce the unnecessary barriers to the access of HIV care and treatment.
In Zambia, programmes have focused on making sure that all children are treated in the same way. They play, live and eat together. Children with HIV would receive antiretroviral therapy in the same setting with other children who are receiving vitamins or other medications. Recognising that stigma is an issue, the programme staff work relentlessly on helping the HIV-positive children to build a positive self-image. One young caregiver advises those caring for HIV-positive children, “First they should show these children that they are loved [and] that being HIV-positive is not the end of life.”
Another form of stigma is the cultural taboos on talking about HIV. Even though children wish they could openly discuss with their family members about HIV, they are often being ignored or rejected. The ability to communicate and to be heard is important in strengthening child resilience and minimising their exposure to risks. This is an area where interventions, such as home visits and case managements, are most effective in addressing.
Attaining an AIDS-free generation depends on the creation of stigma-free environment in the society. Hence, to reach the ambitious goal of eliminating the AIDS epidemic as a public health threat by 2030, more efforts in medical achievement only would not be enough. It must be complimented by child protection responses to ensure that no child is needlessly exposed to the risk of acquiring HIV; and that no child living with HIV is denied his or her right to HIV treatment, care and the support necessary to live a healthy and independent life.