HIV-infected Children in Africa Face Stigma. 09/01/2010

 Children face stigma, inadequate treatment and heightened vulnerability

The stigma facing adults living with HIV has been the target of extensive advocacy, law reform and awareness-raising. However, the stories of children living in Africa with HIV are often not told, despite the fact that they face similar stigma, inadequate treatment and heightened vulnerability when orphaned by the epidemic.

A study presented at a regional consultative meeting on HIV law reform in East Africa held in Arusha, Tanzania in early December, has revealed an absence of laws and policies preventing HIV-stigma against children in States of the East Africa Community (EAC). Conducted by Africa Vision Integrated Strategies on behalf of the Eastern African National Networks of AIDS Service Organizations, the study found that in addition to the absence of legal protections, there is not enough awareness about HIV and AIDS in schools, with some teachers doubting students’ HIV status or questioning students for taking anti-retrovirals (ARVs). As a result, children living with HIV/AIDS do not want to attend, and if forced to do so, face difficulties in concentrating, performing and staying in school.

The EAC is moving towards a common response to HIV/AIDS across Uganda, Kenya, Tanzania, Burundi and Rwanda, with free access to ARV treatment for citizens infected by the virus traveling across the five states. Commenting on the needs of children living with HIV, Allan Achesa Maleche of Africa Vision Integrated Strategies noted the importance of making specific provisions that cover children when legislating on HIV-related issues. “This is fundamental as children’s issues raise special concerns as compared to those of adults…It is thus imperative to have specific clauses that directly address the human rights concerns of children in the context of HIV and AIDS.”

A further problem facing children living with HIV in the EAC is a severe shortage of services. Kenya has as a law providing for free treatment and counseling for HIV-positive people. However, according to a  Human Rights Watch (HRW) report released on World AIDS Day concerning HIV treatment for children in Kenya, only about half of those Kenyan children infected with HIV have access to treatment. Over the last year, the number of HIV-infected children on ARVs in Kenya has risen to about 28,000. However, a lack of access to adequate nutrition increases risks for all infected children of dying of the disease. The report also found that while overt discrimination in Kenyan schools is somewhat reduced, children continue to face more subtle forms of discrimination, with many students feeling the need to hide their HIV status from teachers and fellow students and for those living in boarding schools, secretly taking ARV drugs.

Children orphaned as a result of AIDS, many of whom themselves are HIV-infected, need to tackle further prejudice. The number of children orphaned after their parent(s) died from AIDS reached 15.2 million children worldwide in 2005. HRW documents violation of property rights (including disinheritance of AIDS orphans in Kenya), labor exploitation, sexual harassment and abuse, and violence for AIDS orphans living with non-parent guardians.

The new proposed law on HIV/AIDS for the EAC would be the second in Africa after the Southern African Development Community (SADC) developed a Model Law in November 2008 that provides for a comprehensive framework for harmonizing HIV and human rights issues in southern Africa. However, this leaves many West Africa nations which face similar challenges. According to figures released by USAID, AIDS orphans in West Africa face not only a lost childhood but increased health problems related to inadequate nutrition, housing, clothing, and basic care. The problem is particularly serious in Nigeria, where almost 1 million children have lost one or more parents to HIV/AIDS, while UNICEF’s child information database from 2007 documents 420,000 children in Côte d’Ivoire and 300,000 children in Cameroon having lost one or both parents to the epidemic.

In Burkina Faso, stigma manifests itself in reticence to get children HIV-tested. A Joint UN Program on HIV/AIDS estimated that as of 2006, 10,000 children were infected with HIV in Burkina Faso, with 4,600 needing anti-retroviral drugs.  However, according to the government’s national HIV and sexually transmitted diseases council, only 46 percent of HIV patients in Burkina Faso who required treatment as of June 2009 – 23,000 people – are taking anti-retroviral drugs. The reluctance to be tested and deal with the potential HIV-status is so great that one pediatrician working in the capital Ouagadougou notices that parents, themselves who have not been tested, sometimes leave the hospital in the middle of the night with their untested children.

Most people are aware that laws and policies alone cannot reverse the stigma facing people living with HIV. However, the EAC’s efforts to pass a regional law on HIV/AIDS are momentous given that the new law will attempt to address some of the most contentious and concerning provisions within each member states’ laws. This includes Uganda, plagued by its draft anti-homosexuality bill, as well as the Penal Codes of Kenya, Rwanda, Burundi and Tanzania that prevent sex workers and homosexual men from accessing treatment. In the process of developing the new law, it is essential that the rights of children living with HIV are not left off the radar. Denied access to health care and schooling and facing discrimination by teachers, continued exclusion from legal protection will only
act to isolate them further. Legal protection can help to prevent a life of discrimination from a very young age and provide greater guarantees for the basic rights of these children.