HIV-infected Children in Africa Face Stigma, Discrimination

Little attention is paid to the stigma, discrimination and heightened risks faced by children orphaned by AIDS.

“Many people suffering from Aids and not killed by the disease itself
are killed by the stigma surrounding everybody who has HIV/AIDS”

-Former South African
President Nelson Mandela

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.