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HIV/AIDS And Children In India

By Joseph Gathia

09 July, 2008

New data reveals that HIV/AIDS epidemic in India is smaller than previous estimates.

But with the overall number of HIV cases still high – 2.47 million Indians have the virus- it is cause of concern. Chief among them is concern over the growing impact of the disease among children particularly girls.

Vast numbers of children across the world become infected with HIV every year. Without treatment, thousands die as a result of AIDS. In addition, millions more children who are not infected with HIV are indirectly affected by the epidemic, as a result of the death and suffering that AIDS causes in their families and their communities.

With an estimated 37.2 million adults living with HIV around the world, large numbers of children have family members that are living with HIV, or who have died of AIDS. These children may themselves experience the discrimination that is often associated with HIV. They may also have to care for a sick parent or relative, and may have to give up school to become the principle wage-earner for the family. When adults fall sick, food still needs to be provided ­– and the burden of earning money usually falls on the oldest child.

One of the harshest effects of the global AIDS epidemic is the number of orphans it has created, and continues to create. By the end of 2005, it is estimated that more than 15 million children had lost one or more of their parents as a result of AIDS. Some AIDS orphans are adopted by grandparents or other extended family-members, but many are left without any support. Child-headed households as a result of AIDS are common in some areas, with older children fending for their siblings and themselves. See our AIDS orphans page to learn more.

At the end of 2007, there were 2.5 million children living with HIV around the world.

420,000 children became newly infected with HIV in 2007.

Around 90% of all children living with HIV acquired the infection from their mothers during pregnancy, birth or breastfeeding.

Of the 2.1 million people who died of AIDS during 2007, more than one in seven was children. Every hour, around forty children die as a result of AIDS.

Despite the severity of this situation, many people still think of AIDS as something that affects adults. Some people occasionally think of 'AIDS babies' and children who have lost one or both of their parents to AIDS – AIDS orphans – are sometimes in the media. But since HIV, the virus that causes AIDS, is commonly transmitted through sex or drug use, people don't really think of it affecting children. It does, though – and millions of children around the world continue to have their lives damaged by HIV.

In India out of the identified 55,764 AIDS cases 2112 are children. India has the largest number of AIDS orphans and it number is expected to become double in next five years.

There are around 239 million adolescent in India which accounts for 22.8 percent of population as per last Census Report of 2001.The World Health Organisation defines Adolescents as young people aged 10-19 .Adolescents are no longer children ,but not yet adults .They are considered to be most vulnerable group as far as Sexually Transmitted infections (STIs ) is concerned. Rita Panicker, Director of NGO Butterfly informs that around 300,000 children in India are engaged in commercial sex.

There are conflicting reports about HIV/AIDS in India. But the experts largely agree that India has amongst the largest number of HIV infected people in the world, second only to South Africa. According to National AIDS control Organisation (NACO) the number of HIV infections in India in 2001 was 3.79 million which has been re-estimated to 2.47 million in 2007. The figure of 81 lakhs AIDS cases submitted by NACO to Parliament in 1998 has been subsequently scaled down to 38 lakh cases.

In most cases in India the infants or new born get infection through blood - via blood transfusions or needle sharing from mother to child. A pregnant woman can transmit the virus to her foetus through their shared blood circulation, or a nursing mother can transmit it to her baby in her milk

India has high percentage of street children, child workers and out of school children.

Several micro level studies in India on children and adolescents have shown high incident of sexual activity among them. It also indicated a perceived threat of HIV infection among children as main mode of transmission of HIV through sexual contacts

There are nearly 300,000 children in India who are engaged in commercial sex. According to Rita Panicker of NGO Butterfly apprxoimately18 million children work nr live on streets in India and a high percentage among them are sexually active.

One of the harshest effects of the global AIDS epidemic is the number of orphans it has created, and continues to create. By the end of 2005, it is estimated that more than 15 million children had lost one or more of their parents as a result of AIDS.

Losing a parent is terrible for any child, but children living in India who lose parents to AIDS face unthinkable hardships. Not only have they watched their parents die, but they are stigmatized for having been associated with HIV and AIDS and are often forced to fend for themselves and their siblings. The result is that a growing number of helpless children are facing a cycle of abuse, neglect, stigmatization, malnutrition, poverty and disease.

In addition to the impact of HIV and AIDS as a health issue, in India the repercussions go much further. Children orphaned by AIDS have less chance of gaining an education and getting access to healthcare. Their poverty and vulnerability to exploitation also significantly increases their likelihood of contracting HIV themselves.

Children are being turned away from schools, clinics and orphanages because they or their family members are HIV-positive. Human Rights Watch in its in depth report has listed number of cases of children who had been denied admission to school in —Tamil Nadu, Kerala, and Maharashtra.

The best-publicized case of children being denied access to school is that of Bency and Benson (their real names), two HIV-positive orphans in Kerala who were six and eight years old at the time I interviewed their grand parents in late 2003.

In contrast with the cases above, I also found instances in which well-informed NGOs and individual teachers had successfully educated school officials and other parents about HIV and gained the admission and acceptance of HIV-positive children. The director of a hospice in rural Tamil Nadu and NGOs in Chennai were able to get HIV-positive children into schools by educating school officials. While, these interventions were the exception, they demonstrate that discriminatory practices are not inevitable or cultural but instead can be and have been successfully challenged by courageous individuals.

So far two groups of children – infected (those who are HIV) and affected children (those who are member of an AIDS affected person's family) were in the focus of discussion. But now more comprehensive view is emerging.

Only in the mid-1990s did India start to acknowledge the worsening crisis, and the central government woke up to take action. But the response to children 'experiences with HIV/AIDS has been piecemeal, compared with the response towards adult.

Currently only a few Indian hospitals, all in the big coastal cities and far from the vast majority of infected citizens, are equipped to treat AIDS, and the cost of treatment is far too high for average citizens to afford. These factors, combined with the unwillingness of the government at the local level to take actions such as prevention awareness, converge to increase the likelihood of a future AIDS tragedy in India.

AIDS in India has been a taboo topic for years, and to a large extent it remains so today.

While in recent years the central government has become more involved in raising awareness of AIDS and taking steps to prevent and contain it, the local and provincial governments have been slow to follow suit. Often they make the situation more difficult by refusing to acknowledge the AIDS crisis as it might reflect poorly on them.

A study conducted by Save the Children Fund (UK) in Tamil Nadu reports growing impoverishment of AIDS affected families.

Very few rehabilitation homes are run for the children. In Maharshtra number of Govt child care homes does not take in infected children, a lacuna that needs to be urgently addressed.

"Many teachers, doctors, government officials and ordinary people in India still don't know the basic facts about HIV transmission and AIDS care," Rev. Fr. Alex of Catholic Bishops Conference (CBCI) said.

Addressing the children –HIV/AIDS interface call for a multi pronged holistic approach that operates simultaneously on micro and macro level. Situation is alarming in Nagaland, Manipur, Tamil Nadu, Andhra Pradesh and Maharashtra.

It is clear that much more needs to be done. Many children are dying, while thousands more are experiencing the scars that AIDS can leave on their lives – almost all of which are avoidable.

One area is research. There is a need to monitor the impact of HIV/AIDS on children, estimate the number of orphans, and finally to design child cantered prevention and rehabilitation policy..

Simply acknowledging the existence of these issues, let alone taking bold action on them, is challenging in a cultural environment that is inclined to minimize or ignore its problems, especially those related to traditionally "untouchable" topics like drugs, prostitution and homosexuality.

By now it is clear that in number of ways the spread of the HIV/AIDS is closely connected to processes of globalisation. It is clear that poor people, women, children and a range of marginalised groups are suffering .With G 8 stressing on technological approaches to solve the poverty issue it is unlikely that the HIVAIDS effect on children would be reduce. We are also still waiting for the G8 to enact their long-standing commitment to spend 0.7 per cent of GDP on overseas development assistance each year. We need civil society and grass root voices in developing countries to challenge their governments to tackle HIV/AIDS as merely a health issue. It is a human rights issue.

If we lose this fight, it will have profound impact on the lives of children in times to come.




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