Out of sight, out of mind: children affected by HIV/AIDS in India

Hundreds of thousands of Indian children are living with HIV/AIDS.  Many more are otherwise seriously affected – when they are forced to leave school to care for sick relatives or work in their place, or when they are orphaned. Yet HIV/AIDS-affected children are nearly invisible in India’s response to the country’s burgeoning epidemic.

Mother-to-child transmission is the most common source of HIV infection among very young children, though transmission also occurs through sexual contact, blood transfusions and unsterilised syringes. The number of children living with HIV/AIDS has not been adequately measured, but some estimate more than a million children have lost one or both parents to AIDS.

Children affected by HIV/AIDS may be discriminated against by schools and medical personnel, denied care by orphanages and pushed onto the streets and into the worst forms of child labour. Many children living with HIV/AIDS do not have even the most basic health care. This is particularly true for girls, who are also more vulnerable to HIV transmission when they are targeted for sexual abuse, are pulled out of school or never sent at all, or are unable to demand condom use. Children, as well as the professionals who care for them, are not getting the information about HIV they need to protect themselves or to combat discrimination.

A report from Human Rights Watch (HRW) documents abuses against India’s HIV/AIDS-affected children and calls on the government to take action to protect them. Important findings include:

• Government HIV/AIDS programmes generally focus on adults such as sex workers, truck drivers and drug users, but blame people living with HIV/AIDS for their ‘bad behaviour’.
• Children living with HIV/AIDS or whose relatives are HIV-positive face discrimination in schools, health care facilities, orphanages, and from their own families.
• Many people, including those who look after children, do not know how HIV is transmitted. HIV/AIDS education is not offered in most schools and where it is, tends to be incomplete and taught from grades eight (age 14) or later, by which time most children (especially girls) have dropped out of school.
• Fear of discrimination discourages people from doing anything that might identify them as HIV-positive, such as getting tested, seeking treatment, or taking steps to protect others.
• Children already facing other forms of discrimination, such as that directed at sex workers and their children, street children, and children from lower castes and Dalits (‘untouchables’), suffer even more.
• Government officials frequently dismiss the possibility of children engaging in behaviour that puts them at risk and see orphanages as the first and only solution for children whose families are unable to care for them.

HRW urges the Indian authorities to:

• make discrimination on the basis of HIV status illegal, and set up procedures for victims to get help
• provide comprehensive and accurate information about how the disease is transmitted, to overcome the widespread misperception that HIV can be transmitted by casual contact, including age-appropriate information for children to protect themselves against HIV transmission
• find alternatives to placing children in institutions such as orphanages, including fostering and other forms of community-based care
• address gender discrimination in employment, inheritance, property laws, education, and health care that make women and girls especially vulnerable to HIV transmission and make it harder for women to care for their children
• ensure children are not excluded from or discriminated against in schools or health care facilities because of their HIV status or that of their guardians.

Source(s):
‘Future forsaken: abuses against children affected by HIV/AIDS in India’ by Zama Coursen-Neff, Human Rights Watch, July 2004 Full document.

Funded by: Oak Foundation, Independence Foundation, Ford Foundation, Ladenburg Foundation

id21 Research Highlight: 5 May 2005

Further Information:
Zama Coursen-Neff
Children’s Rights Division
Human Rights Watch
350 Fifth Avenue, 34th floor
New York
NY 10118-3299
USA

Tel: +1 (212) 216-1826
Fax: +1 (212) 736-1300
Contact the contributor: neffzc@hrw.org

Human Rights Watch, Children's Rights Division

Other related links:
'Deadly inheritance – death rates among babies of HIV-infected mothers'

'Where have all the babies gone? HIV and fertility in Uganda'

'Helping older people who care for grandchildren orphaned and affected by AIDS'

'Reducing infant and child mortality: what are the ways forward?'

'HIV/AIDS, children and young people' from ELDIS

UNICEF information on HIV/AIDS