By Chiara Frisone
On 29 November, UNICEF released Children and AIDS: Sixth Stocktaking Report, the first report of its kind since 2010.
An AIDS-free generation once seemed like a far-off dream. But, now, the world has what it takes to make this dream a reality. Advancements in preventing mother-to-child transmission of HIV have greatly decelerated the rate of new infections in babies in low- and middle-income countries. However, the same progress has not been seen in treatment for children living with HIV, and the trajectory of AIDS deaths among adolescents living with HIV remains alarming.
NGOs like OFACI can mean the difference between total isolation and care and support, for adolescents living with HIV in Côte d’Ivoire.
ABIDJAN, Côte d’Ivoire, 4 December 2013 – Coming to terms with HIV has not been easy for 13-year old Jean Sangaré*. Shy and soft-spoken, he is not completely at ease with telling others about the complexities of growing up with HIV.
“When I learnt I was HIV positive, my mother’s big sister told me not to tell anyone because there are some people who, when they hear that you’re HIV positive, they don’t want to get close to you,” he says.
“People here don’t know what HIV is, and, when they find out you are HIV positive, they don’t want to have anything to do with you.”
High prevalence, prevalent stigma
According to the Demographic and Health Survey on HIV Prevalence 2011–2012, Côte d’Ivoire has the one of the highest HIV prevalence rates in West Africa – 3.7 per cent. HIV Specialist with UNICEF in Côte d’Ivoire Dr. Jean Konan Kouamé says that such high infection rates can be attributed to “early sexual debut, ignorance about how HIV can be transmitted and limited access to HIV prevention and treatment services”.
According to recent data, 88 per cent of the population has never taken an HIV test. Dr. Kouamé believes that this is “because people do not know that if they know their HIV status they can access a treatment that allows them to live longer and healthy lives”.
Stigma associated with HIV is such that people living with the virus like Jean are reluctant to disclose their status – even to their immediate family. Stigma can result in isolation and loneliness, which makes it difficult to access care, treatment and support services available to them.
Support for Jean
Jean has lost both his parents. He lives with his aunt in Abidjan, the largest city in Côte d’Ivoire.
Jean came out of isolation when he met Cécile Traoré, a support worker with Femmes Actives de Côte d’Ivoire (OFACI), an NGO that provides support to children and women living with HIV. Ms. Traoré pays regular visits to Jean in his home. She checks whether he is taking his HIV medication correctly and lends him a friendly ear.
“Adolescents need social, physiological and moral support. They need someone to confide in and share their life experiences with,” says Ms. Traoré. “It’s not easy to support an adolescent because they need to be monitored continuously,” she adds. “Otherwise, they let things go.”
With the help of Ms. Traoré, Jean joined a support group for children living with HIV. The group provides children with a safe space where they can share their experiences, learn life skills and forge new relationships.
“During the meeting, we’re asked questions, we draw, we talk about what’s going on in our lives – and we are given advice,” says Jean.
“I feel very good – I feel at ease because I’m with children who have the same HIV status as me.”
Age of adolescence
Adolescence is a difficult period of transition from childhood to adulthood that is characterized by physical and sexual maturation, movement toward social and economic independence, and development of identity.
Health services in Côte d’Ivoire are not always equipped to provide care and support that take into account the specific needs of adolescents living with HIV; the age group can be left in limbo between child and adult care. According to Dr. Kouamé, only a small proportion of adolescents who are long-term survivors born with HIV have access to antiretroviral treatment. Most of these youths receive it through limited numbers of specialized centres in urban and peri-urban settings.
NGOs like OFACI play a key role for adolescents. Thanks to Ms. Traoré, Jean has been able, gradually, to come to terms with being an adolescent living with HIV and to learn the importance of adhering to antiretroviral treatment. Through the support group, he has met other children with whom he can talk freely about common concerns in a non-judgmental environment.
“If a young person who is HIV positive has no one to support them, they need a lot of support from their family or an NGO,” he says. “Otherwise, they are going to think a lot about negative stuff and stress about the fact that they have HIV.”
*Name has been changed.
In Côte d’Ivoire and across the African continent, adolescents face many barriers to accessing health and support services, and they are routinely neglected in national and global HIV/AIDS strategies.
Opportunities for greater success in reducing the impact of HIV on adolescents lie in increasing demand for, access to and uptake of key interventions. Barriers to accessing services must be removed, while the social and economic factors that increase adolescents’ vulnerability to HIV must be addressed.
Only by making the most of these opportunities will an AIDS-free generation be achieved.