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Building protection and resilience: HIV-sensitive child protection systems

Building protection and resilience: HIV-sensitive child protection systems. A decade of work: the UK responds to children and young people affected by HIV and AIDS London, 3 April 2014. Why this study? . 20 million children impacted by HIV globally

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Building protection and resilience: HIV-sensitive child protection systems

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  1. Building protection and resilience:HIV-sensitive child protection systems A decade of work: the UK responds to children and young people affected by HIV and AIDS London, 3 April 2014

  2. Why this study? • 20 million children impacted by HIV globally • 500 million – 1.5 billion children experience some form of violence or abuse each year • Neglect – no global data; US figures estimate ¾ of maltreatment are physical or other neglect • Growing evidence of two-way link between HIV and child protection… • … but linkages not yet being made

  3. Child protection systems - opportunities • Growing focus on child protection systems strengthening • Shift from single-issue interventions to systemic framework • Systems lens identifies what is needed to provide a protective environment for children at all levels • Situate child-focused HIV responses within long-term, locally-owned and sustainable approaches • HIV forces greater focus on family, stigma etc

  4. The IATT study • Aim - better understand how CP and HIV sectors can give greater attention and effectively respond to needs of children especially vulnerable to, living with and affected by HIV • Focus on CABA crucial to development of a strong child protection system that is equitable and reaches the most vulnerable children

  5. emerging evidence

  6. What the evidence shows • HIV impact can increase risk of serious child protection violations • HIV+ caregiver / AIDS orphanhood increases risk of physical / emotional abuse, behavioural problems • Exclusion from social networks and protective environment • Children of HIV+ mothers higher risk of abandonment & institutionalisation (concentrated epidemics).

  7. What the evidence shows • Child abuse, violence and exploitation can increase risk of acquiring HIV • Childhood abuse linked to higher HIV & herpes rates in adult men & women • Childhood sexual abuse linked to higher rates of / earlier initiation into exploitative sexual behaviours, injecting drug use, sex work • Disability & HIV links underexplored but strong and relate to protection issues

  8. Systems lessons

  9. Risks are cumulative … requiring a ‘cumulative’ (long-term) response

  10. Need to focus on the positive • AIDS-orphaned / affected children show wellbeing despite adversity - Kenya, Tanzania, SA, Uganda • HIV-affected children more able to cope with emotional shocks when feel supported by family or community - South Africa, Kenya, Rwanda • Peer and social groups essential to positive wellbeing • Early HIV testing & PMTCT provision correlates with decreased abandonment of newborns – CEE/CIS • Open communication about sexuality and prevention of HIV appear to minimise sexual risk taking, including in alternative care settings – North America, CEE/CIS

  11. Practical actions

  12. Legal and regulatory frameworks HIV Child protection

  13. Sharing monitoring and evaluation information HIV Child protection

  14. Service delivery – statutory health & child protection Child protection HIV

  15. Service delivery – community-based CABA care Child protection HIV

  16. Answering some evidence gaps • Need child-specific definition of HIV stigma • Linked CP/HIV risks for children with disabilities • Treatment neglect for children living with HIV • Protection-related experiences of children living with HIV in emergency contexts • Extent and nature of abuse and violence experienced by children living with HIV, including those in residential care • Household-level resilience & protective factors for key populations in concentrated epidemics • Child protection experiences of children who do not fall into some form of family or alternative care ‘system’ of e.g., street-associated, injecting drugs, selling sex

  17. Looking forward • Integration of CABA into child protection systems builds sustainability & national ownership (where CP systems being strengthened) • Especially for long-term outcomes for HIV-affected households • HIV and violence against children – both sectors need to look at the linkages for mutually improved outcomes • CABA community have expertise to offer the child protection sector e.g. adolescent programming, gender violence • IATT undertaking second phase to identify promising HIV-CP synergies

  18. Thank you! Thanks to IATTCABA, especially to UNICEF and WVI for technical & financial support www.iattcaba.org

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