Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS EMERGING EVIDENCE

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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).

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS SYSTEMS LESSONS

Inter-Agency Task Team (IATT) on Children and HIV and AIDS Risks are cumulative … requiring a ‘cumulative’ (long-term) response

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS PRACTICAL ACTIONS

Inter-Agency Task Team (IATT) on Children and HIV and AIDS Legal and regulatory frameworks Avoid punitive laws on HIV transmission that can drive young key populations underground; Require child protection (& ECD) links to ‘HIV sensitive social protection’ Include HIV impacts in child protection bills & policies HIVChild protection

Inter-Agency Task Team (IATT) on Children and HIV and AIDS Sharing monitoring and evaluation information Include children who are not routinely counted in national data e.g. DHS Collect data on boys & girls re sexual abuse Collect data on boys & girls re sexual abuse; link child abuse data to HIV-related GBV data. HIVChild protection

Inter-Agency Task Team (IATT) on Children and HIV and AIDS Service delivery – statutory health & child protection PMTCT – refer ‘at risk’ mothers for CP support; link to disability & ECD services for early support Refer abuse of HIV+ adolescents living; incorporate GBV programming for HIV+ adolescents HIV guidance in case management & referrals HIV Child protection

Inter-Agency Task Team (IATT) on Children and HIV and AIDS Service delivery – community-based CABA care Avoid using HIV as justification for residential care Ensure OVC / CABA care programming follows international standards HIV guidance in case management & referrals Include HIV-related stigma in all community-based CP work PSS for HIV+ caregivers HIV Child protection

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS 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

Inter-Agency Task Team (IATT) on Children and HIV and AIDS Thank you! Thanks to IATT CABA, especially to UNICEF and WVI for technical & financial support