1. Social and Economic Burden Faced by Children Affected by Aids in Bangladesh Children Affected by AIDS in Bangladesh

2. Outline Background Methodology Results Conclusions Limitations
Acknowledgments

3. Background
In Bangladesh, a lack of awareness as to HIV/AIDS largely exists due to the stigma associated to sex and sexuality.
This puts children and young girls in grave danger, as they will refrain from speaking about contracting STI, STD or HIV/AIDS and even refrain from getting tested/seeking treatment for it because of the social stigma.
Although the prevalence of HIV/AIDS in Bangladesh is 0.1% according to the UNAIDS Country Progress Report (2012), the actual figure is expected to be much higher.
HIV/AIDS affected children are largely stigmatized within their communities and are denied basic rights, services and protection.

4. Objectives
In 2013, the Chetona (Community based Care and Protection for Children of Sex Workers and Children Affected by AIDS) project was conducted a situation assessment on care and protection needs of children affected by HIV/AIDS and children of sex workers.
Overall objective:
To generate a clear understanding of the care and protection needs of these two extremely vulnerable groups of children.
Specific objectives:
To better understand community attitudes and perceptions of social protection needs and the specific type of care required for these children as well as to understand existing and lacking national policies for the protection of these children.

5. Methodology
The study used content analysis of existing literature as well as field data analysis.
The selected content analysis looked at published writings examining sex workers, the children of sex workers and children infected/affected by HIV/AIDS.
The analysis is used to settle on the instruments and guidelines of the study tools.
Informed consent form, guideline and tape recorder were used for quantitative and qualitative data collection.
In order to protect the rights of the respondents, oral and written consent were obtained, provided full and correct information regarding the study.
The name and address of the respondents were not recorded.
Strict confidentiality were maintained and freedom were exercised by the respondents.
Privacy during the interview process was safeguarded.

6. Methodology
The field data analysis focused largely on qualitative data ( 15 In- depth Interviews and 9 Focus Group Discussions) with some attention on quantitative information.
The study was conducted in Dhaka and Rajbari. The target group in Dhaka was children infected/ affected by HIV/AIDS, and in Rajbari the target group was children of floating sex workers.
Besides, mother/caregivers, services providers, community people and NGO representatives also covered as a key stakeholder.
Informed consent form, guideline and tape recorder were used for quantitative and qualitative data collection.
In order to protect the rights of the respondents, oral and written consent were obtained, provided full and correct information regarding the study.
The name and address of the respondents were not recorded.
Strict confidentiality were maintained and freedom were exercised by the respondents.
Privacy during the interview process was safeguarded.

7. Results -Socio Economic Status and access to services
Children affected by AIDS are burdened with limited health services, scarce livelihood options, economic fragility, lack of nutrition support and limited education facilities.
The infected children are in constant requirement of HIV treatment and nutritional support.
The existing treatments of HIV/AIDS in Bangladesh are unaffordable for the poor and middle class of Bangladesh.
These children are largely discriminated and stigmatized within their families and communities and are denied basic care and protection rights. The continuum of denial of human rights emerges as one of the major social challenges.

8. Results –Socio Economic Status and access to services
The nutritional needs of an HIV/AIDS positive child are far more demanding than of an HIV/AIDS positive adult. The child’s nutritional needs may be neglected. As a result, children who are infected with HIV/AIDS become more vulnerable to the illness as the mother is unable to care for them adequately.
Alternate livelihood support is also required for a HIV positive bread earner for financial capacity. Also in many cases, children became the primary caregivers looking after ill parents and their younger siblings.
These children are largely discriminated and stigmatized within their families and communities and are denied basic care and protection rights. The continuum of denial of human rights emerges as one of the major social challenges.

9. Results-Socio cultural attitudes
Due to the prevalence of male dominance in Bangladesh, women do not have say over the practice of contraception or family planning. If a man has entered into pre and/or extra marital unprotected sex and contracted HIV, the man could unknowingly transfer the virus to his partners, thus later, unknowingly transfer it to a child if impregnated.
Children become the constant sufferers of discriminatory perception and attitudes. Within the relatives they are always isolated and unable to make friends due to the fear of social stigma.

10. Results-Socio cultural attitudes
Children, due to the overall situation, fall into tremendous physical and mental vulnerability. Many children require professional counseling after knowing HIV positive status of the parents. Children are always at risk of school dropout.
Large population in Bangladesh still believes that HIV/AIDS is spread due to the mischief of people.
A woman is accused to be a sinner if she contracted an STI or an STD (even if it was transmitted to her by her husband). If contracted, it is rare to get support of any kind from family, service providers and the greater community.

11. Concluding Recommendations
Link children affected by HIV/AIDS to social protection schemes to fulfill their rights to health, nutrition, and education.
Encourage and assist parents/caregiver with additional livelihood support.
Introduce vocational training courses for children, particularly adolescent girls, to prevent them from entering the sex-trade industry. Engage children with part-time work so that they assist with the finances at home while continuing to study.
Children of sex workers face stigmatization and marginalization due to the profession of their mother. In order to help children who are infected/affected by HIV/AIDS, it is important for us to help keep this information confidential so as to avoid further social discrimination and promote inclusion through awareness and the child’s education. The following are concluding notes and recommendations:

12. Concluding Recommendations
Provide children with not only medicine, but also with required nutrition support.
Implement an awareness program at educational institutions with the specific participation of teachers, students and guardians.
Strengthen the family care capacity through intervention and peer support. This includes providing counseling, parenting skill training and monitoring of the child’s welfare.
Children of sex workers face stigmatization and marginalization due to the profession of their mother. In order to help children who are infected/affected by HIV/AIDS, it is important for us to help keep this information confidential so as to avoid further social discrimination and promote inclusion through awareness and the child’s education. The following are concluding notes and recommendations:

13. Limitations
It is a sensitive issue and people are less willing to talk on the issue with someone which they are not familiar with.
Political environment of the country was not favorable. Continuous hartal and hostile environment on the road hampered the required movement of both the research team and the respondents.
Study team had to wait till the day when the respective patients (children and their parents) come to the care center to take services and had to conduct interview with them on that day.

14. Acknowledgments Australian Aid for finding.
Sector Director, Child Protection sector, Save the Children, Bangladesh.
Chief of Party-HIV/AIDS Program, Save the Children, Bangladesh
Ministry of Health and Family Welfare, Bangladesh.
Staff members of Child protection and HIV program, Save the Children, Bangladesh.
Relevant staff members of implementing partner organizations.
Department of Development Studies University of Dhaka.

15. Thank you