A Generation at Risk: The Global Impact of HIV/ AIDS on Orphans and Vulnerable Children

Millions of children worldwide have been orphaned or made vulnerable by the HIV/AIDS epidemic. However, while there has been significant action in the last few years by governments, international organizations, religious bodies, and nongovernmental organizations, the vast majority of children made vulnerable by AIDS have not benefited from any assistance beyond their own extended family and community. This volume's insightful perspectives from experienced professionals address these children's needs in education, community mobilization and capacity building, economic strengthening at household and community levels, psychosocial support, and civil rights. Cover......Page 1 Half-title......Page 3 Title......Page 5 Copyright......Page 6 Contents......Page 7 Foreword......Page 9 Preface......Page 11 Contributors......Page 15 Introduction: HIV/AIDS and Its Long-Term Impact on Children......Page 23 paradoxes and dilemmas......Page 24 the hiv/aids epidemic: scope and trends......Page 26 building an effective response......Page 30 References......Page 31 1 Family- and Community-Based Care for Children Affected by HIV/AIDS: Strengthening the Front Line Response......Page 33 the case against institutional care......Page 34 the need for strategies to support families and communities......Page 38 The Front Line: Building on Existing Coping Strategies......Page 39 The Influence Arena......Page 41 The Enabling Arena......Page 46 Fostering......Page 47 Legal Adoption......Page 51 Other Community-Based Approaches for Children Lacking Protection and Care......Page 52 conclusions......Page 55 References......Page 56 2 Strengthening Households and Communities: The Key to Reducing the Economic Impacts of HIV/AIDS on Children and Families......Page 59 the economic impact on children of hiv/aids-related illness and death......Page 61 the economic impact of hiv/aids-related crises on households......Page 63 how poor households cope economically in response to crises......Page 66 Microfinance Services......Page 69 Savings Mobilization......Page 72 Business Development Services......Page 74 community mechanisms that support households under stress......Page 76 Fund-Raising Activities......Page 77 Community Participation......Page 78 interrelationship between household and community safety nets......Page 79 combining forces: “where there is a will, there is a way”......Page 80 applying the “rule of the tool”......Page 82 References......Page 85 3 The Response of the Educational System to the Needs of Orphans and Children Affected by HIV/AIDS......Page 88 HIV-Infected Children......Page 89 Orphans and Other Children Affected by HIV/AIDS......Page 92 Children Who Become Heads of Households......Page 98 Teacher Absenteeism......Page 99 The Impact of HIV/AIDS on Resources for Education......Page 100 Mainstreaming HIV/AIDS Issues......Page 101 The Need for a More Practically Oriented Curriculum......Page 102 Addressing Psychological Needs of Children Affected by AIDS......Page 103 Integrating AIDS-Affected Children into School Systems......Page 104 What Have Education Systems Done for Orphans and HIV/AIDS-Affected Children in the Past?......Page 106 What Are Education Systems Doing for Orphans and HIV/AIDS-Affected Children Now?......Page 107 What Should Education Systems Do for Orphans and HIV/AIDS-Affected Children in the Future?......Page 108 an expanded vision: the school at the heart of the community......Page 110 References......Page 112 4 Psychosocial Impact of the HIV/AIDS Epidemic on Children and Youth......Page 115 Childhood Chronic and Terminal Illness......Page 117 Illness in a Parent......Page 118 Parental Depression......Page 120 Parental Death......Page 121 Problems of Children of Single Parents with HIV/AIDS......Page 122 Parentification: Child Caregiving to Siblings or an Ill Parent......Page 123 HIV/AIDS Disclosure and Psychosocial Problems in Children......Page 125 Other Risk Factors for Child Mental Health Problems......Page 128 resilience and protective factors......Page 129 Family Characteristics......Page 131 Community Strengths......Page 133 symptoms and manifestations of psychosocial problems......Page 134 Depression......Page 135 Bereavement and Grief in Children......Page 136 Effects in Adulthood......Page 137 strategies for responding to children’s psychosocial needs......Page 138 Screening Children for Psychological and Behavioral Problems......Page 139 Interventions to Meet Children’s Psychosocial Needs......Page 141 putting knowledge into practice: lessons learned......Page 146 References......Page 149 5 Human Rights and Children Affected by HIV/AIDS......Page 156 children’s rights in the context of hiv/aids......Page 158 Children Living with HIV/AIDS......Page 159 Affected Children......Page 160 Vulnerable Children......Page 161 the advent of the rights of the child......Page 162 the crc’s four general principles......Page 163 governments at the forefront: respect, protect, and fulfill rights......Page 165 is there an age for childhood and an age for hiv?......Page 169 still ignoring gender?......Page 171 so where do we go from here? programming efforts......Page 173 conclusion......Page 177 References......Page 178 6 Religion and Responses to Orphans in Africa......Page 181 teachings of major religions on orphans......Page 182 influence of traditional religions......Page 185 religious organizations responding to orphans......Page 187 the values built into faith-based responses......Page 189 strategies for expanding the responses of religious groups......Page 192 acknowledgments......Page 200 References......Page 201 7 Making the Right Choices in the Asia-Pacific Region: Protecting Children and Young People from HIV and Its Impacts......Page 203 diversity in the epidemics of the asia-pacific region......Page 204 Loss of Social and Family Support......Page 206 Stigma and Discrimination......Page 208 at heightened risk: vulnerable children and youth in asia and the pacific......Page 209 evolving patterns of sexual risk among youth in the region......Page 211 evolving patterns of risk through drug use......Page 213 Preemption: Protecting Parents from HIV and Children from Orphaning......Page 215 Preemption: Protecting Children from Perinatal Infections and Loss of Their Mothers......Page 218 Care and Support: Reducing HIV’s Consequences for Children......Page 220 Care and Support: Reducing Stigma and Discrimination......Page 223 Care and Support: Caring for Children Living with HIV and Their Families......Page 224 forewarned, but up to the challenge?......Page 225 References......Page 229 the family center: a team approach......Page 235 the evolution of hiv/aids in the united states......Page 236 public and private responses to hiv/aids in the united states......Page 239 Case Study......Page 241 Health Care......Page 242 Mental Health......Page 243 Fathers......Page 244 Poverty of Income and Housing......Page 245 Secrecy and Stigma......Page 246 custody planning......Page 247 Case Study......Page 248 practices that support families and children......Page 249 References......Page 252 9 Interventions to Support Children Affected by HIV/AIDS: Priority Areas for Future Research......Page 254 which aids-affected children need support?......Page 255 family responses......Page 257 the psychosocial consequences of aids for children......Page 258 children as caregivers......Page 261 extended family support......Page 263 missing the most vulnerable?......Page 266 closing the information gap: what is being evaluated and for whom?......Page 268 conclusion......Page 269 References......Page 272 the elements of an adequate and effective response......Page 276 analyzing the situation......Page 278 a strategic framework......Page 280 programmatic interventions......Page 281 Education......Page 283 Community Mobilization and Capacity Building......Page 284 Microeconomic Strengthening......Page 286 Other Development Interventions......Page 287 Support Grants......Page 289 Activities to Promote Psychosocial Well-being......Page 290 HIV/AIDS Prevention, Treatment, and Care......Page 291 scaling up and sustaining responses......Page 292 targeting responses......Page 293 monitoring, evaluation, and research......Page 295 conclusion......Page 296 References......Page 297 Chronology of Important Events......Page 301 Resource Guide......Page 307 Index......Page 317 Family- And Community-based Care For Children Affected By Hiv/aids: Strengthening The Front Line Response / Stanley Ngalazu Phiri And David Tolfree -- Strengthening Households And Communities: The Key To Reducing The Economic Impacts Of Hiv/aids On Children And Families / Jill Donahue -- The Response Of The Educational System To The Needs Of Orphans And Children Affected By Hiv/aids / Michael J. Kelly -- Psychosocial Impact Of The Hiv/aids Epidemic On Children And Youth / Laurie J. Bauman With Stefan Germann -- Human Rights And Children Affected By Hiv/aids / Sofia Gruskin And Daniel J.m. Tarantola -- Religion And Responses To Orphans In Africa / Geoff Foster. Making The Right Choices In The Asia-pacific Region: Protecting Children And Young People From Hiv And Its Impacts / Tim Brown And Werasit Sittitrai -- Troubled Tapestries: Children, Families, And The Hiv/aids Epidemic In The United States / Barbara H. Draimin And Warren A. Reich -- Interventions To Support Children Affected By Hiv/aids: Priority Areas For Future Research / Douglas Webb -- Finding A Way Forward: Reducing The Impacts Of Hiv/aids On Vulnerable Children And Families / John Williamson. Edited By Geoff Foster, Carol Levine, John Williamson. Includes Bibliographical References And Index. A Generation at Risk brings up-to-date and insightful perspectives from experienced practitioners and researchers on how a better future can be secured for the millions of children who are being orphaned or made vulnerable by HIV/AIDS. The current situation of these children is grim, and while there has been significant action in the last few years by governments, international organizations, religious bodies, and nongovernmental organizations, the vast majority of children made vulnerable by AIDS have not benefited from any assistance from beyond their own extended family and community. A Generation at Risk explains in straightforward terms what is required to fill this gap. The book addresses what needs to be done in the areas of education, community mobilization and capacity building, economic strengthening at household and community levels, psychosocial support, and the protection of children and the fulfillment of their rights With a Foreword by Desmond Tutu, Generation at Risk brings insightful perspectives from experienced practitioners and researchers on how a better future can be secured for the millions of children who are being orphaned or made vulnerable by HIV/AIDS. The current situation of these children is grim, and while there has been significant action by governments, international organizations, religious bodies, and non-governmental organizations, the vast majority of children made vulnerable by AIDS have not benefited from any assistance beyond their own extended family and community. A Generation at Risk explains in straightforward terms what is required to fill this gap. The book addresses what needs to be done in the areas of education, community mobilization and capacity building, economic strengthening at household and community levels, psychosocial support, and the protection of children and the fulfilment of their rights.