New research suggests that young sufferers of HIV are not getting the treatment and care they need to fight the disease.
For almost all age groups HIV related deaths have begun to decline as a result of a concerted effort by NGOs and governments to combat the disease. This has included both increased medical provision and support for those living with the disease and broad based education to lower infection rates. Despite this encouraging trend, recent research suggests that for children and young people HIV related deaths are actually on the rise.
The research was conducted in Zimbabwe by the London School of Hygiene and Tropical Medicine, and focused on children who might have contracted the disease at birth from an HIV positive mother. Between January and May 2013 they interviewed carers at six clinics in Harare, the country’s capital, and tested over 2,000 children between the ages of six and fifteen for HIV. The findings are startling. Even though these children were in a high risk group, more than 90% who were found to be sufferers had never been tested before.
These figures point to serious shortcomings and, by drawing on interviews with health care workers, the study was able to highlight some of the causes. It found that there were a range of reasons why health care workers failed to administer tests. For example, they feared that the child might face abuse if they tested positive. However, the main reasons were that children were often not accompanied by an adult who could provide consent and there was a serious lack of staff and equipment.
The case of Theresa Mpofu* exemplifies these problems. Her mother was killed by AIDS related pneumonia two years ago and she is now cared for by her grandmother. However, her grandmother tells IRIN news that clinics would not test Theresa without the consent of her father, who refuses to provide it. This is despite that fact that Theresa is suffering from chronic health conditions that are consistent with HIV, and which her grandmother is having to pay for with money donated by relatives and friends.
Time for change
Martha Tholanah, from the International Committee of Women Living with HIV in Zimbabwe, tells IRIN that sometimes cultural barriers mean that parents and carers don’t want to give consent. She says that guardians in Zimbabwe are often worried that a positive result would damage the status of the whole family, since it could suggest that the guardians themselves are sufferers. She goes on to say that these problems could be avoided if proper guidelines were put in place to advise health workers on treating children.
The recent paper agrees and calls on the Zimbabwean government to introduce better training for healthcare workers and clearer policies on testing children. It also argues that existing laws that allow caregivers, like doctors or social service workers, to provide consent on behalf of under 16s, should be strengthened and better applied. Changes like this will be essential if progress in the fight against HIV is to benefit all age groups equally.