CAPITULO IV: MARCO HISTÓRICO
4.1. DISTRITO DE LA VICTORIA
of those without.6Despite the undeniable stress placed on the extended family net- work, it is important to emphasize that retaining some sort of family life is extremely important for children who have lost one or both parents to HIV/AIDS. If preserving the family is the best option for orphaned children, then the family’s capacity to care for and protect these children must urgently be strengthened.
Women take on the greater burden of care
When HIV/AIDS affects a family, women – particularly elderly women, as well as girls and young women – take on by far the greater burden of care. The strain is begin- ning to show. Two thirds of caregivers in households surveyed in a recent study in South Africa were female, with almost a quarter of them over the age of 60.7
Female-headed households generally assume more of the care for orphans than those headed by males, often compound- ing their own poverty (see Panel: The ‘feminization’ of HIV/AIDS, page 70).
Children are increasingly forced to head households
Too often children or adolescents are forced to assume the burden of caring for sick parents or for their younger siblings. The proportion of households officially headed by children is still small – less than 1 per cent in most countries – but this vast- ly underestimates the scale of the problem. Though a household in which the lone par- ent is sick may still formally be headed by that parent, in practice the burden of care and responsibility may have already passed to the children. Similarly, even
for a loss of income, girls tend to be the first to be withdrawn from school. This not only deals a devastating blow to their education, it also prevents them from obtaining vital information about HIV/AIDS prevention and trans- mission, and therefore increases the risk that they will become infected. Older women also shoulder the bur- den of care as their adult children fall ill, and often die, from HIV/AIDS. And as the pandemic claims more lives, it is these women who, increasingly often, are left to take care of children orphaned by HIV/AIDS.
When the main income provider falls ill or dies, the remaining caregivers have to contend with additional work and diminished incomes and assets. Women are often responsible for pro- viding the family’s food and shelter, and may not be able to manage on their meagre earnings. As a result, some are driven to transactional sex
in exchange for food and other essen- tial goods. As HIV/AIDS claims the lives of their husbands, fathers and brothers, women, especially those in cultures where property rights devolve along the male line, also face losing the family land and property. In some cases, women may be dispos- sessed of these assets upon disclos- ing their HIV status to their spouse. Women can also be primary targets of the stigma that is attached to HIV/AIDS. Women are often the first to be tested for HIV and blamed for introducing the disease into the household or community, even though their male partners may have been the true source of the infection. There is growing evidence that HIV/AIDS can incite violence as women face retribution for their HIV- positive status. The fear of such vio- lence causes some women and girls to avoid getting tested or seeking
treatment if infected. Lower rates of employment among women also mean that they may encounter diffi- culties in obtaining private medical insurance or paying for treatment. Given that gender inequality is one of the main causes of the dramatic increase in the number of women infected by HIV/AIDS, gender-sensitive approaches are key when designing prevention programmes. Women need to have access to the knowledge and tools that will help them protect themselves from becoming infected. Women should constitute at least half of the millions in developing countries expected to gain access to antiretrovi- ral therapy in the coming years. Communities need to overcome barri- ers to women being tested, including the risk of violence they may face if they are found to be HIV-positive.
THE STATE OF THE WORLD’S CHILDREN 2005
where children have been taken in by grandparents or other relatives, they may be required to work in order to help sus- tain the family.
Running a household inevitably jeopardizes a child’s education
In many cases, assuming this burden of care results in children dropping out of school. Forgoing their education does not just limit the chances that they will be able to create a better future for themselves and their families, it also means they will not receive important, often life-saving informa- tion on how to avoid HIV infection or access treatment for HIV/AIDS.
HIV/AIDS is depriving children of their rights and deepening child poverty
The loss of a parent pervades every aspect of a child’s life: their emotional well-being, physical security, mental development and overall health. Food consumption in an AIDS-affected household can drop by as much as 40 per cent, leaving children at higher risk of malnutrition and stunting.8 In Cambodia, a recent joint study by the Khmer HIV/AIDS NGO Alliance and Family Health International found that about one in five children in AIDS-affected families had been forced to start working in the previous six months to support their family. One in three had to provide care for family mem- bers and take on major household tasks. Others were forced to drop out of school, or were sent away from home. These expe- riences exposed children to high levels of stigma and psychosocial stress, with girls found to be more vulnerable than boys.9