Turning the Tide for HIV-Affected Families

USAID’s ACCELERATE project team is trained to involve and educate families and guardians in the care of orphaned and vulnerable children. (Photograph courtesy Project ACCELERATE)

Nargish (name changed) is an adolescent living with HIV, in Imphal. A child care facilitator monitoring Nargish’s health found that her viral load—the amount of HIV virus present in an infected person’s blood—was not suppressed, despite access to medication. The teenager was not taking her medicines regularly while under her mother’s care. The facilitator arranged for Nargish to be moved to her grandparents’ house, but the teenager was reluctant to take the medication as it made her nauseous. The facilitator guided Nargish to follow a medication routine to manage the nausea and continued with the follow-ups. Five months later, Nargish’s tests finally showed viral load suppression.

Nargish is one of the many beneficiaries of USAID’s orphans and vulnerable children (OVC) programs, wherein children and adolescents are supported to live a full life, with HIV. These programs are funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR). Since PEPFAR’s inception in 2003, the U.S. government has invested over $100 billion in the global HIV/AIDS response, supporting several countries to achieve HIV epidemic control.

Holistic support

The orphans and vulnerable children program—which serves children and adolescents who are at risk of infection, live with HIV or with HIV-positive caregivers—provide peer-led and family-centric care. One such USAID project, ACCELERATE, implemented by John Hopkins University, works closely with national and regional stakeholders to offer HIV-infected and affected children and adolescents consolidated care, including educational support, nutrition-related items, counseling and awareness campaigns on menstrual hygiene, sanitary pads distribution; and life skills education, says Sukhvinder Kaur, project management specialist at USAID India.

ACCELERATE works with children and adolescents living with HIV up to 17 years of age, referred by antiretroviral therapy centers, integrated counseling and testing centers, orphanages and care homes, and other community-based and nongovernmental organizations. “The OVC component is a collaborative process with many partners and stakeholders to reach, serve and improve the quality of life of children and adolescents infected and affected with HIV/AIDS,” says Aditya Singh, executive director and deputy chief of party at ACCELERATE.

Family-inclusive approach

The orphan and vulnerable children program often involves and educates the family on the caregiving process. Kaur says the ACCELERATE outreach team is trained and monitored to ensure they take family-inclusive approaches during home visits and group sessions, and offer services to not just the children and adolescents, but their families too. And this has shown considerable impact. Like in the case of Nargish, where including her grandparents in HIV management helped bring the infection under control.

The OVC teams also sensitize communities on child abuse and inform caregivers on child rights. When necessary, the teams intervene to protect vulnerable children. For example, the district program manager and facilitator under the OVC program in Aizawl intervened in the case of a 12-year-old girl who was being bullied at school for having an HIV-positive mother. During the intervention, the school’s headmaster assured that the bullying would not be repeated and thanked the team for informing the school about the incident.

“The team treats such issues and reports of the registered beneficiaries with utmost care and concern, in confidence,” says Singh. “This enables the OVC team to take quick action, to protect the children from abuse, neglect and discrimination.”

Currently, PEPFAR is working on a case study for the National AIDS Control Program (NACP), which will include provisions for holistic care of children and adolescents living with HIV, and youth up to the age of 24. Additionally, the program team is working on standard operating procedures, guidelines and modules to provide care to children living with HIV, and engaging with NACP for its implementation. This work will continue to develop and solidify the enormously positive impact the program has had since its inception, protecting some of society’s most vulnerable people.

Natasa Milas is a freelance writer based in New York City.

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