Un­der­stand­ing what Aids does to kids

Ox­ford-led col­lab­o­ra­tion fo­cuses on sur­vival and sup­port

Weekend Argus (Saturday Edition) - - NEWS - SHEREE BEGA

THE GIRL was eight when her neigh­bour started to rape her, ev­ery day un­til she was 12. When she went to school, he would stand out­side his house and draw his fin­ger across his throat en­sur­ing her si­lence.

By the time Dr Lucie Clu­ver met her, the girl was sui­ci­dal. “We helped her to take him to court, and it took sev­eral months, but af­ter a whole set of other chil­dren re­vealed he had raped them too, he was con­victed and sent to prison,” the Ox­ford Univer­sity re­searcher said.

The girl went back to school, passed her year with fly­ing colours and was plan­ning to ap­ply to be­come a doc­tor.

“But only a few months later, he was re­leased be­cause the prison was full. She dropped out of school and be­came sui­ci­dal again.

“Some­times, I just don’t know what to do,” said Clu­ver, who is lead­ing the world’s largest lon­gi­tu­di­nal study to un­der­stand the im­pacts of Aids on mil­lions of South Africa’s chil­dren and teenagers.

Clu­ver and her team of re­searchers have sat in count­less homes like th­ese, scat­tered all over South Africa, gen­tly in­ter­view­ing th­ese Aid­saf­fected chil­dren who con­tinue to open their doors and their hearts to them, telling them of their des­per­ate fight for sur­vival.

“We’ve sat in thou­sands of homes, from mats out­side ru­ral huts in KwaZulu-Natal to town­ships in the Cape Flats, to shacks on the side of moun­tains in Mpumalanga. And we’ve seen chil­dren grow­ing up and sur­viv­ing in pretty ter­ri­ble ad­ver­sity.”

Clu­ver’s Young Car­ers project, a pi­o­neer­ing study high­light­ing the lit­tle- known im­pacts of the epi­demic, re­searched more than 6 000 South African chil­dren who care for their sickly par­ents, or have lost their par­ents to the disease. It aims to pro­vide “high-qual­ity ev­i­dence” to help guide pol­i­cy­mak­ers and the gov­ern­ment when they tackle the dev­as­tat­ing fall­out of HIV/Aids.

The project is a col­lab­o­ra­tion be­tween the uni­ver­si­ties of Ox­ford, KwaZulu-Natal, Cape Town and Wits, along with the Depart­ment of So­cial De­vel­op­ment, with the sup­port of the de­part­ments of Health and Ba­sic Ed­u­ca­tion. Also in­volved are the Na­tional Ac­tion Com- mit­tee for Chil­dren Af­fected by HIV/Aids, as well as Unicef, Pepfar-USAID and NGOs Cape Town Child Tholul­wazi.

Clu­ver’s lat­est re­search, gleaned from more than 3 000 chil­dren in Mpumalanga and the Western Cape, has shown how child sup­port grants can halve the in­fec­tion risk for adolescent girls by re­duc­ing their re­liance on “su­gar dad­dies”, a lead­ing cause of in­fec­tion.

Th­ese find­ings were pub­lished this week in the jour­nal, the Lancet Global Health.

Clu­ver said sys­tem­atic re­views were now show­ing that be­havioural in­ter­ven­tions, such as train­ing and ed­u­cat­ing teens, “don’t re­ally seem to be mak­ing enough of a dif­fer­ence to HIV risk be­hav­iours”.

“Al­though the me­dia of­ten says that teenage girls are choos­ing to have su­gar dad­dies to pay for lux­u­ries and cell­phones, the sci­en­tific re­search ev­i­dence says ex­actly the op­po­site.

Wel­fare and

“The great­est pre­dic­tors of trans­ac­tional sex in our fouryear study were ex­treme poverty, abuse and fam­ily Aids.”

Clu­ver said that if a girl had enough to eat at least five days a week, wasn’t phys­i­cally or emo­tion­ally abused, and lived in a healthy fam­ily, she had a 1 per­cent chance of hav­ing trans­ac­tional sex. If she was hun­gry, abused and lived in an Aids-af­fected fam­ily, she had a 57 per­cent chance.

“The grants don’t change all risky be­hav­iour, but they give teenage girls the op­por­tu­nity to make a choice about who they have sex with, rather than hav­ing to have a su­gar daddy just to sur­vive,” she said.

Their on­go­ing re­search had made Clu­ver and her team re­alise three things: “The first was that we now know that Aids-af­fected chil­dren have a much worse time than other kids, but we needed to prop­erly un­der­stand the path­ways that caused this.

“And what we see is that fam­ily Aids im­pacts chil­dren through mak­ing other so­cial prob­lems worse. It makes par- ents more dis­abled, fam­i­lies more stig­ma­tised and poor, and child abuse much more likely.

“But the sec­ond thing we re­alised is that it’s not enough to un­der­stand why things are go­ing wrong for Aids-af­fected kids.

“We also need to work out what can help. One of them is the so­cial grants – and we’re also work­ing flat-out on test­ing whether other so­cial pro­grammes like school feed­ing schemes, food gar­dens and so­cial care like pos­i­tive par­ent­ing and teacher sup­port might be help­ing kids.

“The third thing it made us re­alise was that there are some is­sues that we just don’t yet have the pro­grammes to deal with. A ma­jor one is child abuse.”

Clu­ver said it was es­sen­tial that el­i­gi­ble chil­dren are as­sured ac­cess to grants, that so­cial wel­fare pro­grammes seen to make a dif­fer­ence were up­scaled, and that fam­i­lies were sup­ported so they could sup­port their chil­dren.

“Par­ents re­ally want to know how to do the best for our kids,” she said.

PIC­TURE: AP

RAIS­ING AWARE­NESS: Women labour­ers carry wa­ter to sprin­kle on a sand sculp­ture cre­ated by artist Su­dar­shan Pat­tnaik on the eve of World Aids Day on a beach in Konark, about 60km from Bhubaneswar, In­dia, yes­ter­day.

PIC­TURE: WILLEM LAW

SOUTH AFRICA CARES: About 120 doc­tors, nurses, staff, by­standers and em­ploy­ees of firms in the CBD formed a line around the Chris­taan Barnard Me­mo­rial Hos­pi­tal yes­ter­day to hon­our peo­ple suf­fer­ing from HIV/Aids, in a Netcare-hos­pi­tal ini­tia­tive. Af­ter a mo­ment of si­lence, bal­loons were re­leased.

PIC­TURE: CARA VIERECKL

AID FOR AIDS: Dr Lucie Clu­ver of Ox­ford Univer­sity has been in­volved in a study as­sess­ing the men­tal and phys­i­cal health of Aids-af­fected or­phans.

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