|Caring with Confidence - Practical information for health workers who prevent and treat HIV infection in children (AHRTAG, 1997, 60 p.)|
|Section 1. How HIV and AIDS affect young children|
· Children without parents and displaced children are more vulnerable to rape and sexual abuse, and the associated risk of HIV infection.
Children without parents or who are not living with their parents because of war or economic reasons, are more vulnerable to sexual abuse and exploitation. Refugee and displaced children are particularly vulnerable.
Sexual abuse of children is a taboo subject and rarely reported, and until recently was thought to occur infrequently in developing countries. However, there is growing evidence of very young children being infected with HIV and other sexually transmitted diseases (STDs) following sexual abuse and rape. Although it is usually older children, especially girls, who are most at risk of sexual exploitation, younger children are also vulnerable to sexual abuse.
Often it is only when a child needs treatment for an STD that people become aware that there is a problem of sexual abuse. One study in Zimbabwe found that, in 1990, 907 children aged under 12 years had been treated at the genito-urinary clinic in the capital city, Harare, for STD. In another Zimbabwean study of 54 sexually abused children in Bulawayo, one girl was only two years old. Twelve of these 54 children were tested for HIV and four were found to be positive.
Without family support, education or skills, orphaned children from families affected by AIDS may themselves grow up to be more vulnerable to HIV infection through starting sexual activity at a young age to support themselves. If orphans themselves become HIV infected, they have no parents available to care for them when they are sick or to act as grandparents to their own children.