Studies of children living with HIV/AIDS have neglected the far greater number of young people affected by the sickness and death of close relatives. Few studies  have looked at the coping strategies used by caregivers, children with dying relatives and orphans who must take care of themselves.

HIV/AIDS is worsening the problems already faced by poor Tanzanians. Female-headed and child-headed households are particularly vulnerable to extreme poverty and insecurity, especially given customary laws that deny a widow the right to inherit her deceased husband’s land. For children whose parents are dying or have died of AIDS this can mean a lack of access to health care, education, property and food security. Stigma and discrimination attached to the disease remains widespread.

Research from the University of Birmingham, UK, shows how caregivers, children, and young people cope with the impacts of the HIV/AIDS epidemic in the Tanzanian town of Arusha. Interviews revealed the strength of the social networks through which women and children care for family members in households affected by HIV/AIDS. Female members of the extended family, especially grandmothers, are a vital source of support for women living with HIV, whose ability to care for their children is reduced due to their illness. Young people take on caring responsibilities for their immediate relatives and help to meet the survival needs of the household.

Some young people, shunned by their extended family following the death of a parent, migrate to urban areas and seek a living in the informal sector as a survival strategy. Policy interventions must recognise the broader concept of ‘social orphans’ – children whose parents are unable to provide for them – rather than, as at present, largely focusing on children orphaned by AIDS.

Children and families from households affected by HIV/AIDS criticised the Tanzanian authorities for failing to provide basic services, involve people living with HIV/AIDS in community education programmes or work to challenge social attitudes towards the disease. Those who had become more open about their HIV status reported benefiting from:

• access to free health care provided by non-governmental organisations
• increased awareness of the role of nutritional foods in enhancing resistance to the disease
• supporting and counselling each other by involvement in self-help groups
• developing social networks to help combat isolation.

Community-based care for orphans is cost-effective, builds on local communities’ own coping strategies, keeps children in a familiar environment and reduces their distress. Policymakers can build on children and families’ social resilience by:

• recognising the contribution that people living with HIV/AIDS can make to society and protecting their right to employment
• supporting community-based education programmes to combat stigma and discrimination
• challenging gender norms and supporting men’s involvement in caring for women, children and young people affected by HIV/AIDS
• providing social security to support AIDS-affected households, including child-headed households, and to enable the most appropriate caregivers (often grandmothers) to care for foster children
• doing more to help children to stay with the relatives they feel closest to within the extended family and to be placed together with their siblings.

Source(s):
‘Social networks, migration, and care in Tanzania: caregivers’ and children’s resilience to coping with HIV/AIDS’, Journal of Children and Poverty, Vol.11 (2) pages 11-129, by Ruth M.C. Evans, 2005

id21 Research Highlight: 20 January 2006

Further Information:
Ruth Evans
Institute of Applied Social Studies
School of Social Sciences
University of Birmingham
Muirhead Tower
Birmingham B15 2TT
UK

Tel: +44 (0) 121 4146630
Fax: +44 (0) 121 4144216
Contact the contributor:   R.M.Evans@bham.ac.uk

University of Birmingham

Other related links:
'New burdens on old shoulders - the impact of HIV'

'Social pensions for the developing world'

'Ageing rural populations: a blessing or a curse?'

'Mental health care for older people: what role for primary care?'

Eldis Resource Guide on HIV / AIDS and old people

AIDS Infonet resources on AIDS and Old people