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Results for "children"
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Interventions, policies and budgets are needed to reduce sexual coercion and rape of both boys and girls, create awareness in communities that violence against children is unacceptable, strengthen child statutory protection systems, and conceptualize and implement appropriate child protection services in developing countries. Access to post-exposure prophylaxis in case of rape when the perpetrator is HIV-positive is also needed. [See also %{c:21}] In most countries of Eastern and Southern Africa, the age of consent for sex is 16. Despite these restrictions, more than 10% of girls have had sexual debut before age 15. A study found that in a sample of more than 1,000 males and more than 1,000 females, large numbers had experienced high rates of physical punishment, emotional abuse and touching of sexual organs when not wanted or sex due to force or coercion prior to age 18 and that incident HIV infections were more common in women who suffered emotional abuse, sexual abuse and physical punishment. Sexual abuse in men was associated with alcohol abuse and depression. Other studies found high rates of sexual coercion and high-risk behaviors among street children. “Few children disclose abuse, fewer still seek services and report to authorities, virtually no children actually receive services and perpetrators rarely suffer consequences” (Sommarin et al., 2014: S213). Most research does not provide adolescent-specific data on violence, instead listing results for ages 15 to 49. Reviews have not found evidence that preventive responses have had an impact on rates of sexual abuse. Effective programs in the US and Canada have not been assessed for adaptation in other countries.
Further interventions are needed to provide support (physical, psychological, technological, economic) to patients and caregivers. Studies showed that patients and caregivers have many physical, psychological, and economic unmet needs, with high rates of depression and poverty, and in some cases, rely on their young children or relatives to provide care with no outside support. Some studies show that caregivers suffer from stigma attached to caring for someone HIV-positive. [See also %{s:67}] Some studies showed that women have a lower quality of life than men. A study in a high HIV prevalence area showed that for women, lack of control in sexual decision-making was associated with depression, while for men, intergenerational sex was associated with depression.
Adolescents living with HIV need information and services through adolescent-friendly HIV services on a number of topics, including disclosure, safer sex, contraception, safe motherhood and gender-based violence. Studies found that health providers were unprepared to discuss HIV and contraception with adolescents who acquired HIV through perinatal transmission, despite the fact that significant numbers of these adolescents were already sexually active. Another study found that these adolescents need skills to disclose their serostatus to sexual partner. WHO recommends that perinatally infected adolescents be advised of their positive serostatus by age 6 (WHO, 2013) but there is little guidance on disclosure for adolescents. Facilitated disclosure by parents and providers to adolescents living with HIV may lead to higher retention in HIV care (Arrive et al., 2012). Parents living with HIV whose adolescents may be living with HIV also need assistance to disclose to their adolescents, as parents fear rejection from their children. Positive health dignity and prevention interventions can help people living with HIV lead healthy lives and reduce HIV transmission, but tailored interventions for adolescents and their parents have not been evaluated for effectiveness, although a trial is currently ongoing (Cunningham, 2015; Mofeson and Cotton, 2013). One study found that 29% of young women aged 16 to 24 living with HIV reported being forced to have sex. No validated curriculum that was shown to be effective for reducing unsafe sex among adolescents living with HIV was found, although some manuals have been developed (Parker et al., 2013c; UNESCO and GNP+, 2012).
