Ukraine is facing the worst HIV/AIDS epidemic in Eastern Europe. The number of people living with HIV in the region has almost tripled since 2000 and now affects 1.4 million people. Children are especially vulnerable and severely affected. Already more than 6,000 are living with HIV/AIDS and a further 75,000 are living with HIV-positive parents – and these numbers are predicted to rise by up to a staggering 1000% over the next decade.
Seeking to contain the growing epidemic, the Ukrainian government prioritized HIV/AIDS on the national agenda and funds have been provided by international mechanisms, such as The Global Fund for TB, AIDS & Malaria (GFTAM), to finance urgent prevention and treatment needs the country faces. Nevertheless several gaps in the response, particularly in relation to children, remain. Some of these include no structured psychosocial support for very vulnerable children living in poor conditions where their adult carer is HIV-positive; a lack of programmes for children infected with HIV who are unaware of their disease or its implications and, outside the family, a daily battle for both HIV infected and affected children facing stigma and exclusion from school. These factors combine to increase the likelihood of the family unit disintegrating and frequently end in the child being placed in an institution. EJAF identified the key gaps that required support and secured co-funding from the Big Lottery Fund and ANTI AIDS Foundation for a joint project delivered by the All-Ukrainian Network of People Living with HIV, with technical support from the Romanian Angel Appeal.
Children Plus Services
The ambitious 5 year programme, “Improving the Quality of Life of HIV-positive Children and Their Families” known as “Children Plus” aims to do just that. Nine centres, located in 5 regions of Ukraine and managed centrally by the Network, deliver the services on the ground. Each centre identifies children affected or infected with HIV in the local community and institutions. Then a multi disciplinary team, comprising a psychologist, social worker and project manager work with individual children and their families to restore their access to quality healthcare and education, psychological and emotional support. Over 1200 of the targeted 1500 families have already received this support.
The team also identifies suitable foster and adoptive parents for HIV-positive children living in institutions and supports adults and children through the fostering and adoptive process. The first 88 HIV-positive babies and children successfully adopted in Ukraine came from this element of the programme.
Training curricula for use at state teacher training academies has also been developed that will ensure 2,472 teachers foster a non-discriminatory environment for the four million children they will teach in school. Finally, the programme has enrolled 753 out of a targeted 1,000 children who are living with HIV to support them and their families through a unique staged disclosure process to ensure they manage their illness effectively into adulthood. Technical support for this element of the work is provided by the Romanian Angel Appeal, one of the leading providers of services for HIV-positive children in Romania.
Protecting Children for the Future
To ensure its sustainability, the programme is working with local and national government to embed the approach into state provision. To date this has worked exceptionally well. It began in July 2008 with a unique meeting between staff from the Children Plus project and representatives of Regional Services on Children Issues and the Centers of Social Services for Families, Children, and Youth. This collaboration established mutual areas of responsibility and, for the first time, a shared list of different stakeholders’ areas of responsibility.
The teacher training module - “Forming tolerant attitudes towards HIV-positive children in the pre-school and school system of education” - has been incorporated as part of the “National Program on HIV-infection prevention, treatment, care and support of HIV+ people for 2009-2013”. Furthermore the government now requires all Regional Ministry of Education authorities to incorporate this training module into their professional refresher courses.
Most recently, the Ministry of Education and Science, Children and Sport directed all seven regional State Social Services for Family, Children and Youth to use the projects’ handbook and expert module written by the Romanian Angel Appeal and adapted for Ukraine by the All-Ukrainian Network PLWHIV on staged HIV diagnosis disclosure amongst children.
This strong cooperation with key government ministries has been vital to the success of the project thus far and will play an important role in its sustainability and future achievement.