Sex Trafficking and HIV
Every 100 seconds a child dies of an AIDS related illness and another becomes diagnosed with HIV.
3.4 million children under 15 are living with HIV
320,000 children were diagnosed with HIV every day in 2019
110,000 children died of AIDS related diseases in 2019
Children can become diagnosed with HIV in their earliest years through pregnancy, breastfeeding, or childbirth. They can also contract HIV by being married off at young ages or even injecting drugs.
Over 25 million children under 18 have been orphaned by AIDS.
Eight out of every 10 children in the world whose parents have died of AIDS live in sub-Saharan Africa.
What is a Child?
A young human being below the age of puberty or below the legal age of majority.
What is Poverty?
The World Bank Organization describes poverty as this:
“Poverty is hunger. Poverty is lack of shelter. Poverty is being sick and not being able to see a doctor. Poverty is not having access to school and not knowing how to read. Poverty is not having a job, is fear for the future, living one day at a time.
Poverty has many faces, changing from place to place and across time, and has been described in many ways. Most often, poverty is a situation people want to escape. So poverty is a call to action -- for the poor and the wealthy alike -- a call to change the world so that many more may have enough to eat, adequate shelter, access to education and health, protection from violence, and a voice in what happens in their communities.”
In 2016…
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24% of pregnant women living with HIV did not have access to adequate healthcare to prevent transmission to their infants.
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Around 160,000 children became infected with HIV, equating to 438 children a day.
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In the 21 highest-burden countries, only 54% of children exposed to HIV were tested within the recommended two months.
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An estimated 1.8 million children were living with HIV, but just 49% had access to antiretrovirals.
Why are so many children at risk of HIV worldwide?
The majority of children contract HIV via mother-to-child transmission (MTCT) during pregnancy, childbirth, or breastfeeding. Breastfeeding is now the primary cause of MTCT. In 2013, only 49% of women continued to take antiretrovirals while breastfeeding, compared to 62% of women who took antiretrovirals during pregnancy and delivery. MTCT of HIV can be prevented if expectant mothers have a combination of both adequate resources to healthcare and education about the importance of continuing treatment post-birth. Although it is lesson common in present day, HIV infection in children can occur in medical settings. For instance, in 2012, it was reported that over the past decade in Kyrgyzstan, 270 children were diagnosed with HIV in hospitals as a result of doctors not following universal precautions during medical procedures.
The Loss of Parents
One of the most devastating impacts of HIV is the loss of
whole generations of people in communities that are hit
hardest by the epidemic. Therefore, children often feel the
greatest impact due to the loss of their parents or other guardians. The United Nations defines an “orphan” as a child who has “lost one or both parents.” As of 2015, an estimated 13.4 million children and adolescents (0-17 years) worldwide had lost one or both parents to HIV. More than 80% of these children lived in sub-Saharan Africa. As many as 74% of children in Zimbabwe are orphaned due to HIV.
HIV Testing for Children
Access to HIV testing in children over 18 months of age remains poor in many countries. Screening children for HIV at inpatient sites and nutrition clinics provides the best opportunities for diagnosing HIV infections in children that might otherwise go undetected. Many HIV-positive children in low and middle-income countries remain undiagnosed. For example, one estimate from Kenya suggests that only 40% of children with HIV are diagnosed.
Within the United States
In 2015, youth aged 13 to 24 accounted for 22% of all new HIV diagnoses in the United States. Most of those new diagnoses among youth (81%) occurred among gay and bisexual males. Young African American and Hispanic gay and bisexual males are especially affected. However, there is progress being made; it is estimated annual HIV infections fell 18% among young gay and bisexual males from 2008 to 2014. Among youth who were diagnosed with HIV in 2015, 68% were linked to care within 1 month- the lowest rate of any age group.
Inadequate sex education plays a large role in the rates of HIV amongst adolescents. In most states, fewer than half of high schools teach all 16 topics recommended by the Center for Disease Control and Prevention (CDC). Many curricula do not include prevention information for young gay and bisexual men. In addition, often times sex education does not start early enough; in no state do more than half of middle schools meet the goals set by CDC. Moreover, sex education has been declining over time. The percentage of schools in which students are required to receive instruction on HIV prevention decreased from 64% in 2000 to 41% in 2014.
There are many risk behaviors that adolescents engage in, making them more likely of acquiring HIV. There are extremely low rates of testing within the country. As of 2015, only 10% of high school students had been tested for HIV. Substance use also heightens the chances of HIV. Nationwide, 21% of all students who are currently sexually active used drugs or drank alcohol before their most recent act of sexual intercourse. There are also low rates of condom use. In 2015, nearly half of all sexually active high school students surveyed did not use a condom the last time they had sexual intercourse.
Kids and Their Family
HIV and AIDS have exacted a terrible toll on children and their families. During the 30 years of the global HIV epidemic, an estimated 17 million children lost one or both parents due to AIDS. Ninety percent of these children live in sub-Saharan Africa. In addition, 3.4 million children under age 15 are living with HIV. Despite some decline in HIV adult prevalence worldwide and increased access to treatment, the number of children affected by or vulnerable to HIV remains alarmingly high.
Families and communities have led a massive response to protect, care for and support children affected by HIV and AIDS. Since 2003, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has provided more than $85 billion in funding and technical support to greatly enhance these efforts. These investments have enabled children to stay in school, strengthened households and ensured families continue their roles as primary caregivers.
Prevention Challenges
Inadequate Sex Education: The status of sexual health education varies throughout the United States and is insufficient in many areas according to CDC’s 2018 School Health Profiles, Sex education is not starting early enough: in no state did more than half of middle schools teach all 20 sexual health topics recommended by CDC. Comprehensive sexual health is not reaching most high school students either: in most states, fewer than half of high schools teach all 20 sexual health topics recommended by CDC. Finally, sex education has been declining over time. The percentage of US middle schools in which students are required to receive instruction on HIV prevention decreased from 82% in 2000 to 71% in 2016, according to the School Health Policies and Practices Study.
Health-related behaviors: 2017 data from the Youth Risk Behavior Surveillance System (YRBSS), which monitors health behaviors that contribute to the leading causes of death and disability among youth.
Low rates of testing: Only 9% of high school students have been tested for HIV. Among male students who had sexual contact with other males, only 15% have ever been tested for HIV. Low rates of testing mean more young people have undiagnosed HIV. People who do not know they have HIV cannot take advantage of HIV care and treatment and may unknowingly transmit HIV to others.
Substance use: Nationwide, 19% of all students who are currently sexually active (had sexual intercourse during the previous 3 months) and 20% of male students who had sexual contact with other males drank alcohol or used drugs before their most recent sexual intercourse. Young people may have sex without protection (such as using a condom or taking medicine to prevent HIV), when under the influence of drugs or alcohol.
Low rates of condom use: Nationwide, 46% of all sexually active high school students and 48% of male students who had sexual contact with other males did not use a condom the last time they had sexual intercourse. Using condoms the right way can protect from HIV and some sexually transmitted diseases (STDs).
Number of partners: Nearly one-quarter (24%) of male students who had sexual contact with other males reported sexual intercourse with 4 or more persons during their life, compared to 10% of all students. The more sexual partners you have, the more likely you are to have sex with someone who has HIV and doesn’t know it.
Older partners: Research has also shown that young gay and bisexual men who have sex with older partners are at greater risk for HIV infection. This is because an older partner is more likely to have had more sexual partners or other risks and is more likely to have HIV.
Socioeconomic challenges for young people with HIV: Among people with HIV who are receiving medical care, young people aged 18 to 24 are more likely than older people to be living in households with low income levels, to have been recently homeless, recently incarcerated, or uninsured. All of these factors pose barriers to achieving viral suppression and highlight the need for youth-specific support for HIV care retention and medication adherence.
Low rates of pre-exposure prophylaxis (PrEP) use: A 2018 study found that young people are less likely than adults to use medicine to prevent HIV. Barriers include cost, access, perceived stigma, and privacy concerns.
Feelings of isolation: High school students may engage in risky sexual behaviors and substance misuse because they feel isolated from family or peers and lack support. This is especially true for gay and bisexual students who are more likely than heterosexual youth to experience rejection, bullying, and other forms of violence, which also can lead to mental distress and engagement in risk behaviors that are associated with getting HIV. In the 2017 YRBSS, 33% of gay, lesbian, or bisexual students reported being bullied on school property in the previous 12 months, compared to 19% of all students.
Stigma and misperceptions about HIV: In a 2017 Kaiser Family Foundation survey, 51% of young adults aged 18 to 30 said they would be uncomfortable having a roommate with HIV, and 58% said they would be uncomfortable having their food prepared by someone with HIV. More than half of young people incorrectly believe that HIV can be transmitted by spitting or kissing. Stigma and misperceptions about HIV negatively affect the health and well-being of
young people, and may prevent them from testing, disclosing their HIV status, and seeking HIV care.
High rates of STDs: Some of the highest STD rates are among youth aged 20 to 24, especially youth of color. Having another STD can greatly increase the chance of getting or transmitting HIV.
The Exacerbation Among Poorer Youth
It's estimated that 37 million people are living with AIDS — approximately 1 in 200 people in the world today, including more than 2.6 million children under age 15. That's why Save the Children has prevention programs to stop the spread of AIDS and protection programs to help children who have been orphaned or are vulnerable due to the infection. In 2014, we helped 11.8 million children with HIV/AIDS prevention and treatment.
A growing body of evidence demonstrates how children living with or affected by HIV and AIDS are especially vulnerable to issues of violence, abuse, neglect and exploitation. Save the Children works to prevent the spread of HIV and ensure children affected by AIDS get the help they need. With the support of donors and partners, we help communities to care for sick and vulnerable children, as well as provide education, emotional support, nutritious food and much more.
Save the Children envisions a world where children and families can live free of HIV infection and in which families that are affected by HIV and AIDS can live positively and productively without stigma and discrimination.
Drawing on our global experience, Save the Children supports hundreds of thousands of children and young people at risk for, and affected by, HIV. Save the Children takes a comprehensive approach in addressing HIV and AIDS, focusing on orphans and other vulnerable children; young people most at risk to the epidemic; and efforts to combat pediatric AIDS including mother-to-child transmission prevention programs.
Healthcare
The Medicaid program is the main provider of insurance for low-income individuals. For people that are at 138 percent of the federal poverty level — so what that actually translates to is around $29,000 a year for a family of three — The result: HIV was detected in 2.4 percent, or 1 in 42 people living below the poverty line in those neighborhoods. HIV is at epidemic levels in certain poor urban areas across the United States, defined by UNAIDS as a prevalence in the general populations of more than 1%
According to leading HIV expert Amesh Adalja, MD, of the University of Pittsburgh School of Medicine, the average cost of care for an HIV patient in the U.S. is about $25,000 a year.
This shows that those families in poverty, even with medicaid, barely have the funds needed to get the medical care they need. If 1 in 42 people living below the poverty line are infected and/or exposed to HIV and the average cost per year is about 25,000$ for just one person, and medicaid gives approximately 29,000$ for a family of three than the amount left over which is 4,000$ is the only amount given left for the remaining two family members.
This information is the federal standard for Medicaid but can differ from state to state.
MORE RESOURCES
Sources
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https://www.medicaid.gov/state-overviews/scorecard/annual-medicaid-chip-expenditures/index.html https://www.kff.org/hivaids/fact-sheet/medicaid-and-hiv/ https://www.americanprogress.org/issues/poverty/news/2010/07/21/8101/poverty-is-driving-an-hiv-epidemic/
