Detect, prevent and respond to physical, sexual and emotional abuse and neglect through the HIV continuum of care

Data from the Violence against Children (VAC) surveys and global analyses illustrate the scale and scope of violence against children and adolescents and emphasizes the urgency of responding effectively. 4Children, a USAID... [ view full abstract ]

Data from the Violence against Children (VAC) surveys and global analyses illustrate the scale and scope of violence against children and adolescents and emphasizes the urgency of responding effectively. 4Children, a USAID funded consortium, has undertaken a project to identify opportunities for violence prevention and response interventions within HIV pediatric testing and treatment.

Objective: Develop guidance that will enhance detection, prevention and response to all forms of VAC within HIV services.

Methods:
- Literature review on the linkages between HIV and child protection;
- Semi-structured interviews with global policymakers and practitioners across nine countries;
- Synthesis of findings to inform the development of guidance tools.

Results:
- Documented linkage between HIV and all forms of child protection violations;
- Lack of clinical guidance to systematically detect, respond and prevent VAC and the limited focus on physical and emotional abuse and neglect within HIV services ;
- Resource limitations hindering an appropriate response to issues of violence and neglect within HIV services;
- Need for robust and accountable systems to identify and support prevention and response to VAC throughout the HIV continuum of care.

Conclusion: There is widespread evidence of the linkage between HIV acquisition and treatment outcomes with violence and neglect. HIV services are an important entry point for identifying children at risk of and experiencing violence who may not access other services. However, this linkage is not translating into routine identification and appropriate support to children throughout HIV services. Health and social workers require guidance and systems to work more closely together to detect, prevent and respond to the needs of children who have experienced or are at risk of physical, emotional, sexual abuse or neglect. The next step is for these findings to inform the development of guidance such as job aids in clinical and community settings.