New Evidence Shows How Social Protection Can Support Children Affected by HIV

It is well known that social protection measures, which include a range of activities designed to combat poverty and exclusion, can reduce the risk of contracting HIV. However, there has been little evidence showing how social protection can protect and support vulnerable children and adolescents affected by HIV. This lack of documentation has stalled investment in solutions that work and left community-based organisations with limited funding to share their innovations.

Last year, the Coalition for Children Affected by AIDS (the Coalition) and ViiV Healthcare set out to address this evidence gap through the Reaching All Children Positive Action Challenge. The competition awarded $40,000 in grants to eight organizations dedicated to helping children and adolescents affected by HIV in low- or middle-income countries. Each winner received $5,000 to produce either a scientific article or a case study that documented how the use of social protection supports HIV testing, treatment, and care for children.

In response, the Coalition received over 150 pages of evidence showing how social protection is currently working to help children in Kenya, South Africa, Malawi, Rwanda, Ethiopia, Uganda, and Zimbabwe. These case studies have greatly expanded our body of knowledge and will be an invaluable tool to drive attention towards integrated programming.

The research shared by the grant winners was compelling. In Kenya, women participating in a bread baking program saw their viral suppression jump from 36% to over 90%, while mother-to-child transmission rates dropped to zero. In Rwanda, adolescents receiving cash transfers and peer-led life skills training reported financial, psychosocial, and health benefits, with one participant saying the program helped them “overcome despair.” And a program relying on peer counselors in Zimbabwe increased the likelihood of viral suppression among adolescents by 42%.

The Coalition has long championed the fact that excluded children, adolescents, and families need a combination of biomedical, social, and economic support to improve their HIV outcomes.  Social protection is a central pillar enabling vulnerable families to survive and thrive. We can all learn from this new body of evidence, showing how social protection can be harnessed to improve HIV outcomes in children. Not only will this work contribute to building the much-needed evidence base, but it can also be used to encourage investment in smart solutions that help vulnerable children and adolescents affected by HIV.

Social protection is more important than ever as the world faces COVID-19. The pandemic has left low- and middle-income countries with even fewer resources, adding to the challenges that people affected by HIV must overcome. In addition to straining local health systems, shutdowns and quarantines have hurt small businesses run by parents and caregivers, making life harder for the children in their care. It is, therefore, essential to implement and scale up programs such as those highlighted by the Reaching All Children Positive Action Challenge winners to ensure children and adolescents affected by HIV are not made even more vulnerable at this precarious time.