Children at risk of contracting HIV/AIDS in
By Leslie Knott
Source: United Nations Children's Fund (UNICEF)
KABUL, Afghanistan, 1 December 2008 – With 504
recorded cases, Afghanistan has a relatively low
number of confirmed
HIV cases, but experts on the
disease are raising alarm bells for an expected rise
in reported numbers, especially among street children.
"Children are at high risk to contract HIV in
Afghanistan," said Dr. Malalai Ahmadzai, UNICEF
Maternal Health and HIV Specialist. "Those children
who have lost their parents due to war, those children
who are doing street work and labour, and also those
children who may be at risk because of transmission
from mother to child."
According to Aschiana, a Non-Governmental
Organization working with street children, there are
more than 70,000 children who live on the street, working
to support themselves and their families. Engineer
Yousuf, head of Aschiana, has expressed a growing
concern for Afghanistan's children and their
"In Afghanistan there is an issue of child
vulnerability to HIV/AIDS," he said. "The modes of HIV
transmission in Afghanistan are also taboo subjects
that can't be openly discussed."
Included in these taboo subjects are male-to-male
sex with children and intravenous drug use. He added
that the lack of dialogue on taboo subjects is
contributing to the epidemic.
A growing concern
The last 30 years of war has created broken
families, widows, and redistributed the roles and
responsibilities among the breadwinners. Children who
are orphaned, or are responsible for providing an
income to keep their family fed, will routinely spend
their days on the begging on street. Their
vulnerability is preyed upon by criminal groups who
use children as sex workers and introduce them to drug
Intravenous drug use is one of the high-risk
activities that is contributing to the growing
possibility of an HIV epidemic in Afghanistan. As one
of the world's largest suppliers of heroin, the drug
is readily accessible, and it is common to see
syringes strewn through garbage – the same garbage
that children sift through looking for fuel for their
families or bits of metal that can be sold.
A lack of education among children regarding the
risks of drug use and interaction with needles also
contributes to the growing trend of addiction and
According to Afghanistan's National Aids Control
Program (NACP), as of November 2008, 504 cases have
been documented. But UNAIDS has reported that the
actual number of cases is more likely in the
thousands. Low levels of surveillance and testing, and
a heightened sense of taboo and stigma has made it
almost impossible to document the reality of the
These barriers combined with a weak government,
high rates of illiteracy and migration, and the large
domestic production of heroin has enabled HIV/AIDS to
take root and grow among the vulnerable populations.
Reaching out and breaking barriers
Since 2003, UNICEF has been working with the
Ministry of Public Health to raise awareness about
HIV/AIDS and its contributing factors and risks.
Activities have been focused on education of religious
leaders, Imams, and peer educators, as well as
developing a national strategic framework for
Prevention of Mother to Child Transmission.
Currently UNICEF is working with the Ministry of
Public Health to better assess the risks associated
with child abuse and exploitation within communities.
Various projects include a HIV and gender symposium to
raise awareness about the disease, and to gather data
on mother-to-child transmission in Afghanistan.
Help line services in five testing centres around
Afghanistan are due to open by the end of 2008. These
would be support centres for people looking for
anonymous assistance if they feel at risk of
contracting HIV, or if they have tested positive for
Whilst the subject of HIV and its contributing
factors continues to be taboo in Afghanistan, UNICEF,
working with local partners and the government, has
shown that it is possible to break through the
barriers and reach out to the vulnerable populations.
The goal is to ensure that Afghanistan protects itself
and its children from what could be a crippling