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Substance abuse The abuse of alcohol and drugs, particularly injection drug use are all associated with increased risk of HIV infection. Children affected by HIV AIDS may become involved in drug use at much younger ages (Hein, Dell, Futterman, RotheramBorus, & Shaffer, 1995; Naar-King et al., 2006). The use of drugs and alcohol has also been linked to mental health problems as well as problems in school and impairments in social functioning (CDC, 2008). Substance abuse presents an excellent portrayal of the dynamics discussed under the SAFE model. In this instance, a negative coping strategy (use of drugs or alcohol), in some cases to deal with issues like family loss or separation (connection to others) or life in a bad neighbourhood (safety/security) may lead a young person to cope by getting drunk or high. This negative survival strategy undermines their success and well being in all other basic dimensions of their security. For instance, social relationships may become even more strained or fail – or young people may perform poorly in educational or vocational training opportunities due to their use of substances. Migration and the disruption of social networks The death or illness of family members due to HIV/AIDS can necessitate migration of children away from communities where they have established support networks (Ansell & Young, 2004). Oftentimes, assistance for HIVAIDS affected children that is directed at communities may fail to consider these migration patterns. Research has documented that due to parental HIV infection, children already living with extended family for financial reasons may return home to care for dying relatives or upon parental death may relocate yet again to join the homes of extended family members (Ansell & Young, 2004). When family members take in children out of a sense of obligation, as is often the case with AIDS affected youth, they may receive different treatment or care compared to ‘‘biological’’ children in the same household (Human Rights Watch, 2005). These dynamics of migration as well as potential for discrimination of children taking into new households due to parental death or illness also merit close attention in the development of protection strategies, monitoring and support services. Child headed households In many countries in sub-Saharan Africa, orphans were traditionally cared for within the extended family. However, high mortality of young adults due to the pandemic has meant that the burden of orphan care is increasingly shifting to the very young and the very old (Drew, Makufa, & Foster, 1998). In some cases, older siblings or associates are assuming care for younger children (Foster et al., 1995; Human Rights Watch, 2005). This is one example of children engaging in survival strategies when formal mechanisms for care of orphaned children fail. As noted by Foster (1995), child-headed households may sometimes represent a temporary survival strategy that some families employ during transitions due to the death of primary caregivers and the logistical and economic adjustment that results. In this manner, the emergence of child headed households presents an example of positive and adaptive survival strategies that some families and children employ. Such responses should be recognized and supported by outside agencies, rather than

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Children affected by HIV/AIDS: SAFE, a model ...  

Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development Authors: Theresa S. Betancourt, Mary K.S...

Children affected by HIV/AIDS: SAFE, a model ...  

Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development Authors: Theresa S. Betancourt, Mary K.S...

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