Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance

The Forgotten Children


Children playing outside © Michael Nott/Khana/Alliance

As news of the sterilisation of female drug users hit the UK headlines this week it has highlighted the appalling manner in which some of the most vulnerable parents and their children are treated.

All women, including women who inject or use drugs, are entitled to receive the same care and attention when it comes to their health, their right to maternal health and their right to parent.

The Alliance works hard to support marginalised women such as sex workers and injecting drug users to access health services and ensure they can protect themselves from HIV and other sexually transmitted infections, access sexual and reproductive health services, including preventing mother to child transmission of HIV (PMTCT).  

But there is another group that has received very little attention and is of increasing concern to the Alliance. These are the ‘forgotten children’ of sex workers and injecting drug users, who are particularly vulnerable to HIV and stigma and discrimination.

Struggling with stigma

Excluded from educational opportunities, bullied and ignored by wider society, these children and families have fallen through the gap in terms of HIV programming.

Research shows that children are more likely to die before they are two years old if their mother is living with HIV and not able to access necessary treatment.

The Alliance believes that children do best when they remain with their families but as children of sex workers or injecting drug users they are at a much greater risk of being taken away and put in care, institutions or face neglect and violence.

Missing out on HIV services

These ‘forgotten children’ and their mothers are more likely to miss out on the chance of PMTCT because mothers are reluctant to come forward for testing as they fear disclosing their activities and the often inevitable consequences of the intervention of the authorities.  It therefore increases the likelihood of mother to child transmission of the HIV virus

These children and their parents are also likely to miss out on receiving healthcare, including early testing and diagnosis of HIV, anti-retroviral support and other support services such as access to education, early childhood development and psychosocial support.

What can be done?

Alliance partners are reviewing the work currently being done with children. A survey conducted later this month aims to document the programmatic experience, identify common factors and look at what the structural and legal barriers are, facing this group of children.

We already know that when social protection is in place it keeps vulnerable families together which means that children who are not removed can access their entitlement to child benefit grants, educational grants, cash transfers and food vouchers.

We now need to be sure that these programmes are reaching the ‘forgotten children’ and their families.

In India, the children’s programmes are starting to look at how the children of sex workers can be more systematically reached.

The Alliance is also writing a Best Practice Guide to support programming for this group of children and their families, and we are initiating and taking part in discussions with organisations working with children to see how best to meet the needs.

At the forthcoming ‘Family Support First’ Symposium on Children Affected by HIV and AIDS being held in Vienna before the International AIDS Conference in July, Alliance partners will present the experiences of key populations and their children. The session will explore:

  • The issues around women who use drugs during pregnancy,
  • & identifying the best support women can be provided with to care for their babies.
  • The barriers facing parents who use drugs in Russia,
  • And the experiences of sex workers and their families in Cambodia.
Our goal?

The Alliance believes women who inject drugs or who are sex workers need to be protected from HIV and supported to deliver healthy babies. They need to be able to access ongoing support to provide care for their children and access services that all children are entitled to.  

    Children of sex workers or injecting drug users are at a much greater risk of being taken away