Belize has the highest HIV prevalence in Central America and yet, in common with most countries in the region, very little work has been done to understand the social impact of this epidemic on children. In 2004, UNICEF conducted a rapid assessment to fill this critical research gap. The objectives of the assessment were to develop a better understanding of the impact of HIV/AIDS on the children of Belize and to inform national stakeholders so they could agree on appropriate action. The assessment process included a review of existing data relating to HIV/AIDS and children, interviews with officials from related government and non-government agencies, focus group discussions with community groups, structured interviews with children made vulnerable by HIV/AIDS and their caregivers, and a national consultation with key stakeholders to report back on the rapid assessment, canvass further opinion and identify follow-up action.
The assessment found that many of the vulnerabilities typical of developing countries were not present in the Belizean population. Belizeans demonstrate in many ways that they put children first. Although poverty is common, relatively few children are starving, being excluded from school, or being denied basic medical services. Children living on the street and child headed households are extremely rare. Government and civil society appear united on avoiding institutional care of children. Although many children are born to under-age mothers, are growing up in single-female-headed households, and are in the care of adults other than their own parents, there is little evidence that these children are accorded ‘second-class’ status.
With specific regard to the effects of HIV, however, the assessment noted an intense amount of perceived and real stigma. Fear of stigmatization leads some HIV-positive individuals to forgo antiretroviral therapy, which can exacerbate child vulnerability as HIV disease progresses and caregivers become increasingly ill. Measures such as a public awareness campaign to challenge the stigma surrounding HIV/AIDS are recommended. General interventions for children affected by HIV/AIDS, such as strengthening the social safety net and providing appropriate psychosocial support, are also identified as necessary steps forward.