How the AIDS Initiative Works

Compassion's HIV/AIDS intervention strategies exist in three major categories: prevention, treatment and rehabilitative care for the affected. Prevention is the only cure and the only strategy for mitigating the spread of the pandemic itself; therefore, prevention is of first importance. Treatment refers to the medical and psychosocial care given to those who are already infected by HIV. Many children in Compassion's care are not themselves infected, yet their lives and well-being are jeopardized by HIV infection within their families and communities. Therefore, Compassion's response to HIV/AIDS extends beyond prevention of new infection and treatment of the infected, to include care for those whose lives are indirectly affected by the pandemic.

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Our goal is to reduce the incidence of new HIV infections among Compassion-assisted children through a focus on purity in sexual behaviors (abstinence and faithfulness) and the prevention of mother-to-child transmission (PMTCT).

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The true goal of prevention is to reduce the prevalence of HIV/AIDS in the population, and see fewer people infected. While raising awareness, educating at-risk populations, and distributing materials are important, they are secondary to achieving reduced rates at which the disease is transmitted from one individual to another.

Each day, 6,000 new HIV infections occur in young people 15 to 24 years of age. Compassion is aggressively targeting this demographic through our church-based prevention programs. Each day, 2,000 babies are born into the world with HIV already flowing in their blood because of HIV infection in their mothers. Sadly, up to 90 percent of these infections in newborns are preventable. Compassion is rapidly expanding its Child Survival Program, as well as other efforts, to reduce the rate of mother-to-child transmission during and after pregnancy.

The basic truth is that the vast majority of HIV infections are preventable. Directly or indirectly, nearly all new infections are the result of people's decisions. Prevention strategies must influence those decisions — in short, to change behavior.

The strategic value of Compassion's 700-plus local church partners in East Africa is clearly seen in the area of prevention education. These grassroots, local churches are well positioned to present the positive, life-giving message of "sex within marriage" that African youth need to hear — and to which they do respond. Uganda, for example, has witnessed a decline in HIV prevalence from roughly 12 to 4.1 percent over the past decade and that decline is largely attributed to successful prevention strategies encouraging abstinence and faithfulness.

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• Prevention education and awareness campaigns (drama, song, testimony from people living with HIV/AIDS [PLWHA], use of curricula, posters and other materials that promote positive behavioral choices and reduce stigma)
• Prevention counseling for adolescents and for parents
• Peer discussion groups; formation of "Life Clubs" or "positive living" groups
• Encouraging disclosure of status
• Promotion of voluntary counseling and testing (VCT) and routine testing
• PMTCT treatment for mothers of Compassion-assisted children
• Mobilizing the church to engage in stigma-reduction, awareness and a Biblical foundation for life choices, as well as the Biblical basis for loving the afflicted
• Networking to leverage the capacities and resources of other organizations and government

Note: Compassion funds will not be used to purchase or promote the distribution of condoms. The message of "safe sex" to youth is contradictory to the Biblical message of sexual purity.

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Our goal is to respond to the medical and psychological needs of HIV-positive children through medical treatment, counseling and social support.

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The goal of our treatment program is straightforward. Compassion wants to impact the lives of children, and to see children treated for HIV/AIDS — especially those who would not normally receive care.

Surprisingly, the greatest challenge is not to deliver pills, build clinics, or hire doctors. These cannot be considered successful endeavors unless they actually result in children being effectively treated.

The challenge is identifying children and families in need, earning their trust, and motivating them to go for care. This is difficult in light of the stigma that can come when they acknowledge their infection status.

What's more, there must be strong local support that does everything possible to keep children on therapy. The local church is a proven, replicable model for care delivery that ensures that infected children will receive the ongoing attention that will save their lives.

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Programs that fail to ensure that children continue taking their medicine each day will fail to treat the child and complicate future therapy for that child. Furthermore, such failure will promote the emergence of drug-resistant strains of HIV. That event is a catastrophic risk that the global fight on AIDS simply cannot allow.

The challenge is in the small places. In the soft places. It isn't about multibillion-dollar access programs and infrastructure. It is about providing loving encouragement and ongoing motivation to a 9 year-old girl who lost her parents to AIDS. It is about training those responsible for her care and removing anything that discourages her from making that regular trip to the clinic to get her next month's supply of medicine, or from taking her next dose of medicine even though it tastes bitter.

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• Provision of antimicrobial prophylaxis (such as Septrin)
• Treatment of opportunistic infections and disease
• Provision of nutritional supplements
• Monitoring of immunologic and virologic status (such as CD4* or HIV RNA tests)
• Facilitation of medical access through referrals and transportation
• Provision of ART to Compassion-assisted child
• Provision of ART to siblings and caregivers of children
• Provision of psychosocial support through individual and family counseling
• Facilitation of the formation of "positive living" groups
• Provide home care

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Our goal is to respond to the needs of children whose lives are directly or indirectly impacted by HIV infection of caregivers or siblings.

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The goal of rehabilitative care is to restore normalcy and security to the lives of children who are the indirect victims of AIDS. The majority of these children are orphans who have lost their parents or caregivers to AIDS, or who are otherwise made vulnerable by HIV infection in their family.

A child may not be infected, yet the infection of their mother or father often results in loss of employment, income, and subsequently, the security of housing and food. In addition, stigma and despair shred the caregiver's capacity to meet the emotional-psychological needs of their children. Compounding this vulnerability is the presence of opportunistic infections such as TB, which increase the risk of infectious disease in children living with a parent with AIDS.

Rehabilitative care must meet not only the physical needs of children for housing and food, but also the emotional and psychological needs of children by restoring to the child a loving and consistent caregiver. Ideally, this care will be found within the context of families related to the child, such as aunts or grandmothers. In some cases, non-relatives can offer excellent nurturing care to orphans. When needed, family-like models of child care are reconstituted by integrating orphans of different ages and gender under the care of a "mom" who lives with the children in a home integrated into the community (not a home perceived by the community to be institutional).

In any model of care for orphans and vulnerable children, Compassion offers support for physical needs such as housing, food and income generation, as well as psychological needs such as caregiver training and education, emotional support and counseling.

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• Provision for medical needs of caregivers and siblings, including treatment of opportunistic infections, medical tests, as well as transportation costs associated with access
• Provision of psychosocial support through individual counseling and family counseling
• Support for care of orphans and vulnerable children
• Housing and shelter assistance: home rent, home repair, blankets, mattresses 
• Housekeeping assistance
• Home visits, monitoring and encouragement by child development staff
• Provision of food and nutritional supplements 
• Replacement care: family-like settings to rebuild the critical elements of family for the orphan
• Income-generating activities

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Four Distinct Categories of Care

Compassion's AIDS Initiative has a profound impact for every child we serve, as well as for those children directly affected by the disease. Your support brings a complete package of practical help based on the level of need.

All Compassion-assisted children receive health-related training for prevention of disease and promotion of healthy living. Compassion-assisted children are also eligible to receive nutritional support, as needed, medical treatment and clinical care that includes everything from antibiotics to heart surgery. AIDS-related care is provided within Compassion's overall health management framework.

Compassion implements AIDS Initiative strategies through distinct categories of intervention. Depending on the level of need, the categories and specific interventions are as follows:

Category 1: For All Compassion-assisted Children

• Health education
• HIV prevention education
• Promotion of voluntary counseling and testing
• Risk assessment

Category 2: For All Compassion-assisted Children With Health Issues (HIV-related or Not)

• Health education
• HIV prevention education
• Stigma-reduction interventions
• Assessment surveys and support
• Voluntary counseling and testing
• Disease treatment
• Nutritional support
• Institutional care as needed
• Transportation assistance
• Income generation
• Housing/shelter assistance

Category 3: For All HIV-positive Compassion-assisted Children and Their Caregivers

• Antimicrobial prophylaxis (such as Septrin) and treatment for opportunistic infections
• Laboratory services to monitor the progression of HIV, such as CD4* tests
• Family training
• Nutritional assistance
• Counseling, home-based care and support
• Transportation assistance for clinical access
• Prevention of mother-to-child transmission
• If needed: Income generation assistance, housing/shelter assistance

The above interventions may be extended to biological siblings as funds allow.

Category 4: For All HIV-positive Compassion-assisted Children Qualified for ARV Therapy

• Antimicrobial prophylaxis (such as Septrin) and treatment for opportunistic diseases
• ARV therapy and monitoring
• Family training
• Counseling and support
• Aggressive nutrition supplementation
• Transportation assistance for clinical access
• Biannual testing (CD4*, etc.)
• Home health care and supplies
• Institutional care
• Livelihood support
• If needed: Income generation assistance, housing/shelter assistance

The above interventions may be extended to caregivers and biological siblings if the funds are available.

*CD4 testing measures the capacity of the immune system to defend the body against infection. When the T-cell count reaches 200 or lower, the body is too weak to ward off infection and is recognized as having AIDS.

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