At the age of 12, a minor we will identify as Julie for ethical reasons is HIV-positive.
She was born healthy to HIV-negative parents, but adversity started to haunt her life at the age of 10. Her mother recalls spending huge sums of money on drugs treating various infections, but to no avail.
“First was a terrible fever. Then a persistent cough and skin rashes. Nobody thought it could be HIV and Aids considering that none in the family is HIV-positive. It was after I took her for a full blood test that we realised it was HIV and Aids,” she explains.
Upon probing, the mother, whom we will identify as Naphiri, says the girl revealed having unprotected sex with peers during role playing games (Zawana).
“She said being a mother to a family during their games, she was having sexual intercourse with different boys, who acted as fathers,” explains Naphiri.
She insists the child was infected through sex. Naphiri says one of the boys the daughter slept with was rumoured to be HIV-positive.
“The boy was between 11 and 13. I wish I could trace the family to know the truth, but I can’t. We all relocated from the houses we were renting in Mbayani Township,” laments Naphiri.
Julie’s case can just be an example. In Malawi, role playing games are major childhood activity. During these games, kids practise what they see in their homes, watch on televisions or Internet. Sexual intercourse form part of the games.
However, of concern is the ignorance that surrounds the practice and the vulnerability to contract HIV.
HIV testing counsellor and psychotherapist Dominic Nsona says the probability of a minor to pass on HIV virus to another is high based on HIV status of the minor, the nature of penetration and the bruises incurred.
Minors do sexual intercourse for fun. Thirteen adults we sampled agree from experience that minors spend more time doing sex than adults because they are not controlled by ejaculation or orgasm. So far, there are no contraceptives for minors apart from parental care.
Six of the mothers confirmed having suspected their minors were engaging in sexual intercourses during kids’ games. However, they all agree that minors do sexual intercourse and try hard to keep the escapades private. Two caught their minors in the act.
Queen Elizabeth Central Hospital senior nursing Officer Lucia Mbulaje says menarche, the beginning of the menstrual function in women, also determines the vulnerability of a minor.
“Of course, girls reach menarche at different ages. While many reach menarche in teens, some start as early as seven. At 10, Julie was at high risk if the boy was HIV positive and there was seminal fluids contact,” she says.
UNAids 2017 report praises Malawi on HIV fight, saying it is close to reaching two of the 90-90-90 targets. The report further says Malawi has prevented two million new HIV infections among children aged 0-14.
“The cut-off point for minors is 13 years. This group deserves special attention. HIV interventions begin at mother-to-child transmission through pregnancy, delivery and breastfeeding. They are discharged at 24 months upon confirmed HIV-negative. Until they are 14, HIV interventions are offered with parental consent,” says Nsona.
However, most data on HIV infections among children only concentrate on mother-to-child transmission and children born HIV-positive. In the 2003 National Aids Policy branded a “Call for Renewed Action”, children aged 13 and below are only covered in a component that calls for “support programmes that strengthen the role of parents and guardians in shaping positive attitudes and healthy behaviours of children… in the context of HIV and Aids and other STIs”.
However, this seems to be for parents with HIV-positive children.
“I have never got any advice on HIV for my children during antenatal services. If there is any, it should be for those with HIV-positive children,” says Evelyne Kwashi, a resident of Chilobwe Township.
Mbulaje observes that minors are neglected because of the belief that chances for new infections are low if one is born HIV negative. She says the opposite is true. Sustainable Development Goals (SDGs) preach that no one should be left behind in attainment of the goals which include zero HIV infection by 2030.
While parents remain a major player in protecting minors from new infections, scholars say this is not enough because parenting is freehand.
Drug abuse counsellor Nungu Segemetsi Kamau speaking to Zodiak Television Insight programme recently said there is no manual for parenting in Malawi and it is not enough to expect parents to successfully provide comprehensive care to their children. She says this is one of the reasons some children indulge in immorality. Thus, there is need for more interventions to protect minors.
Ministry of Health spokesperson Joshua Malango agrees children aged below 14 have been a neglected group, but says the Malawi National Peadiatric and Adolescence HIV prevention roadmap which is aligned with the Malawi National Strategic plan for HIV and Aids (2015-2020) gives some hope to protect minors such as Julie.
However, still missing in the interventions is a comprehensive roadmap that addresses neglected traps for minors such as role playing games and growing up with a nanny.