title: Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development.
abstract: A human security framework posits that individuals are the focus of strategies that protect the safety and integrity of people by proactively promoting children's well being, placing particular emphasis on prevention efforts and health promotion. This article applies this framework to a rights-based approach in order to examine the health and human rights of children affected by HIV/AIDS. The SAFE model describes sources of insecurity faced by children across four fundamental dimensions of child well-being and the survival strategies that children and families may employ in response. The SAFE model includes: Safety/protection; Access to health care and basic physiological needs; Family/connection to others; and Education/livelihoods. We argue that it is critical to examine the situation of children through an integrated lens that effectively looks at human security and children's rights through a holistic approach to treatment and care rather than artificially limiting our scope of work to survival-oriented interventions for children affected by HIV/AIDS. Interventions targeted narrowly at children, in isolation of their social and communal environment as outlined in the SAFE model, may in fact undermine protective resources in operation in families and communities and present additional threats to children's basic security. An integrated approach to the basic security and care of children has implications for the prospects of millions of children directly infected or indirectly affected by HIV/AIDS around the world. The survival strategies that young people and their families engage in must be recognized as a roadmap for improving their protection and promoting healthy development. Although applied to children affected by HIV/AIDS in the present analysis, the SAFE model has implications for guiding the care and protection of children and families facing adversity due to an array of circumstances from armed conflict and displacement to situations of extreme poverty.
authors.affiliation: François-Xavier Bagnoud Center for Health and Human Rights, Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA. theresa_betancourt@harvard.edu
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
authors.forename: Mary K S
authors.initials: MK
authors.lastname: Fawzi
authors.forename: Claude
authors.initials: C
authors.lastname: Bruderlein
authors.forename: Chris
authors.initials: C
authors.lastname: Desmond
authors.forename: Jim Y
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000517:prevention & control; D002657:Child Development; D005195:Family Relations; D005260:Female; D015658:HIV Infections; D006293:Health Promotion; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D006815:Hunger; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D008962:Models, Theoretical; D028701:Patient Rights; D010549:Personal Satisfaction; D013315:Stress, Psychological