Give a future for 950 Indian kids living with HIV

Nandhakumar is 14 years old and HIV-positive, diagnosed following treatment at a government hospital. His parents, accused each other and separated even though both tested HIV-negative. He he now lives with his mother, who has consulted a fortune teller and believes treatment is unnecessary. We meet them regularly but this is not the time to try and find out how he was infected.

Annual Report April 2025 – March 2026

Working through HIV-positive networks across 8 Districts in Tamil Nadu, the programme follows up and counsels HIV-positive children and their guardians to ensure treatment adherence at government centres, manage complications, support education, secure government entitlements, and address wider social issues affecting their wellbeing. The programme currently supports 438 HIV-positive children under 18 (231 boys, 207 girls).

New cases and transfers Nine children were newly detected as HIV-positive during the year, most born to irregularly treated or untreated mothers. Two cases — both 14-year-old boys with confirmed HIV-negative parents — remain unexplained, with possible routes including contact with infected blood, sexual transmission or abuse, or unofficial adoption. All nine are now on ART, with one exception. Twenty children (14 girls, 6 boys) were transferred from other districts, 16 from two closed hostels; all but one are on ART.

Treatment adherence Of 438 children, 432 are currently on ART. Five children or guardians who had stopped or refused treatment were successfully persuaded to recommence. Of 31 children with irregular adherence, 27 have been regularised through counselling and follow-up. Twenty-six children on second-line ART received specialised adherence support. During the year, 83 children experienced opportunistic infections, 16 requiring hospitalisation.

Young adults 541 HIV-positive unmarried young adults over 18 received premarital, safe sex, and related counselling — 167 in group sessions, the remainder individually. Twenty-seven individuals with HIV-negative partners received specialised counselling on status disclosure.

Key constraint Access to second-line ART drugs remains the most significant challenge. Around 100 children require a more expensive drug regimen — often due to earlier use of cheaper off-patent drugs or irregular treatment — but are not receiving it. Authorities deny drug shortage or cost considerations, and HIV networks, most of whom receive government funding, are constrained in challenging this formally.

Mohammad Althaf was born in 2007 to a widowed mother living with HIV, and he too was infected at birth. When Althaf was two years old, his mother remarried an HIV-negative man and moved away, leaving him in the care of his grandmother, Fathima. Fearing stigma and social consequences, the family decided to keep his condition a secret.

When our programme began work in that district, we initially assumed that Althaf had either moved away or passed on—after all, it is rare for someone infected at birth to survive for 16 years without treatment. But to our surprise, he was there: alive, somewhat thin, but otherwise appearing well.

Fathima firmly insisted that nothing was wrong with him. “See for yourself,” she would say. “God has protected him so far, and will continue to do so.” When our volunteers persisted, she became distressed and even threatened self-harm if they continued to trouble her or tried to speak to Althaf.

Shortly afterward, Althaf’s mother fell seriously ill. With the help of our volunteers, she was admitted to the hospital. This created an opportunity for the team to meet both Fathima and Althaf in a medical setting. It was there that Althaf, for the first time, became aware of his condition. Confused and shaken, he asked, “How come no one told me?” He chose to be tested.

Today, both Althaf and his mother are on treatment. Within a short time, he gained eight kilograms, a clear sign of improving health. He is doing well in his studies and seems to embody the meaning of his name—Althaf, derived from Arabic, meaning “kind-hearted.”

The programme you support operates across eight districts and is implemented through networks of people living with HIV. Of these networks, four are led by women, one by a transgender woman, and three by men. At the district level, activities are coordinated by part-time staff under the guidance of each network’s president. Network volunteers play an active role, contributing significantly to the overall development and well-being of children living with HIV.

The work of the past year

We currently provide follow-up support to 438 HIV-positive children under the age of 18, including 231 boys and 207 girls. During the reporting period, eight children were newly identified as HIV-positive and initiated on antiretroviral therapy (ART). While a small number of children continue to refuse treatment, progress has been made in strengthening adherence: of 31 children previously irregular in taking ART, 27 are now adhering regularly, and five out of nine who had discontinued treatment for a prolonged period have restarted therapy.

Twenty children (14 boys and 6 girls) were newly enrolled in programme activities. Additionally, 272 children who had not undergone required medical tests to see how well the treatment was working were identified, referred, and successfully completed testing.

During the reporting period, 83 children experienced opportunistic infections, of whom 16 required hospitalization for treatment.

Beyond child-focused interventions, the programme also provided premarital counselling, safe sex education, and related guidance to 541 HIV-positive unmarried young adults above the age of 18 (376 men and 165 women), as well as 218 adolescents aged 16–18 (114 boys and 102 girls). Of these, 167 participated in group sessions, while the remainder received individual counselling. A total of 23 marriages took place during this period, including 10 in which individuals married HIV-negative partners following disclosure.

Thanks so much for your support,

John Dalton

(Note: photos are representative)