Aside from the physical and psychosocial stress associated with the onset of the disease itself and the experience of loss of loved ones, children affected by HIV/AIDS may additionally be subjected to the burden of caring for others, stigma, discrimination, exploitation, abuse, financial hardships, and are less likely to attend school. The social and economic effects of the disease means that areas with high AIDS-related mortality are less able to provide traditional family and community care, protection and basic services for its children.
Children with HIV-positive parents are at a greater risk of being orphaned, abandoned, removed by social services, placed into foster or institutional care, becoming homeless, or left to head households on their own. Orphaned children infected with the virus often have more difficulty obtaining care. Families and communities have rallied to provide kinship care to the large majority of the children who have lost their parents, however families and communities are struggling to cope, physically and financially, with the numbers of children involved. Despite international recognition of the damaging effects of institutional care and its high costs, institutional care has proliferated, often supported by external groups wanting to help. Far too little has been done in such countries to systematically strengthen and support HIV/AIDS-affected families and families caring for orphans, or to develop family-and community-based care for children without adequate family care.
Children should be cared for by their immediate and extended families wherever possible, with support services put in place to avoid abandonment. Regulated kinship, foster care, and local adoption should be developed for children without close relatives. Young people and communities should be provided with information on HIV/AIDS to avoid infection. Adequate medical treatment is needed to enable infected parents to live longer and to prevent HIV transmission from mother to child.
The literature in this section includes background information on countries and projects tackling the crises, including statistics, policy papers, implementation projects, and care options for children orphaned or infected by HIV/AIDS.