Children Affected by HIV and AIDS

The HIV/AIDS pandemic is having a devastating impact on the well-being of children, particularly in those countries with the highest HIV prevalence rates in sub-Saharan Africa, the Caribbean, and parts of Asia. The virus affects children in multiple ways; they may lose one or both parents and other family members, or become infected with the disease.

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.

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Political factors shaping national systems of care for orphans and vulnerable children in low-income countries: Scoping review and framework

Yusra Ribhi Shawar, Shafkat Meraj, Adam D. Koon, and Jeremy Shiffman, 01 Sep 2025

This article reviews the political factors shaping orphan and vulnerable children (OVC) care systems in low-income countries, highlighting weak governance, limited political commitment, and heavy dependence on external actors. It introduces a social science–based framework of eight key factors—spanning policymaking, governance, and context—to guide research and strengthen OVC care systems.

The evolution of priority for the care of orphans and vulnerable children in Zambia

Yusra Ribhi Shawar, Joseph Mumba Zulu , 01 Aug 2025

Given the severe impacts of the HIV/AIDS epidemic and chronic poverty, the care of orphans and other vulnerable children (OVC) is a significant national issue in Zambia. This article examines the evolution of governance and policy for the care of OVC and identifies the factors that have shaped Zambia’s priority for and capacity to address this issue.

Trends in the prevalence and incidence of orphanhood in children and adolescents <20 years in rural KwaZulu-Natal South Africa, 2000-2014

Gabriela Mejia-Pailles, Ann Berrington, Nuala McGrath, Victoria Hosegood - PLoS ONE, 24 Nov 2020

In South Africa, large increases in early adult mortality during the 1990s and early 2000s have reversed since public HIV treatment rollout in 2004. In a rural population in KwaZulu-Natal, the authors of this study investigated trends in parental mortality and orphanhood from 2000–2014.

A Case-Study of OVC Case Management Through the Zambia Family (ZamFam) Project

Lyson Phiri, Drosin Mulenga, Nancy Choka, Caila Brander, Nachela Chelwa, Nkomba Kayeyi - Population Council, 01 Sep 2020

This case study was employed to understand actors, perceptions and document best practices by the ZAMFAM program, a project aimed at improving the care and resilience of vulnerable populations while supporting HIV epidemic control in Zambia.

Cognitive and Educational Interventions for Orphans and Vulnerable Children Affected by HIV/AIDS: A Meta‐Analysis

Tina Thomas, Yusra Ahmed, Mei Tan, Elena L. Grigorenko - Child Development, 07 Aug 2020

In this study, interventions addressing cognitive or educational outcomes for HIV OVC worldwide were examined through systematic searches conducted from October 2016 to 2019.

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Relationship Between Food Insufficiency and HIV Infection Among Caregivers of Orphans and Vulnerable Children in Tanzania

Amon Exavery, John Charles, Erica Kuhlik, Asheri Barankena, Godfrey Martin Mubyazi, Levina Kikoyo, Elizabeth Jere - HIV/AIDS - Research and Palliative Care, 24 Jul 2020

This study examines how food insufficiency relates to HIV infection among caregivers of orphans and vulnerable children (OVC) in Tanzania.

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Determinants of undisclosed HIV status to a community-based HIV program: findings from caregivers of orphans and vulnerable children in Tanzania

John Charles, Amon Exavery, Asheri Barankena, Erica Kuhlik, Godfrey M. Mubyazi, Ramadhani Abdul, Alison Koler, Levina Kikoyo & Elizabeth Jere - AIDS Research and Therapy, 16 Jul 2020

This study assesses the magnitude of, and factors associated with undisclosed HIV status to a community-based HIV prevention program among caregivers of orphans and vulnerable children (OVC) in Tanzania.

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PEPFAR Technical Guidance in Context of COVID-19 Pandemic

PEPFAR, 03 Jun 2020

This document provides technical guidance for a variety of PEPFAR issues, including the care of orphans and vulnerable children (OVC), and will be updated routinely as the situation evolves.

Adolescent mothers affected by HIV and their children: A draft advocacy agenda

Coalition for Children Aected by AIDS and the World Health Organization, 19 May 2020

This document sets out the draftadvocacy messages and recommendations for donors, governments, and civil society, which were prioritised by participants of the December 2019 Learning Session co-hosted by the Coalition for Children Affected by AIDS and the World Health Organization to develop an evidence-informed advocacy agenda on adolescent mothers affected by HIV and their children.

“Barriers to” and “Recommendations for” Providing Care and Support for Children Living as AIDS Orphans in Township Communities in the Eastern Cape South Africa; A Cluster Analysis

Sharron Frood & Edward Purssell - International Journal of Africa Nursing Sciences, 15 May 2020

This study used empirical data from health and social care professionals and cluster analysis to identify “barriers to” and “recommendations for” providing care and support to children living as AIDS orphans in township communities in Nelson Mandela Bay South Africa.

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