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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The State of the Ugandan Child: An Analytical Overview

Walakira, E.J., D. Muhangi, S. Munyuwiny, F. Matovu, E. Awich, I. Ddumba Nyanzi, J. Kayiwa, J. Akellot, P. Mubiri, J. Majugo, A. Mutebi, M. Ruiz-Rodriguez - USAID, 2016

The State of the Ugandan Child: An Analytical Overview focuses on four thematic areas, namely: health and nutrition, education, child protection and child participation; with emphasis placed on the girl child.

Positioning Programs for Cost Effective Outcomes: The Uganda Interagency OVC Portfolio Review and Cost Analysis

Terence Beney, Charlotte Muheki, DeeDee Yates, Stephan Lagony, and Shibah Kanoowe, 2016

The purpose of the review is to provide evidence to support planning that will maximize the impact of the PEPFAR Uganda OVC portfolio.

Applying a Family-Level Economic Strengthening Intervention to Improve Education and Health-Related Outcomes of School-Going AIDS-Orphaned Children: Lessons from a Randomized Experiment in Southern Uganda.

Ssewamala FM, Karimli L, Torsten N, Wang JS, Han CK, Ilic V, Nabunya P. - PubMed, 01 Aug 2015

This study was designed to evaluate the effectiveness of a family-level economic strengthening intervention with regard to school attendance, school grades, and self-esteem in AIDS-orphaned adolescents aged 12-16 years from 10 public rural primary schools in southern Uganda.

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Household Economic Strengthening in Support of Prevention of Family-Child Separation and Children’s Reintegration in Family Care

Lisa Laumann, FHI 360, 01 Jul 2015

This paper presents an overview of learning related to the prevention of family-child separation, the reintegration of children into family care, and economic interventions that support both.

Promoting Education for Vulnerable Children by Supporting Families: A Holistic Intervention in Uganda

Stephanie Simmons Zuilkowski & Inbal Alon - Journal of Social Service Research, 11 Jun 2015

This article reports on the Western Uganda Bantwana Program, which worked with more than 1,000 HIV/AIDS-affected families with the goals of improving socioeconomic status, psychosocial functioning, and educational participation.

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Country Care Review: Ghana

Better Care Network, 09 Jun 2015

This country care review includes the care related Concluding Observations adopted by the Committee on the Rights of the Child.

Effects of cash transfers on Children’s health and social protection in Sub-Saharan Africa: differences in outcomes based on orphan status and household assets

Thomas M. Crea, Andrew D. Reynolds, Aakanksha Sinha, Jeffrey W. Eaton, Laura A. Robertson, Phyllis Mushati, Lovemore Dumba, Gideon Mavise, J. C. Makoni,Christina M. Schumacher, Constance A. Nyamukapa and Simon Gregson - BMC Public Health, 28 May 2015

This study, conducted in eastern Zimbabwe, addresses the gap in current understanding about the extent to which household-based cash transfers differentially impact individual children’s outcomes, according to risk or protective factors such as orphan status and household assets.

Review of Alternative Care in Thailand: Policy to Implementation with Special Focus on Children Affected by HIV/AIDS (CABA)

UNICEF, 01 May 2015

The purpose of this research was to capture more accurate and detailed information regarding children in various forms of alternative care in Thailand, as well as the legal, policy, management and oversight environment surrounding them in order to plan and programme more strategically in the area of alternative care, and simultaneously contribute to the global evidence base for international findings and recommendations on alternative care.

การศึกษาทบทวนด้านการเลี้ยงดูทดแทนในประเทศไทย: นโยบายสู่การปฏิบัติโดยมุ่งเน้นเด็กที่ได้รับผลกระทบจาก เอชไอวี/เอดส์ (CABA)

UNICEF, 01 May 2015

The purpose of this research was to capture more accurate and detailed information regarding children in various forms of alternative care in Thailand.

USAID/Uganda OVC Portfolio Review

4Children, 02 Apr 2015

This portfolio review of OVC programming in Uganda focuses on several priority issues, including: (1) targeting case management and referral mechanisms; (2) graduation; (3) links with HIV/AIDS care and treatment partners; and (4) overall coordination amongst implementing partners.