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 Development, Implementation and Evaluation of Interventions for the Care of Orphans and Vulnerable Children in Botswana, South Africa and Zimbabwe

Anna Strebel, 2004

A review of interventions for orphaned and vulnerable children that focuses on community-supported, home-based care examples. Highlights several models and programs, such as the COPE approach and Village AIDS Committees. Advocates the need for more research-based interventions and evaluation.

An Initiative Supporting the Basic Income and Needs of HIV/AIDS Affected Households and Individuals (SIMBA)

Anuj Jain, 2004

This paper outlines a program (SIMBA) established to work with local AIDS Service Organizations (ASOs) in Zimbabwe to promote economic development in HIV/AIDS affected communities. Efforts to promote capacitiy building of organizations, self-managed and savings-based microfinance services, and basic business management training are described.

Children on the Brink 2004: A Joint Report of New Orphan Estimates and a Framework for Action

UNAIDS, UNICEF and USAID, 2004

This report examines the current state of orphans and vulnerable children. It provides a regional overview, highlights trends, urges support for alternatives to institutional care and child participation, and presents a framework of protection and care of orphans and vulnerable children. Includes comprehensive data appendices.

Children in Residential Care: The Zimbabwean Experience

G. Powell, T. Chinake, D. Mudzinge, W. Maambira, and S. Mukutiri, 2004

Analyzes the state of institutional care in Zimbabwe against the national child protection policy. Focuses on the role of donors in the proliferation of institutional care and strategies to better regulate the development and provision of child protection services.

Safety Nets for Children Affected by HIV/AIDS in Southern Africa

Geoff Foster, 2004

Discusses the interplay between informal and formal safety net mechanisms in supporting orphans and children made vulnerable by HIV/AIDS. Includes recommendations for strengthening traditional family and community safety nets weakened by the epidemic.

Child Protection: A Handbook for Parliamentarians

Dan O'Donnell and Dan Seymour, 2004

A handbook that includes examples of the many ways in which Parliaments and their members around the world have responded to the challenges of child protection through laws, policies, advocacy and other means. It also describes how Parliaments and their members can gain a clearer understanding of what their contribution can be, and equips them with the knowledge and tools they require to make that contribution.

Linking Safety Nets, Social Protection, and Poverty Reduction: Directions for Africa

Michelle Adato, Akhter Ahmed, and Francie Lund, 2004

A short discussion of various safety net program options and considerations for effective program design. Focus on reducing poverty in sub-Saharan Africa

Small Voices, Big Concerns: A Child Rights Approach to HIV/AIDS

Jane Blackhurst, Sarah Collen, and Helen Young, 2004

Outlines how a child rights approach can be used to strengthen policy implementation and provides recommendations as to how the EU institutions can move forward in implementing commitments to OVC.

Monitoring and Evaluation: Discovering and Utilizing Sound Practices

Catholic Relief Services and USAID, 2004

This brief outlines Monitoring and Evaluation sound practices of “spot checking” when costs can be prohibitive and the use of “station days”, a participatory method to collect accurate data on children.

Care for Children Affected by HIV/AIDS: The Urgent Need for International Standards

International Social Service and UNICEF, 2004

Brief summary of the role of informal, institutional and child-headed households as a result of the AIDS epidemic. Includes general standards by which to implement good practices in child care.