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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Mass Orphanhood in the Era of HIV/AIDS: Bold Support for Alleviation of Poverty and Education May Avert a Social Disaster

Neddy Rita Matshalaga and Greg Powell , 2002

A brief editorial which argues that only by addressing the fundamental causes of the HIV/AIDS epidemic, such as poverty and social exclusion, will a sustainable solution be achieved. Support for extended families and education for children affected by HIV/AIDS are needed to respond the crisis, as well as a larger scale effort to transfer resources, strengthen economies and secure investments throughout Africa.

Best Practices for Care of AIDS Orphans

Interagency Coalition on AIDS and Development , 2002

Brief overview of successes, challenges, threats and programmatic best practices in addressing the needs of children affected by AIDS.

Survival in Child-Headed Households: A Study on the Impact of World Vision Support on Coping Strategies in Child-headed Households in Kakuuto County

Frederick Luzze, 2002

This paper presents a study in Uganda on the effects of NGO interventions, and focuses on coping strategies in child-headed households (CHHs) and on community support systems.

HIV and Children Affected by Armed Conflict: A UNICEF Fact Sheet

UNICEF, 2002

Outlines links between HIV/AIDS and armed conflict, with emphasis on their joint impacts on children. Summarizes key priorities for dealing with HIV/AIDS, children, and conflict.

Suffering in Silence: The Links between Human Rights Abuses and HIV Transmission to Girls in Zambia

Janet Fleischman, 2002

Documents the nature of sexual abuse against girls in Zambia, why it continues to happen, and the links with HIV infection. Outlines policies for prevention and details what each relevant organization on the ground is doing (or not doing) to address the problem.

Costs of Care and Support

Tim Quinlan and Chris Desmond, 31 Dec 2001

Discussion of the cost of care and support for children affected by HIV/AIDS in South Africa, with a recommendation for the combined use of state based interventions and community based solutions.

Romania's Abandoned Children Ten Years After the Revolution

U.S. Embassy Bucharest, Romania, 01 Feb 2001

An account of the massive child welfare crisis in Romania which erupted from a movement in Romania during its communist regime to institutionalize thousands of children. This paper also reports the efforts of NGO’s, PVO’s and the international communities to reverse the damage after the fall of communism and also where the efforts need to be directed.

Transitioning From Institutional Care of Orphans to Community-Based Care: The Experience of Ethiopia's Jerusalem Association Children's Homes

Mulugeta Gebru and Rebecca Atnafou, 2001

An account of Jerusalem Association Children’s Homes’ work involving deinstitutionalization of orphaned children in Ethiopia. The report is a summary of the steps taken by this organization to reunify/reintegrate the children into their families and society and some next steps are also mentioned.

Child Needs Assessment Tool Kit

N/A, 2001

A comprehensive tool kit providing a methodology, questionnaire and software for assessing the needs of young children affected by the HIV/AIDS epidemic. Used to help design of service programs, secure funding, and monitor and evaluate programs specifically targeting the needs of young children and their families.

Care For Orphans, Children Affected By HIV/AIDS And Other Vulnerable Children

Family Health International, 2001

A summary of comprehensive care needs for children affected by AIDS. Includes several case studies which highlight key components of comprehensive program design, implementation and evaluation.