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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Social Protection: How important are the National Plans of Action for Orphans and Vulnerable Children?

Rachel Sabates-Wheeler and Lissa Pelham, 2006

This briefing paper emerges from a review of 14 national plans of action (NPA), or in the absence of a NPA, outputs from the rapid assessment analysis and action planning (RAAAP) work for orphans and children made vulnerable by HIV/AIDS. The purpose is to analyse the way that issues of social protection are incorporated into these plans and to highlight areas within the plans where social protection activity may be needed to achieve stated outcomes. Annex 3 summarises, country by country, the social protection content of each NPA.

Faith Untapped: Why Churches can Play a Crucial Role in Tackling HIV and AIDS in Africa

Tearfund, 2006

Contains a set of forward-leaning recommendations for churches and the donor community. Also contains an analysis of the role of faith-based groups in the response, specific case studies, the potential to do more on the ground, and challenges faced by churches.

Barriers and Incentives to Orphan Care in a Time of AIDS and Economic Crisis: A Cross-sectional Survey of Caregivers in Rural Zimbabwe

Brian Howard, Carl Phillips, Nelia Matinhure, Karen J Goodman, Sheryl McCurdy, and Cary Johnson, 2006

A survey of caregivers designed to assess barriers and incentives to fostering in rural Zimbabwe. Suggests that incentives for sustainable orphan care should focus on financial assistance.

Capacity Needs Assessment Report

Uganda Ministry of Gender, Labour and Social Development , 2006

An assessment to determine MGLSD and District Management and operational capacity needs in providing leadership, coordination, and monitoring and evaluating the national response to OVC and AB/Y in Uganda.

A Situational Analysis of Orphans and Vulnerable Children in Four Districts of South Africa

Alicia Davis and Donald Skinner (eds.), 2006

Identifies strengths and weaknesses of services offered to OVC in South Africa. A detailed list of recommendations suggests improvements to services.

A Model for Community-Based Care for Children: Nkundabana

CARE , 2006

A lessons learned document reviewing impacts of a community-based care and mentoring program for child-headed households in Rwanda.

Handbook on Paediatric AIDS in Africa

Denis Tindyebwa, Janet Kayita, Philippa Musoke, Brian Eley, Ruth Nduati, Hoosen Coovadia, Raziya Bobart, Dorothy Mbori-Ngacha and Mary Pat Kieffer, 2006

A practical resource handbook for health professionals. Topics covered include HIV epidemiology, preventing HIV infection, care of HIV-exposed or HIV-infected children, diagnosis and clinical staging of HIV infection, clinical conditions associated with HIV, antiretroviral therapy, adolescent issues, long-term and terminal care planning for children affected by HIV/AIDS and their families, counseling and psychosocial support, and nutrition.

Study of the Responses by Faith-based Organizations to Orphans and Vulnerable Children

Geoff Foster, 2006

A study that looks at the response of faith-based organizations in Kenya, Malawi, Mozambique, Namibia, Swaziland, and Uganda. The report contains statistical information, and details positive care practices to build on, and negative examples to avoid.

Child Protection and Children Affected by AIDS: A Companion Paper to Framework for the Protection, Care and the Support of OVC

UNICEF, 2006

This paper provides more detailed information on the provisions that should be in place in relation to the state social welfare sector, social protection, legal protection and justice, and alternative care. It also addresses the need to combat the stigma of abuse and HIV and AIDS.

A Study of Integrated Interventions for Children Made Vulnerable by HIV/AIDS in Haiti: A Case Study of La Maison l'Arc-en-Ciel

Mark Louden, 2006

Examines a community-based care program for children living with HIV in Haiti called Arc-en-Ciel. Includes an overview of services provided (residential care, home based care, and community mobilization) and lessons learned.