Worldwide it is estimated that more than 15 million children under 18 have been orphaned as a result of HIV and AIDS. Of these children more than 12 million live in sub-Saharan Africa. As HIV infections increase among the adult population in Africa, millions more children will lose their parents to the AIDS epidemic.

It is predicted that by 2010, there will be around 15.7 million AIDS orphans in sub-Saharan Africa given the number of adults that are infected with HIV and AIDS.i

What is the definition of an orphan?

According to UNAIDS, orphans are children who lose their mothers to AIDS before reaching the age of 15.ii Unfortunately, this definition does not include children who have lost only their father and/or children who are orphans between the ages of 15 and 18. Children who are non-orphans but who live in households that foster orphans are also excluded from the current definition. The UNAIDS definition fails to recognize the many children that are rendered vulnerable by the AIDS pandemic who fall out of the narrowly defined category of orphan. As a result, the current UNAIDS estimates and future projections of the number of children orphaned by HIV and AIDS grossly underestimates the scale and impact that the disease has on children.iii An expanded definition of orphan with a greater emphasis put on "vulnerable" children as opposed to "orphaned" children would have drastic policy implications, allowing for stakeholders to more accurately identify and respond to the needs of AIDS-affected children.iv

What are some of the challenges that orphans face?

Emotional Neglect (impact): Many of the children whose parents are living with HIV and AIDS suffer from neglect as either one or both of their parents are unable to provide sufficient economic and emotional support for their children. As a result, these children often experience high levels of emotional neglect and psychological distress. Children whose parents are living with HIV and AIDS often become responsible for economically sustaining their families and younger siblings, putting extra pressure on them to take on the role of the parents as they must perform household tasks such as cooking, cleaning, farming and taking care of their ill or dying parents. According to some studies children who have been orphaned by AIDS have been found to experience higher levels of anxiety, depression and anger, than other children.v Furthermore, these psychological problems often become more severe if the child is forced to separate from their siblings after becoming an orphan. In some countries like Zambia, this happens regularly, given that some fifty-six percent of orphaned children no longer live with all their siblings.vi The isolation that orphaned children face is exacerbated by the stigma, shame, rejection, and fear that is often associated with people affected by HIV and AIDS.

Lack of Education Opportunities: Children that have become orphans after loosing either one or both of their parents to AIDS often miss out on school or perform poorly, as their education is interrupted because of domestic and economic pressures. Often these children must leave school to work, since many of them hold the responsibility as the sole money earners for their remaining family and siblings. AIDS orphans also miss out on the valuable life-skills and practical knowledge that they would have received from their parents. Without these skills and basic school education, many of these children's lives are negatively affected in the long run as they are more likely to face economic, social, and health problems as they grow older.vii This also has an effect on a larger scale as the whole country often ends up suffering when a significant number of its youth are unable to get an education, making the future national economic prospects diminish as a further consequence of the AIDS epidemic.

Stigmatization: Children who have been orphaned because of HIV and AIDS often experience stigma and discrimination from their families and communities through their association with the virus. They suffer from the sorrow and social isolation that is associated with people who are infected with the virus. They must also face the sickness and death of their parent(s), which is exacerbated by the stigma, shame, fear, and rejection that they experience within their communities. The stigma and discrimination that is associated with AIDS often causes direct consequences for children who lost their parents to the virus, as they are sometimes denied access to school, inheritance, property and often outcast in their communities. Children whose parents have died from AIDS are often assumed to be HIV-positive themselves; though often untrue, they remain outcast and stigmatized within their families and communities.

Family: In many situations, after either one or both parents have deceased, natural brothers and sisters are separated in an effort to distribute the burden of responsibility among a number of relatives. They are either placed with relatives or, in some instances, taken to other locations. Grandmothers are often the first to take on the responsibility of raising their grandchildren who have been orphaned. In some African countries where the death rate among adults form the ages of 25 to 44 is very high because of HIV and AIDS, most of the responsibility of raising children is left to grandmothers and the elderly.

Legal rights: Many parents suffering from HIV and AIDS do not provide clear instructions regarding the care of their children after they decease. Often, this happens because they lack basic knowledge of their legal rights and obligations, and/or they fear openly discussing AIDS and its consequences, still taboo subjects in many societies, often leading to stigmatization and marginalization.viii As a result, many children continue to be robbed of their inheritance since their parents have not left a will that names them as the sole beneficiary or the children fall victim to customs that require that the new guardian of the child take care of the property.ix

What is the impact of HIV and AIDS on children in general and orphans in particular?x

  • Children that have HIV and AIDS or have lost one or both of their parents to the virus often experience psychological and social distress.
  • They also experience various forms of stigmatization and discrimination.
  • Orphaned children are also more likely to suffer from malnutrition.
  • They often also lack the basic emotional and physical security that parents provide their children as they are growing up.
  • Orphaned children often lack parental guidance.
  • They also have less access to healthcare and medication.
  • They have fewer opportunities to access education and schooling.
  • They often lose their inheritance and other material possessions when they are placed with relatives.
  • Orphaned children are more likely to become homeless and suffer from hunger, and they are also more likely to be forced to resort to crime in order to survive.
  • They also have a higher risk of being exposed to HIV infection and other STDs (Sexually Transmitted Diseases).
  • Orphaned children, especially girls, are in many instances more vulnerable to sexual exploitation (both domestic and commercial) as well.

The Role of the Extended Family (i.e., grandmothers)

The care of AIDS orphans is increasingly falling to the elderly, primarily women, in several countries and communities. In Zimbabwe, for example, where some 26 percent of all adults are infected with HIV, a government-sponsored survey found that out of 11,514 orphans in three rural communities more than 11,000 were being cared for by relatives, most of whom were poor women who were widowed and above 50 years old.xi

The countries with the largest number of AIDS orphans in Africa:xii

(Table coming soon)

HIV and AIDS have had devastating effects on children who are orphaned after losing one or both of their parents to the disease. Consequently, an increasing number of households are headed by children, as AIDS erodes the traditional community support system. Orphaned children often end up being their family's principle wage earners, as AIDS prevents adults form working, and creates expensive medical bills. In many countries, orphans (particularly girls) are vulnerable to neglect. Because orphans are often considered a burden on society, they live under circumstances where they have few rights and little protection. Orphans are often treated less favorable in many instances compared to other children. They are more likely to suffer from abuse and emotional neglect.

i Children on the Brink 2004: A joint report of new orphan estimates and a framework for action” as cited at http://www.avert.org/aidsorphans.html
v Atwine B., Cantor-Graae E. and Banjunirwe F. (March 2005), ‘Psychological distress among AIDS orphans in rural Uganda’, Social Science & Medicine 61 555-564 as cited in AIDS orphans on Avert.org
vi USAID/SCOPE-OVC/FHI (2002), 'Results of the orphans and vulnerable children head of household baseline srvey in four districts in Zambia' as cited in African orphans on Avert.org
xii Chart retrieved from http://www.avert.org/aidsorphans.html
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