Inter-generational Linkages of AIDS: Vulnerability of Orphaned Children for HIV Infection

As the number of deaths associated with AIDS increases, especially in the developing world, addressing the health and wellbeing of children affected by AIDS becomes ever more important. Much has been debated about the intergenerational impact of AIDS and the vulnerabilities among orphaned children, but evidence to resolve these debates has remained limited and existing studies have not been synthesised in a coherent manner. A concern among public health scientists and policymakers is whether children orphaned in the context of HIV/AIDS are at heightened risk for becoming infected with HIV – not through vertical transmission, but through sexual behaviours or exposure to infectious bodily fluids. This article examines the evidence on this issue, focusing attention on three subgroups of children who might experience intergenerational consequences of AIDS: (1) children orphaned by AIDS, (2) children with caregivers who are living with HIV and (3) children in families affected by HIV/AIDS. This final group has a range of definitions, but refers here to children who either live in a household with person/s infected by HIV, or who have immediate family members (whether co-resident or not) who are infected with HIV. Heightened associations between orphanhood and risk for HIV infection would necessitate a call for improved linkages between social care and HIV prevention programmes for children orphaned by AIDS or other children vulnerable to familial HIV/AIDS.