An expanded definition of vulnerable children affected by HIV/AIDS

The concept of AIDS orphans has been gradually expanded to include other children made vulnerable by the HIV/AIDS epidemic. The situation of orphans does not address the full scale of the problem; the HIV/AIDS epidemic and the surrounding poverty intensified by the disease are generating a context where large numbers of children are becoming vulnerable; hence the term “orphans and vulnerable children.” According to UNAIDS, vulnerable children refer to children whose survival, well-being, or development is threatened by HIV/AIDS UNICEF, UNAIDS et al., 2004.

However, vulnerability remains difficult to define. The non-governmental organisation (NGO) World Vision has identified vulnerable children in a context of HIV/AIDS as children who live in a household in which one person or more is infected by HIV/AIDS, dying or deceased; children who live in households that take in orphans; and children who live with persons too old or too young to take care of them World Vision, 2002.

Other factors relating to vulnerability need to be considered to better define the general aspects of the child’s context, such as poverty, access to shelter, education, health facilities or other basic services, stigma due to HIV/AIDS, and political and socio-economic crisis—all factors that influence vulnerability.

Furthermore, there is no methodology to date that enables the estimation of the number of vulnerable children by AIDS and its consequences.

The definition of a vulnerable child is based on indicators of basic needs. Skinner et al. have identified a list of variables to measure vulnerability in children Skinner, Tsheko et al., 2004 :

• Death or desertion of parents
• Severe chronic illness of parents: HIV/AIDS or others
• Illness of a child
• Physical or mental disability of a child
• Poverty
• Access to basic needs: education, health, social services, etc.
• Inadequate clothing
• Emotional problems
• Abuse of the child
• Drug abuse by caregivers or the child

However, there is a debate over the question of grouping orphans and vulnerable children under the same term. In a World Food Programme (WFP) report, Landis indicates: “Orphans and vulnerable children have different characteristics. Therefore, it is incorrect to consider them as a homogeneous group of needy children. Each orphan or vulnerable child can face different risks and specific vulnerabilities depending on gender, and whether he or she lives in urban, peri-urban or rural settings,  in the extended or a foster family,  in an institution or on the street, and whether he or she is infected or not by HIV.” Thus, “most publications consider it useful to distinguish orphans from vulnerable children only for matters related to psychosocial support, protection of orphan’s rights, specific interventions for orphans, and epidemiological surveys” Landis, 2002

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