HIV/AIDS affects children even before the death of a parent

Drop in activity rates and income in a context of HIV/AIDS

Even before parents die, children affected by HIV/AIDS are more vulnerable than children who are not, and they encounter problems well before becoming orphans. Sick and weakened parents are no longer a sufficient active labour, reducing their income generating activities and thus worsening the existing poverty, which is further exacerbated by the high cost of treatments and care for the disease. In order to provide for the family’s needs, children must often abandon school and work.

In the rural regions of Zambia, households headed by someone who is stricken by chronic disease reduce the area under cultivation by 53% compared to households with no chronic illness, leading to a reduction in agricultural production and food quantity Haan, Marsland et al., 2003.

The reduced rate of activity leads to considerably lowered income for families affected by HIV/AIDS: in Welkom, South Africa, the average monthly household income for households affected by HIV was more than 50% lower than unaffected household incomes Booysen, Bachmann et al., 2002.

As highlighted by Robin Landis in a WHO report, “deprived of the labour from a healthy adult and related income, the family begins to depend on each member’s contribution, even the youngest. Moreover, the family often does not have the means to pay for school fees and other indirect costs incurred by a child’s education, and they cannot do without a child who does domestic chores or earns a little income.

Children from families that lack labour do not go to school because they must contribute to food production or small business in place of adults, or even beg for food or money. Given that girls often stay at home to help with household work, taking care of younger children and sick family members, their access to education is even more limited than for boys within the same household” Landis, 2002.

The high cost of treatment for HIV/AIDS

The costs generated by HIV/AIDS treatment are very high relative to the low standard of living in most African households. “Studies conducted in urban households in Cote d’Ivoire show that when a family member has HIV/AIDS, the household spends four times as much on health care as households unaffected by HIV/AIDS. These expenditures are even heavier since the household income has been reduced by at least half due to the sick person’s missed work days.” Bechu, 1998 (double translation English-French-English)

Treatment expenditures for the disease are higher than those of other pathologies Ankrah, 1991, with most of them exceeding, and widely/much more, the monthly income of an African family Chièze, 1994. This weighs heavily on family budgets, even more so since the infection mainly hits young, active adults, meaning a severe loss in revenues.

In addition to these economic problems, children living in a family affected by HIV/AIDS are in psychological distress due to parents’ HIV/AIDS infection and must face stigmatisation and discrimination about HIV/AIDS within their communities.

Therefore, even before orphanhood, a child can be profoundly affected and vulnerable because of HIV/AIDS, hence the term “Orphans and Vulnerable Children.” Nevertheless, all children who lack support and care must be considered rather than focusing exclusively on AIDS orphans Kleintjes, Peltzer et al., 2004.

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