HIV and AIDS in South Africa

Impact upon children and families

South Africa’s HIV and AIDS epidemic has had a devastating effect on children in a number of ways. There were an estimated 330,000 under-15s living with HIV in 2009, a figure that has almost doubled since 2001. HIV in South Africa is transmitted predominantly through heterosexual sex, with mother-to-child transmission being the other main infection route. The national transmission rate of HIV from mother to child is approximately 11%. Because the virus is transmitted from the child's mother in cases of mother-to-child transmission, the HIV-infected child is born into a family where the virus may have already had a severe impact on health, income, productivity and the ability to care for each other.
The age bracket that AIDS most heavily targets – younger adults – means it is not uncommon for one or more parents to die from AIDS while their offspring are young. The number of premature deaths due to HIV/AIDS has risen significantly over the last decade from 39 percent to 75 percent in 2010.

AIDS orphans with their grandmother

The loss of a parent not only has an immense emotional impact on children but for most families can spell financial hardship. One survey on HIV’s impact on households found that, “80% of the sample would lose more than half their per capita income with the death of the highest income earner, suggesting a lingering and debilitating shock of death.”
It is estimated there are 1.9 million AIDS orphans where one or both parents are deceased in South Africa, and that the HIV/AIDS epidemic is responsible for half of the country’s orphans. Another estimate puts the proportion of maternal orphans – those who have lost their mother – orphaned by AIDS as over 70 percent. Orphans may put pressure on older relatives who become their primary carers; they may have to relocate from their familiar neighbourhood; and siblings may be split apart, all of which can harm their development.
In some cases orphaned, often HIV infected, children are cared for by institutions, such as the Mohau Centre in Pretoria.  Institutions such as this deliver essential care and support for children throughout their childhood years, many of whom have special needs. As treatment has improved and become more available, children are surviving beyond childhood. Whilst this is a great achievement, governments now need to consider how to deliver care and support for HIV infected orphans that have survived into adulthood.

Harrison, D (2009, December) 'An Overview of Health and Health care in South Africa 1994-2010: Priorities, Progress and Prospects for New Gains' Commissioned by the Henry J. Kaiser Family Foundation