A review of current literature on the impact of HIV/AIDS on children in sub-Saharan Africa.

Introduction Of the 49.7 million HIV infections that had occurred worldwide by late 1999, 72% were in sub-Saharan Africa; 84% of AIDS deaths, 91% of child HIV infections and 94% of child AIDS deaths worldwide have occurred in Africa [1]. Of children orphaned by AIDS throughout the world, 95% have occurred Africa where numbers of orphans will continue to rise throughout the next decade reaching 40 million by 2010 (Figure 1). Long term solutions will need to be crafted for these children because the impact of HIV/AIDS will linger for decades after the epidemic begins to wane. Even if rates of new infections were to level off in the next few years, the long incubation period means mortality rates will not plateau until 2020. Thus, the proportion of orphans will remain unusually high at least through 2030 [2]. For a variety of reasons, little attention has been paid to the situation of children affected by HIV/AIDS [3]. Greater understanding of the impact of HIV/AIDS on children is important in the design and evaluation of programmes to support children living in difficult circumstances. This paper reviews epidemiological characteristics of children affected by HIV/AIDS, coping mechanisms and current knowledge of the impact of HIV on children. Areas where important gaps in knowledge exist are highlighted.