Creating an Evidence Base to Better Serve HIV-Affected Children

Sean Dryer

Senior Project Associate

Doreen Kahigwa Arinaitwe, a former direct beneficiary of an OVC program, shares her story of hope and success. Photo: Rebecca Simon/MSH

On October 2, 2014, the findings of a model that predicts the long-term consequences of adult HIV on children at the population level were presented the PEPFAR-sponsored Children’s Risk & Resilience in the age of HIV/AIDS event at the World Bank in Washington, D.C.  The model was produced by the South-Africa based Human Sciences Research Council (HSRC) in partnership with the LMG Project, USAID, and PEPFAR and allows us to better serve children affected by HIV in several ways:
  • It provides an alternative to orphan estimates for assessing the number of HIV-affected children, which allows for more informed population-level policy decisions on how to best reach vulnerable children with the services they need.
  • It allows for risk and adverse outcomes of HIV-affected children to be estimated at the population-level.
  • It allows us to examine how changes to contextual factors, such as poverty and adult adherence, affect these population-level estimates, providing another tool to guide programming priorities.

The event, co-sponsored by the LMG Project, USAID, and PEPFAR, also featured presentations and panel discussions with top global experts on children. Direct beneficiaries of Orphan and Vulnerable Children (OVC) programs shared their stories, including Doreen Kahigwa Arinaitwe. Doreen credited this support in allowing her to overcome childhood HIV, stigma, depression, and the loss of her family to reach adulthood, graduate from university, achieve a rich career as a schoolteacher, and rebuild her self-confidence. Doreen especially stressed the importance of psychosocial support in empowering her to reach her goals and build a fulfilling life.

HSRC’s Dr. Chris Desmond, the lead developer of the model, described the structure of the model and presented some of its key findings in his presentation titled, “Modeling the long-term impacts of adult HIV and AIDS on affected children.” These findings include:

  • In areas with high-prevalence of HIV, risk of adverse outcomes associated with adult HIV is widespread and may require population-level interventions.
  • Of the large population of children at risk, a much smaller proportion will suffer long-term adverse outcomes, such as school dropout, depression, and abuse. For these children, intense, targeted interventions will be needed to mitigate these impacts.
  • Health risks associated with maternal HIV are likely to occur in the first decade of a child’s life, which is also when adverse events are most likely to have long-term health consequences on children.  These findings indicate a need for interventions that support families with young children.

The full presentations and video recordings from the event, as well as complementary resources providing greater detail on all three phases of the research effort, are available at

The development of this model was the third phase of a two-year research effort to strengthen our understanding of both the short- and long-term consequences of HIV and AIDS on children, including infected and uninfected.  The first two phases of the research brought together and connected relevant findings within the HIV and AIDS and broader child development literature.

As with all good research, for every question answered two more were raised.  Throughout 2015, the LMG Project will continue to partner with HSRC, PEPFAR, and USAID to support additional important research that strives to answer the most critical questions, and to disseminate the findings to those who program or set policy for at-risk or marginalized children worldwide. Outputs of this partnership will include the use of the forecasting model to evaluate the potential value of further integration between OVC programs and other interventions shown to have benefits for HIV-affected children, as well as expansion of the model to include additional pathways and provide new and more powerful insights.