THE ORPHAN PROBLEM - EXPERIENCE OF A SUB-SAHARAN AFRICA RURAL-POPULATION IN THE AIDS EPIDEMIC

An assessment of the prevalence of orphans and the magnitude of their problems and the extent to which HIV-I is contributing to this was don e in a rural population in South-West Uganda with an HIV-1 seroprevale nce of 8% among adults. Slightly over 10% of children aged less than 1 5 years were reported to have lost one or both parents. Loss of the fa ther alone (6.3%) was more common than loss of the mother alone (2.8%) . Generally orphans were living with their surviving parent or other r elatives but it was also noted in this study that some children with b oth parents alive lived with relatives as part of the extended family system. HIV-I seroprevalence rates were higher among orphans than amon g non-orphans and were up to 6 times higher in the 0-4 year age group. Seropositivity rates were also higher among surviving parents of orph ans than among parents of non-orphans. No significant difference in mo rtality between orphans and non-orphans was observed. During a 3-year follow-up period a total of 169 children became orphans and 43% of the se cases resulted from the death of an HIV-I positive parent. There wa s a limited effect on school attendance by orphanhood. The HIV-I epide mic has substantially increased the number of orphans in this communit y, a finding which is probably typical of many other sub-Saharan Afric an countries. It appears that these orphans were generally well looked after within the community. This coping capacity may, however become overstretched if the epidemic evolves further.