Article2005

The incidence and prevalence of orphanhood associated with parental HIV infection: a population-based study in Rakai, Uganda

Fredrick Edward Makumbi · Ronald Henry Gray · David Serwadda · Fred Kakaire Nalugoda · Mohamed Kiddugavu · Nelson Kaulukusi Sewankambo +2 more

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Poverty, Education, and Child Welfare HIV/AIDS Research and Interventions HIV/AIDS Impact and Responses

Abstract

BACKGROUND: There are limited empirical data on the prevalence and incidence of orphanhood due to parental HIV infection. OBJECTIVE: To assess the prevalence and incidence of orphanhood, and the population attributable fraction (PAF) of incident orphanhood associated with parental HIV infection, in a rural population with a 14.8% adult HIV prevalence. METHODS: The data are derived from a community cohort in Rakai District, Uganda. Census data were collected on all resident members in 10,657 households, including survival of parents of resident children in 1996/1997. Consenting adults were interviewed, provided blood for HIV testing, and were followed up 10 months later to determine parental death and incident orphanhood. The incidence rate ratio (IRR) of orphanhood associated with parental HIV-infection was estimated by Poisson multivariate regression. RESULTS: A total of 22,712 children aged 0-14 years were enumerated in 1996/1997. The overall prevalence of orphanhood was higher among children of HIV-infected parents (22.7%) compared with children of uninfected parents, 7.9%. The annual incidence of orphanhood was 8.2% if at least one parent was HIV positive, and 0.5% if both parents were HIV negative (adjusted IRR = 18.93). Older age of children, and older maternal age were significantly associated with an increased risk of orphanhood. The PAF of incident orphanhood due to parental HIV infection was 37.3%, and was highest among younger children (adjusted PAF = 50.6% for 0-4 year olds), and children with younger mothers aged < 25 years (adjusted PAF = 75.7%). CONCLUSIONS: Parental HIV infection markedly increased the incidence of orphanhood, especially among younger children and the children of younger mothers.

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2004Orphans in Africa: parental death, poverty, and school enrollment 2003Dimensions of the emerging orphan crisis in sub-Saharan Africa 1990Orphans as a window on the AIDS epidemic in sub-saharan Africa: Initial results and implications of a study in Uganda 1995Orphan prevalence and extended family care in a peri-urban community in Zimbabwe 1996The orphan problem: Experience of a sub-Saharan Africa rural population in the AIDS epidemic 1996Supporting children in need through a community-based orphan visiting programme 1994AIDS orphans in Kinshasa, Zaïre 2005Rising incidence and prevalence of orphanhood in Manicaland, Zimbabwe, 1998 to 2003

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