FAQs about HIV and AIDS and World Vision's Hope Initiative

What is World Vision doing in response to the global AIDS pandemic?

How has AIDS affected World Vision programs?

Where is the need greatest?

Who are the most affected?

How are women affected?

How are children affected?

Where in Africa is World Vision working?

How many children orphaned and made vulnerable by AIDS does World Vision care for?

What services do they receive?

What prevention programming has proven most effective?

Does World Vision provide AIDS medication?

Where does World Vision get its funding for AIDS programming?

How much of World Vision contributions go to actual people in need versus administrative costs?

What is World Vision’s policy on use of condoms as a preventive measure?

What is World Vision’s policy regarding encouraging breastfeeding or use of formula among mothers with HIV?

How much difference can World Vision hope to make in light of the magnitude of this crisis in Africa?

Q: What is World Vision doing in response to the global AIDS pandemic?

A: World Vision operates AIDS prevention and care programs in more than 60 countries. The organization’s work is particularly focused on meeting the needs of millions of children who have been made vulnerable because of the pandemic, especially those who have lost parents to AIDS-related causes. AIDS awareness is also a significant aspect of World Vision development programs, which provide long-term aid to communities pursuing self-sufficiency.

In December of 2000, World Vision launched The Hope Initiative, a global effort focused on high-prevalence and high-risk countries around the world.

Our national offices, supported by regional AIDS advisors and the Hope Initiative Models of Learning team, implement comprehensive responses to AIDS. These responses focus on prevention, care, and advocacy. Integrating our AIDS response with existing World Vision efforts in child health, micro-enterprise development, food security, education, and peace building, is also a focus.

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Q: How has AIDS affected World Vision programs?

A: Rising child mortality rates and falling life expectancies indicate that much of the development progress made in recent decades is being lost.

For example, in hardest-hit areas, an emerging middle class has been pushed back below the poverty line by loss of income and medical bills. On the other hand, many of the poorest families never see a medical bill; few have seen a doctor, and even fewer can afford AIDS medications (anti-retrovirals; also referred to as ARVs).

As a generation of parents is lost to AIDS, grandparents sometimes become the guardians of 10 or more children. If grandparents are gone, older siblings, some of whom are not even in their teens, raise families. These children often must quit school to earn a living.

AIDS creates an overwhelming need for new services, including prevention education, care for people living with HIV or AIDS, and support for surviving children and families. Because these and other factors contribute to its spread, AIDS is addressed in the context of poverty, unemployment, lack of education, prostitution, child sexual abuse, and the low social status of women in many African cultures. Women are often powerless to insist that their partner wear a condom or even remain faithful.

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Q: Where is the need greatest?

A: Sub-Saharan Africa. According to the United Nations, nearly 23 million Africans are living with HIV, and in some of the hardest-hit countries, more than a fifth of the population carries the virus. The adult rate of infection is five percent in Africa as compared with a world average of 0.8 percent. The vast majority of countries with the highest HIV and AIDS prevalence rates are in Africa.

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Q: Who are the most affected?

A: Of the more than 33.2 million people living with AIDS worldwide, more than 22 million are African. Of that group, 61 percent are women. Overall in the world, 50 percent of people living with HIV are women. In part because of cultural limitations on female rights and freedoms, more African women are infected than men. In addition, almost 2 million HIV-positive Africans are younger than 15 years of age; about 90 percent of children living with HIV in the world are African. Children are most often infected in utero or during breastfeeding; in Africa more than 90 percent of adult infection is through sexual transmission between a man and a woman. Also, the impact of HIV on children has been rising, with children making up a greater percentage of people living with HIV in 2007 as compared to 2001.

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Q: How are women affected?

A: For physiological and social reasons, women and girls are particularly susceptible to sexual transmission. Often bound by cultural traditions that afford them a much lower social standing than men, they cannot control the sexual behavior (including adultery) of their husbands, and have no voice in contraception. Because of poverty and few or no legitimate employment opportunities, many women sell their bodies to survive, further spreading the disease. Ignorance about AIDS exacerbates the situation. For example, many men believe that having sex with a virgin will cure the disease. As a result, child molestation and rape are common in many places.

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Q: How are children affected?

A: Nearly two million African children younger than 15 are HIV positive— almost 90 percent of the worldwide number of children directly affected by the pandemic.

In countries like South Africa and Zimbabwe, AIDS has increased the under-five mortality rate significantly. In addition to those who are living with HIV, orphaned children are one of the most significant populations in need of support.

In Africa, 11.4 million children have lost one or both parents to AIDS; worldwide, that number is estimated at 15.2 million — and by 2010 is expected to reach nearly 20 million (some 16 million in Africa alone).

Roughly 30 million additional children around the world are desperately vulnerable because of AIDS, a number expected to climb to 40 million by 2010. These are children whose parents are sick, whose families have taken in extra children or who live in communities where there is not enough food, teachers, or health workers because of the pandemic.

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Q: Where in Africa is World Vision working?

A: In Africa, World Vision operates in 25 mostly sub-Saharan countries, including: Angola, Burundi, Chad, Congo, Ethiopia, Ghana, Kenya, Lesotho, Liberia, Malawi, Mali, Mauritania, Mozambique, Niger, Rwanda, Senegal, Sierra Leone, Somalia, South Africa, Sudan, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe.

World Vision is committed to establishing an HIV and AIDS component in each of its Africa programs.

The organization also runs prevention, care and advocacy programs in Haiti, the Dominican Republic, Mexico, Brazil, Chile, Honduras, Guatemala, Romania, Albania, Georgia, Armenia, Uzbekistan, Afghanistan, Azerbaijan, Pakistan, the Russian Federation, India, China, Myanmar (Burma), Vietnam, Thailand, Bangladesh, Cambodia, Papua New Guinea, and many other countries around the world.

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Q: How many children orphaned and made vulnerable by AIDS does World Vision care for?

A: World Vision cares for hundreds of thousands of children orphaned by AIDS in Africa and other regions. We cannot calculate the total number because often, the cause of a parent’s death is unknown because of lack of medical testing, or undisclosed because of the stigma associated with the disease. World Vision mobilizes and trains volunteer caregivers to assist orphans and vulnerable children. These caregivers provide assistance to thousands more children who are not covered by sponsorship. In Africa alone, between October 2006 and September 2007, 842,000 children received some form of care or assistance from WV-associated volunteer caregivers in Africa alone.

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Q: What services do they receive?

A: For sponsored children who have lost one or both parents to AIDS-related causes, World Vision provides vital assistance that includes meeting educational, health care, shelter, and other urgent basic needs. Older orphans, some of whom have become their families' breadwinners, are given vocational or agricultural training.

In addition, World Vision trains volunteer caregivers to provide continuous monitoring of children’s well-being, protection against abuse and neglect and spiritual and psychosocial support. Help in overcoming barriers to education, assisting with basic household tasks, caring for chronically ill family members, school fee assistance, food aid and other material support, when possible, is also offered.
Caregiver kits are given to
family members and local volunteers around the world who are providing compassionate support to people living with AIDS. The kits contain basic supplies like washcloths, latex gloves, cotton balls, antibacterial soap, antifungal cream, petroleum jelly, antidiarrheal medicine, and acetaminophen. World Vision’s Caregiver Kit program allows churches and other groups to participate in the kit-building process so that we can equip caregivers with the practical materials they need.

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Q: What prevention programming has proven most effective?

A: World Vision's health professionals believe that a holistic approach to HIV prevention is most effective. World Vision encourages the biblical principles of abstinence before — and faithfulness after — marriage to prevent sexual transmission.
The organization also provides accurate information about how to reduce the risk of HIV transmission if unhealthy behaviors are chosen. In addition, it addresses HIV and AIDS as part of a comprehensive program within the context of poverty, gender disparities, warfare, lack of education and other challenges. World Vision’s prevention strategy, focuses foremost on “primary behavior change,” or helping to change the behaviors that lead to vulnerability to HIV infection, a strategy which has been shown effective through other faith and government groups in a number of countries, including Zimbabwe, Kenya, Uganda, Thailand, Jamaica, and others — at reducing the spread of HIV.

World Vision works through schools, churches, and other community groups to provide values-based life-skills training for children and youth — ages 5 to 17 years of age — to avoid behaviors putting them at risk of contracting HIV.

The organization has also found that when youth educate each other, the information tends to effect more change in behavior. World Vision augments its Life-Skills training program by equipping youth peer HIV and AIDS educators, as well as forming peer HIV and AIDS support groups in many communities. Between October 2006 and September 2007, more than 59,000 children and youth in Africa were active as peer educators; more than 8,800 peer support groups were in operation and 895,000 children received values-based HIV prevention and life-skills training.

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Q: Does World Vision provide AIDS medication?

A: Outside of a few specific grant-funded programs, World Vision does not directly provide anti-retroviral drugs to people who are HIV-positive or who have AIDS. However, the organization provides referrals to programs that do provide ARVs, when available. In many contexts, staff are active in providing voluntary counseling and testing as well as basic healthcare, reducing the stigma that surrounds AIDS, and working in many other areas to promote and facilitate the success of ARV programs.

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Q: Where does World Vision get its funding for AIDS programming?

A: As with most World Vision programs, funds are provided by individuals, churches, corporations, and foundations. The U.S. government provides cash and food commodity grants that benefit people in need, including those living with HIV or AIDS, their families, and children orphaned by AIDS.

In Fiscal Year 2007, World Vision raised more than $28 million in private contributions specifically for its AIDS programs, and more than $53 million in grants from the US government, the Global Fund for AIDS, and other organizations.

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Q: How much of World Vision contributions go to actual people in need versus administrative costs?

A: For the past seven years, World Vision has continued to lower administrative costs and overhead rates. In fiscal year 2007, 86 percent of revenue went to programs that benefit children, families, and communities in need.

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Q: What is World Vision’s policy on use of condoms as a preventive measure?

A: World Vision’s primary AIDS-prevention message is abstinence before marriage and mutual faithfulness within marriage. Not only is this God’s intended means of sexual and marital wholeness and fulfillment, but it is also the most effective way to prevent the spread of AIDS.

However, We also recognize that there are those who cannot (such as faithful spouses or girls forced into prostitution) or will not choose to remain abstinent or mutually faithful to one partner. Because their lives and the lives of their partners are also precious to God, World Vision will recommend consistent condom use as a secondary strategy.

Orphans and vulnerable children are the priority concern to World Vision. One of the best ways to help these children is by keeping one or both parents alive to care for them as long as possible. The use of condoms can prevent infection or re-infection between husband and wife.

World Vision endorses a balanced ABC (abstain before marriage, be faithful in marriage, but in certain situations use a condom) approach to managing the spread of HIV and AIDS, believing it to be consistent with scriptural truths and God’s commandments of love, compassion and justice for the innocent. This approach is endorsed by the Christian Medical and Dental Association.

In Africa, World Vision uses curriculum from Scripture Union to teach young people life skills that will help them to have healthy relationships. Empowering young people-especially girls-through education, economic opportunity and life skills training, is far more effective than condoms in preventing the spread of AIDS.

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Q: What is World Vision’s policy regarding encouraging breastfeeding or use of formula among mothers with HIV?

A: World Vision affirms the policies of the United Nations Children's Fund (UNICEF), the World Health Organization (WHO), and UNAIDS: When a safe water source and sufficient supply of infant formula are not available for the full formula feeding of infants, breastfeeding should be encouraged among mothers who are HIV-positive. While the danger of breastfeeding mothers transmitting the disease to their children is substantial — 10 to 20 percent — children's risk of serious illness from unsafe water is even greater and mixed feeding — eg. breast-milk, formula and/or solids — is the most unsafe for babies with respect to HIV-transmission.

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Q: How much difference can World Vision hope to make in light of the magnitude of this crisis in Africa?

A: AIDS has devastated millions of African families — but there are signs of hope. Uganda was the first country to report a decline in instances of infection. Uganda's infection rate decreased from 15 percent in 1991 to 6.7 percent by the end of 2005. Similar successes have been seen in Rwanda, Kenya, Senegal, and urban areas of Zimbabwe, as well as in countries in the Caribbean and Asia.

World Vision hopes, through values-based life skills training — curriculum provided by Scripture Union aimed at encouraging youth to resist unhealthy behaviors — to contribute to further prevention successes in the countries in which it works. Indeed, during Fiscal Year 2007, more than 895,000 children and youth received life-skills training through World Vision programs in 23 African countries.

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