Around the globe, the HIV and AIDS pandemic has devastated families, leaving children without the essential care and support they need to survive, grow, and thrive. About 16.6 million children have lost one or both parents to AIDS-related causes, according to UNAIDS.
About 37.9 million people around the world were living with HIV in 2018, and 1.7 million people contracted the infection that same year. Every year since 1988, Dec. 1 has been recognized as World AIDS Day to call attention to this scourge that has infected more than 77.3 million people since it was identified in 1981.
Children who are made vulnerable by AIDS include children living with HIV, children whose parent or parents have the disease or died from it, and children in households that take in orphans from families affected by HIV and AIDS.
Challenging the church to care about the AIDS crisis when it was a controversial topic, World Vision spurred global action to support special programs and child sponsorship to help thousands of orphans. Reflecting on the challenges of the late 1990s, World Vision U.S. President Emeritus Rich Stearns remarks, “Everything we do should advance public awareness by making people aware and helping people to care. Sometimes that means challenging the attitudes and beliefs of the culture and proclaiming God’s standards of mercy, justice, and compassion.”
History of the HIV and AIDS pandemic
More than 35 million people have died of AIDS since the U.S. Centers for Disease Control and Prevention reported the epidemic on June 5, 1981. More than 16.6 million children under the age of 18 have lost their mothers, fathers, or both parents to AIDS, and that number continues to rise, especially in sub-Saharan Africa, which is home to 15 million AIDS orphans.
At the height of the epidemic in 2005, as many as 40.3 million people were living with HIV worldwide, roughly two-thirds of them in Africa. Every day in 2005, more than 13,000 people were newly infected with HIV. About 3.1 million people died of AIDS in 2005, including nearly 600,000 children.
Progress against HIV and AIDS
UNAIDS detailed in its 2016 report the results of its six-year global plan to eliminate new HIV infections among children and keep their mothers alive.
More than 90 percent of children who contracted HIV received it from their infected mother while in the womb, during birth, or while breastfeeding. The 21 targeted countries accounted for the vast majority of people living with AIDS globally, according to the joint U.N. program.
In six years, those countries helped 1.2 million children avoid HIV infection. More than 2 million more pregnant women started receiving life-saving antiretroviral therapy, which can hold the virus at bay and prevent them from developing AIDS. Contracting HIV no longer is a death sentence because treatment is more effective and readily available to many.
Among the greatest gains were in Uganda, where public health workers and families reduced new HIV infections among children by 86 percent. South Africa and Burundi both reduced infection rates by 84 percent.
Seven countries reduced HIV infections among children by more than 70 percent between 2009 and 2016:
- Uganda — 86 percent
- Burundi — 84 percent
- South Africa — 84 percent
- Eswatini (Swaziland) — 80 percent
- Namibia — 79 percent
- Mozambique — 75 percent
- Malawi — 71 percent
The 14 other countries reduced new HIV cases among children by anywhere from 21 percent to 69 percent.
FAQs: What you need to know about HIV and AIDS
Explore frequently asked questions about HIV and AIDS, and learn how you can help children and families living with HIV and AIDS.
- Fast facts: HIV and AIDS
- How can I help children and families affected by HIV and AIDS?
- What are HIV and AIDS?
- How is HIV spread?
- What are the symptoms of HIV and AIDS?
- What is the treatment for HIV and AIDS? Is there a cure?
- Can HIV and AIDS be eradicated?
- Is there an HIV vaccine?
- Are women and girls at high risk for HIV?
- How are children most likely to contract HIV?
- How is World Vision responding to the HIV and AIDS pandemic?
Fast facts: HIV and AIDS
- HIV (human immunodeficiency virus) causes deterioration of the immune system so that the body is not able to fend off diseases and infections. AIDS (acquired immune deficiency syndrome) is the most advanced stage of HIV infection.
- Treatment with combination antiretroviral therapy (ART) keeps the virus from reproducing in the body, so the immune system continues to function.
- An estimated 37.9 million people were living with HIV in 2018; 1.7 million of them were children under age 15.
- Most children infected with HIV live in sub-Saharan Africa and were infected by their mothers during pregnancy, childbirth, or breastfeeding. Elimination of mother-to-child transmission is becoming a reality.
- About 1.7 million people became infected with HIV during 2018 compared to 2.9 million in 1997.
- Globally, HIV infection is the greatest risk factor for the development of tuberculosis.
How can I help children and families affected by HIV and AIDS?
Pray: Ask God that children and families will have the healthcare and nutrition they need to ward off infections and maintain good health.
Give: Support World Vision’s HIV and AIDS care and prevention programs.
What are HIV and AIDS?
HIV (human immunodeficiency virus) causes deterioration of the immune system (immune deficiency) so the body is not able to fend off diseases and infections. While there is no cure for HIV infection, there are drugs that can control the virus and help prevent transmission.
AIDS (acquired immune deficiency syndrome) is the term applied to the most advanced stages of HIV infection. AIDS is defined by the development of any of more than 20 opportunistic infections or HIV-related cancers.
How is HIV spread?
HIV is transmitted by certain body fluids through unprotected sexual intercourse, transfusions of contaminated blood, use of contaminated surgical equipment, syringes, or tattooing equipment. Mothers can also transmit the disease to children during pregnancy, childbirth, or through breast milk.
Education and testing are important to prevent the spread of HIV. When women are tested early in their pregnancy, they are able to start treatment to prevent spreading the infection to their newborn. Globally, between 2008 and 2017, 1.6 new child infections were prevented by mothers using HIV antiretroviral medicines.
What are the symptoms of HIV and AIDS?
Within two weeks of exposure to HIV, some people develop flu-like symptoms such as chills, fever, sore throat, night sweats, rash, fatigue, mouth ulcers or swollen lymph nodes. Not everyone shows any or all of the symptoms and the virus may not yet be detectable in a test for a few weeks.
An untreated HIV infection will eventually wear down the immune system and become full-blown AIDS, with much more severe symptoms. They include rapid weight loss, extreme tiredness, recurring fever, swelling of the lymph glands, long bouts of diarrhea, blotchy skin, mouth sores, and memory loss.
What is the treatment for HIV and AIDS? Is there a cure?
There is no cure for HIV. However, antiretroviral drugs offer very effective treatment. They fight HIV by stopping or interfering with the reproduction of the virus in the body, reducing the amount of virus in the body. In people who adhere to treatment with antiretroviral drugs, the progression of the disease can be slowed way down. They can remain well and productive for a long time, even in low-income countries.
When HIV becomes AIDS, with its severe symptoms, it is much more difficult to treat because the other infections or cancers involved require other forms of treatment. Tuberculosis is the most common cause of death in patients with AIDS, so new treatment regimens are being sought for TB and other diseases that piggyback on AIDS.
Can HIV and AIDS be eradicated?
Researchers are a long way from eliminating the virus, but ever closer to stopping the spread of HIV and AIDS. As scientists have studied HIV and found ways to fight it with antiretroviral drugs, they also discovered that the virus can hide within long-lived immune cells in many parts of the body. To eradicate the virus within an individual would mean attacking the virus in all the cellular reservoirs where it hides.
But what about eradicating the spread of the disease? That’s another matter and that’s much more doable. There are ways to prevent new infections, and to keep people living with HIV healthy. Antiretroviral treatments not only save the lives of people with HIV, they can reduce the chance of infected people spreading the disease.
Is there an HIV vaccine?
No, though not for lack of trying. There have been at least 40 potential HIV vaccines in human trials, and other trials are being developed.
A major obstacle to developing an HIV vaccine is that it would need to stimulate an immune response, while the immune system — and especially the lymph glands — are the target of the infection, too.
Are women and girls at high risk for HIV?
Yes, women and girls are at high risk for HIV. Globally, 18.8 million girls and women are living with HIV. In sub-Saharan Africa, three out of four new HIV infections in 15- to 19-year-olds are among girls.
HIV and AIDS is the leading cause of death among women ages 15 to 49. Young women are the left behind population when it comes to HIV prevention, care, and treatment, according to UNAIDS.
Globally, young women are twice as likely to acquire HIV as their male counterparts. Lack of knowledge on how to protect themselves from HIV, gender inequalities including gender-based violence, and stigma are barriers that impact access to available HIV prevention, care, and treatment services for adolescents and young women.
How are children most likely to contract HIV?
The majority of children with HIV contracted it from their infected mother while in the womb, during birth, or while breastfeeding. That’s why World Vision’s efforts focus on helping pregnant women with HIV understand their situation and get the treatment they need. It not only helps them rejuvenate their health, but it protects their babies from contracting the disease.
How is World Vision responding to the HIV and AIDS pandemic?
As AIDS devastated rural communities where we were working, World Vision called upon churches to join its HIV and AIDS Hope Initiative to help thousands of orphans and vulnerable children.
HIV and AIDS Hope Initiative
August 1998: World Vision U.S. President Emeritus Rich Stearns visits Uganda, meets AIDS orphans, and learns about the impact of AIDS on children.
July 2000: Wilfred Mlay, World Vision’s Africa region vice president, appeals for help to fight AIDS in Africa.
Dec. 1, 2000: On World AIDS Day, World Vision International President Dean Hirsch announces the formation of a global initiative to fight against HIV and AIDS.
Jan. 12, 2002: The Hope Initiative officially launches at a conference in South Africa attended by staff from the 17 African countries hardest hit by HIV and AIDS.
Three key components of the work are prevention, care, and advocacy:
- Prevent new cases, focusing on children, high-risk groups, and pregnant and lactating mothers
- Improve the quality of care for children affected by AIDS, including orphans and those living with HIV-positive parents
- Advocate for public policies and programs to stem the spread of HIV and provide care for people living with or affected by HIV and AIDS
2003: World Vision receives its first grant for HIV programming. The Channels of Hope curriculum is introduced in Africa to engage faith leaders and congregations in advocacy and prevention against HIV and AIDS.
2005: World Vision scales up HIV programming outside of Africa.
2006: World Vision introduces Channels of Hope in Latin America, the Caribbean, Middle East, Eastern Europe, and the Asia Pacific regions.
2009: A Channels of Hope study in three countries affirms the importance of addressing stigma through faith communities and mobilizing community action.
Dec. 1, 2010: On World AIDS Day, World Vision phases out the Hope Initiative now that HIV and AIDS programming is mainstreamed in World Vision’s program areas.
Beyond the Hope Initiative: We dare not stop
Much progress has been made to mitigate the impact of HIV on children, as well as women and men. Thanks to the support of the international public health community and the generosity of the American people through USAID’s President’s Emergency Plan For AIDS Relief (PEPFAR), the number of people on lifelong, life-saving antiretroviral therapy has greatly increased. Through PEPFAR, the number of children accessing antiretroviral treatment has more than doubled since 2014 and is now at 1 million annually.
Through World Vision’s Channels of Hope program, clergy and lay leaders from various faith communities learn about critical issues such as gender violence, child protection, and HIV/AIDS. Together, they implement solutions that demonstrate love and caring.
An army of 220,000 World Vision-trained community health workers throughout Africa play an ongoing role in this achievement as they walk with patients and community leaders to bring hope to HIV- and AIDS-affected families.
Efforts focus on helping pregnant women with HIV understand their health status and get the treatment they need. It not only helps them recover their health, but it protects their babies from contracting the disease.
World Vision partners with governments to influence healthcare policy and with schools to promote HIV and AIDS awareness. Other staff partnerships assist community care providers to maintain relationships and monitor care and church leaders to reduce stigma and help lead a community response in supporting people suffering from the disease. While these countries have made monumental progress, the work continues. About 180,000 children were newly infected in 2017.
In 2017, World Vision carried out HIV and AIDS work under the Global Fund in Democratic Republic of the Congo, Haiti, Kenya, Malawi, and Zimbabwe that benefited more than 845,000 people with programs that:
- Provide HIV testing
- Prevent HIV in adolescent girls and young women
- Screen HIV positive people for tuberculosis and start them on TB prevention
- Enroll HIV positive people in antiretroviral drug programs
- Train young people in life skills to prevent risky behavior
- Improve service delivery to HIV-affected populations
- Support HIV service providers
- Organize community groups for HIV prevention and care
Chris Huber of World Vision’s staff in the U.S. contributed to this article.