President’s Emergency Plan for AIDS Relief (PEPFAR’s) response to the millions of children impacted by HIV/AIDS was to designate 10% of its budget to securing their futures, making it the leading supporter of programs reaching orphan and vulnerable children (OVC) programs globally. This article describes the evolution of PEPFAR’s OVC response based on programmatic lessons learned and an ever growing understanding of the impacts of HIV/AIDS. In launching this international emergency effort and transitioning it toward sustainable local systems, PEPFAR helped establish both the technical content and the central importance of care and support for OVC as a necessary complement to biomedical efforts to end the HIV/AIDS epidemic.
Case management is a standard practice in the United States for the effective care of people living with HIV and AIDS (PLHA); however, application of this approach in developing countries has not been demonstrated. Although great advances have been made in Africa to increase PLHA’s access to HIV services, care and support systems often remain fragmented. In September 2004, CARE International initiated a case management program in health facilities in Rwanda designed to enhance linkages between clinical and non-clinical services for PLHA.
Sampling methods to study street children often rely on convenience approaches. Respondent-driven sampling (RDS) is a relatively new methodology for sampling hard-to-reach populations utilizing peer-driven recruitment. It includes both field and analytical procedures to account for non-random recruitment patterns and generates statistically valid samples. This article describes RDS and assesses its effectiveness to recruit a diverse sample of street children, defined as children aged 10–17 years who engage in economic activity on the street in Tirana, Albania.
Addressing the psychosocial needs of vulnerable children and youth is viewed increasingly as a priority of humanitarian programs, particularly in Africa, where the scale of the problem necessitates community-based solutions. This quasi-experimental study tested a model of adult mentorship and support to improve psychosocial outcomes among youth-headed households in a rural area of Rwanda. Two rounds of data were collected from youth who served as heads of their households.
Objective To examine the level of depressive symptoms and their predictors in youth from one region of Rwanda who function as heads of household (ie, those responsible for caring for other children) and care for younger orphans.
A consistent theme in the literature on interventions for orphans and vulnerable children is the need for community-based care. However, a number of socio-cultural factors may impede community response. In this study, mixed methods are used to elucidate community-level barriers to care for orphans and vulnerable youth in Rwanda. Data from a large survey of youth heads of household on perceptions of marginalization from the community and the factors predicting that marginalization are considered in light of additional data from a survey of adults who volunteered to mentor these youth and focus groups with both community adults and youth heads of household.
There is concern that orphans may be at particular risk of HIV infection due to earlier age of sexual onset and higher likelihood of sexual exploitation or abuse; however, there is limited empirical evidence examining this phenomenon. Utilizing data from 1694 Black South African youth aged 14–18, of whom 31% are classified as orphaned, this analysis explores the relationship between orphan status and sexual risk. The analysis found both male and female orphans significantly more likely to have engaged in sex as compared to non-orphans (49% vs. 39%).