Orphans and Vulnerable Children Affected by HIV and AIDS

Photo of a young boy
Philippe Desmazes/AFP


HIV and AIDS have exacted a terrible toll on children and their families. During the 30 years of the global HIV epidemic, an estimated 17 million children lost one or both parents due to AIDS. Ninety percent of these children live in sub-Saharan Africa. In addition, 3.4 million children under age 15 are living with HIV. Despite some decline in HIV adult prevalence worldwide and increased access to treatment, the number of children affected by or vulnerable to HIV remains alarmingly high.

Families and communities have led a massive response to protect, care for and support children affected by HIV and AIDS. Since 2003, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has provided more than $2 billion in funding and technical support to greatly enhance these efforts. These investments have enabled children to stay in school, strengthened households and ensured families continue their roles as primary caregivers.

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Vulnerable children spanning a range of ages stand in front of their village dwelling.
Vulnerable children spanning a range of ages stand in front of their village dwelling.
Mary Jordan/USAID

The U.S. Agency for International Development’s (USAID’s) programs for orphans and vulnerable children (OVC) affected by HIV and AIDS contribute to the achievement of an AIDS-free generation by responding to the social, economic and emotional consequences of the disease on children, their families and the communities that support them. The goal of USAID and PEPFAR’s Orphans and Vulnerable Children Program is to improve the health and well-being of children and families by mitigating the impact of HIV and AIDS and increasing children’s resilience and reducing their risk to the disease. Key program areas and objectives include the following:

  1. Education: Support efforts to reduce educational disparities and barriers to access among school-age children through sustainable “systemic” interventions.
  2. Psychosocial Care and Support: Prioritize psychosocial interventions that build on existing resources; place and maintain children in stable and affectionate environments.
  3. Household Economic Strengthening: Reduce the economic vulnerability of families and empower them to provide for the essential needs of the children in their care.
  4. Social Protection: Reduce vulnerability and risks, foster human capital development and interrupt the transmission of poverty from one generation to the next.
  5. Health and Nutrition: Improve children’s and families’ access to health and nutritional services.
  6. Child Protection: Develop appropriate strategies for preventing and responding to child abuse, exploitation, violence and family separation.
  7. Legal Protection: Develop strategies to ensure basic legal rights, birth registration and inheritance rights to improve access to essential services and opportunities.
  8. Capacity Building: Prioritize capacity building and systems strengthening interventions according to country context.


USAID has programs for orphans and vulnerable children in the following countries:

Botswana Haiti South Africa
Burundi India South Sudan
Cambodia Kenya Swaziland
Cameroon Lesotho Tanzania
Cote d’Ivoire Malawi Uganda
Democratic Republic of the Congo Mozambique Ukraine
Ethiopia Namibia Vietnam
Ghana Nigeria Zambia
Guyana Rwanda Zimbabwe


Strong monitoring and evaluation systems are an essential foundation to improve the effectiveness of programs. USAID and PEPFAR will continue to scale up and ensure robust monitoring of existing high-impact OVC programs and to support countries in developing, implementing and evaluating OVC pilot programming.

USAID through PEPFAR has supported the MEASURE Evaluation project to develop a new OVC program evaluation toolkit designed to measure changes in child, caregiver and household well-being. Application of the tools will result in standardized information on child well-being, caregiver well-being and household economic status beyond what is available from routine surveys. It will also allow USAID Missions and PEPFAR programs to compare measures of well-being across a diverse set of interventions and geographical regions. For more information, please click here.


The USAID/PEPFAR Orphans and Vulnerable Children Program [PDF, 1.9MB] is a key supporter of the United States Government Action Plan on Children in Adversity. The Action Plan provides whole-of-government strategic guidance on international assistance for children in adversity, including those orphaned and affected by HIV and AIDS. More information on the National Action Plan.


Over 105,000 orphans have benefited from USAID’s integrated programming in Zimbabwe.
Over 105,000 orphans have benefited from USAID’s integrated programming in Zimbabwe.
CRS Zimbabwe/Giacomo Pirozzi