title: The effects of high HIV prevalence on orphanhood and living arrangements of children in Malawi, Tanzania, and South Africa.
abstract: Using longitudinal data from three demographic surveillance systems (DSS) and a retrospective cohort study, we estimate levels and trends in the prevalence and incidence of orphanhood in South Africa, Tanzania, and Malawi in the period 1988-2004. The prevalence of maternal, paternal, and double orphans rose in all three populations. In South Africa - where the HIV epidemic started later, has been very severe, and has not yet stabilized - the incidence of orphanhood among children is double that of the other populations. The living arrangements of children vary considerably between the populations, particularly in relation to fathers. Patterns of marriage, migration, and adult mortality influence the living and care arrangements of orphans and non-orphans. DSS data provide new insights into the impact of adult mortality on children, challenging several widely held assumptions. For example, we find no evidence that the prevalence of child-headed households is significant or has increased in the three study areas.
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. vicky.hosegood@lshtm.ac.uk
authors.forename: Victoria
authors.initials: V
authors.lastname: Hosegood
authors.forename: Sian
authors.initials: S
authors.lastname: Floyd
authors.forename: Milly
authors.initials: M
authors.lastname: Marston
authors.forename: Caterina
authors.initials: C
authors.lastname: Hill
authors.forename: Nuala
authors.initials: N
authors.lastname: McGrath
authors.forename: Raphael
authors.initials: R
authors.lastname: Isingo
authors.forename: Amelia
authors.initials: A
authors.lastname: Crampin
authors.forename: Basia
authors.initials: B
authors.lastname: Zaba
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002669:Child Welfare; D054540:Child, Orphaned; D003710:Demography; D005190:Family; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology