Little Needles, Big Haystack: Orphans of HIV/AIDS in the Deep South

ABSTRACT Portrayals of children being affected by a parent's illness or death from HIV/AIDS typically involve survivors from high-prevalence countries in sub-Saharan Africa. Little is known about such children in the United States, even though HIV/AIDS is a significant cause of morbidity and mortality for adults of childbearing age. To address this issue, the present study investigated children who had been orphaned (or were at risk of being orphaned) in the American Deep South. The study also sought to describe the family contexts of at-risk children. Three research methods were used: a chart review of deceased and active adults at a public HIV clinic; an obituary review; and an examination of data from a statewide needs-assessment survey. The triangulated results indicated that at-risk children outnumbered orphans by 2 to 1. Most of these at-risk and orphaned children were African Americans living in abject poverty and facing an uncertain future. Privacy issues raised problems in identifying the children, and knowledge of their whereabouts was hampered by HIV-related stigma. Further research is needed to assess the needs of children for health policy purposes and to identify this group as a special population for intervention or referral to social services.