The ‘Office of the Global AIDS coordinator’ (OGAC, the home of the PEPFAR program), through USAID, has of late been funding research activities aimed at understanding the phenomenon known in the industry as ‘HIV Affected Children’ (children who are not infected themselves, but who have family members, in particular parents, that are infected). In recent months, this has led to a special issue of the journal AIDS as well as a symposium OGAC hosted on this work in DC this past October.
In South Africa, this work has been led by the Human Sciences Research Council (HSRC) through a substantial grant from OGAC, which has enabled the commissioning of the contributions to the AIDS special edition, including SACEMA’s involvement in the development of a modelling framework, which is the subject of one of the pieces in the special edition. This early attempt to identify appropriate modelling frameworks suggests that gaps in insight and data probably preclude any short term production of robust ‘whole population’ scenario models that reliably capture the majority of key factors, and in particular, the various feedback loops from one generation to the next or from one policy review cycle to the next. Nevertheless, useful insights can be generated by modelling cohorts of mother-child dyads in which the conditions of the mothers health, possibly also impacted by interventions, become risk factors for children, affecting their nutrition, education and mental health, possibly even their later HIV acquisition risk (bearing in mind the paradigm of HIV affected children excludes the actually infected ones).