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HIV/AIDS is wreaking havoc with children's lives in the worst-affected countries

Children living with or affected by HIV/AIDS, or in countries with high prevalence rates, face an extremely high risk of exclusion from access to essential services, care and protection, as parents, teachers, health workers and other basic service providers fall sick and eventually die. The epidemic is tearing away at the social, cultural and economic fabric of families, the first line of protection and provision for children that safeguards against their exclusion from essential services and protection from harm.

Some 15 million children have already lost one or more parents to the disease, and millions more have been made vulnerable as the virus exacerbates other challenges to the health and development of families, communities, regions and, in the worst-affected countries, whole nations.

Of those children orphaned by AIDS, more than 80 per cent are in sub-Saharan Africa, reflecting not only the region's disproportionate burden of HIV infection, but also the epidemic's relative maturity in Africa.

The protracted illness and eventual death of parents and other caregivers exert enormous pressures on children, who often have to assume adult roles in treatment, care and support. Surviving siblings can suffer stigma and discrimination, experience greater exposure to violence, abuse and exploitation and drop out of school for a variety of reasons.

HIV/AIDS also threatens the very survival of children and young people. Every day, nearly 1,800 children under 15 are infected. Children under 15 account for 13 per cent of new global HIV/AIDS infections and 17 per cent of HIV/AIDS deaths annually. HIV/AIDS has reversed the gains in child survival made in many of the worst-affected countries, and has dramatically reduced average life expectancy in those countries, particularly in Southern Africa. [figure 2.5]

Young people aged between 15 and 24 years now account for nearly one third of people living with HIV/AIDS globally. Given that it can take up to a decade for any decrease in HIV prevalence to be translated into lower death rates from AIDS - owing in large part to the slow roll-out of antiretroviral treatments - deaths from AIDS will continue and the number of orphans will rise.