Effective HIV treatment doesn’t just improve health, reduce mortality, prevent transmission of HIV to sexual partners and allow people with HIV to have children without medical procedures. It also reduces the number of children who lose a parent  or parents to AIDS-defining illnesses, according to data published in The Lancet HIV.

In the 1980s and 1990s, orphanhood increased dramatically in sub-Saharan Africa because of HIV-related illness. Butas antiretroviral therapy became widely available, the number of teens ages 15 to 19 in Rakai, Uganda, who lost a parent decreased. The proportion of teens who lost a single parent declined from 52% between 2001 and 2002 to 23% between 2016 and 2018. The proportion who lost both parents decreased by 83%. Loss of a father dropped by 44%; loss of a mother dropped by 29%.

Notably, this decrease in orphanhood coincided with a 67% spike in the availability of HIV treatment since 2005 as well as increased uptake of voluntary medical male circumcision, which has been shown to prevent HIV acquisition among men. As more people survived, that was reflected in higher HIV prevalence—the number of people currently living with HIV. A 10% increase in use of antiretroviral treatment was associated with decreases in both loss of a mother and double orphanhood, while a 10% increase in medical circumcision was associated with decreases in loss of a father and double orphanhood.

But it wasn’t just HIV treatment and circumcision that were associated with lower mortality among parents. It was also socioeconomic status and overall HIV prevalence, study coauthor John Santelli, MD, MPH, a professor of population and family health and pediatrics at Columbia University, said in a press release.

“Before our study, we knew that the combination of [antiretroviral treatment] and male circumcision was highly effective in preventing HIV transmission; now we know it is also effective in reducing orphanhood,” he said. “Reductions in orphanhood promise improved health and social outcomes for young people, including improved mental health, higher educational attainment and reduced child marriage.”


Click here to read the study abstract.

Click here to learn more about parenthood options for people living with HIV and children and HIV.