Estimating Orphaning Prevalence and Incidence before and after Antiretroviral Treatment (ART) Roll-Out in Rural South Africa, 2000-2013

Gabriela Mejia-Pailles, University of Southampton
Victoria Hosegood, University of Southampton
Ann M. Berrington, University of Southampton

In the context of HIV treatment in sub-Saharan Africa, reliable data on the levels and trends of orphaning are needed to understand the impact of improved survival of HIV-infected parents. Using data from a longitudinal demographic surveillance system, collected since 2000 by the Africa Centre Demographic Information System (ACDIS), we first) quantify paternal, maternal and double orphaning prevalence (level) and incidence (new orphans/risk of becoming an orphan) in rural South Africa between 2000-2013, before and after ART roll-out; and second) explore the causes of parental deaths to identify whether the proportion attributable to HIV is declining as a result of increased effectiveness of treatment. Our results show recent decreases in orphaning prevalence and a decreasing orphaning incidence with the introduction of ART. This said, the incidence of orphanhood remains tragically high as a result of high rates of adult (particularly male) mortality from both AIDS and non-AIDS related causes.