Abstract

The aim of this study was to determine the prevalence of orphaned HIV-infected children in Mumbai, India and analyze whether orphanhood affects care of these children. This study is a retrospective analysis of prospectively collected data of 147 HIV-infected children referred to our pediatric HIV clinic at B. J. Wadia Hospital for Children (Mumbai, India). All children underwent a detailed history and clinical examination. Transmission of HIV was determined by parental HIV status, history of blood transfusion or sexual exposure. Orphan status was determined by verbal autopsy of parent death (either mother or father or both). Factors affected by orphan status such as follow up, caregiver, antiretroviral treatment and age of the child when orphaned was determined. Fifty nine (40%) HIV-infected children were orphans. In 28 children (19%), father had died; in 20 children (13.6%), mother had died; in 11 children (7.5%) both parents had died and in 2 children (1.4%), parents death status was not known. Cause of death was AIDS in 19 parents (38%) and TB in 21 parents (42%). The mean age of the child when mother had died was 5.6 +/- 2.2 years; when father had died was 7.08 +/- 3.5 years and when both parents had died was 10.9 +/- 2.4 years (p < 0.0001). There was no statistical difference in follow up (p = 0.48) or initiation of antiretroviral therapy (p = 0.04) in orphaned and nonorphaned children. In orphaned children, grandparents (5.4%) and aunts (4.8%) took responsibility of taking care of the children. Only two children (1.4%) were put in orphanages. Prevalence of HIV-infected orphans is high (40%). However, there is no difference in HIV care between orphans and nonorphans.