Orphans and Vulnerable Children
USAID's investments in orphans and vulnerable children aim to improve health, education, protection, and socio-economic outcomes among children and adolescents living with and affected by HIV, their caregivers, and families.
USAID’s orphans and vulnerable children (OVC) programs, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), serve children in a range of adverse situations, including children and adolescents who are living with HIV, infants who have been exposed to HIV, children living with HIV-positive caregivers, children who are orphaned, children at a high risk of HIV infection, children who have experienced violence, or a combination of these factors.
Children and adolescents face significant risks and vulnerabilities as a result of HIV/AIDS and its socio-economic effects:
Globally, in 2022, an estimated 13.9 million children ages 0-17 have lost one or both parents due to AIDS;
As of 2022, an estimated 1.5 million children ages 0-14 are living with HIV and only 57 percent of these children are on life-saving HIV treatment;
In 2022 there were approximately 84,000 AIDS-related deaths among children ages 0-14;
An estimated 130,000 children ages 0-14 were newly infected with HIV in 2022; and,
Adolescent girls in sub-Saharan Africa are disproportionately more likely than boys to acquire HIV.
Critical risks to OVC include interruption in HIV treatment among HIV-exposed infants, suboptimal viral load suppression among children and adolescents living with HIV, mortality among children living with HIV who are less than five years of age, high risk of HIV infection and sexual violence among adolescent girls, and household economic and food insecurity. USAID continues to refine service delivery for OVC in high HIV burden communities to improve their health, well-being, and protection as well as strengthen child, adolescent, and family resilience.
Our Approach and Results
USAID’s OVC programs, through PEPFAR, aim to improve health, education, protection, and socio-economic outcomes among children and adolescents living with and affected by HIV, their caregivers, and families.
USAID's OVC programming has led to achievements in the following areas:
Contribute to equitable, accelerated access to HIV testing, care, and treatment and to viral suppression among children and adolescents living with HIV using child-centered, family-based case management;
Deliver evidence-based interventions for the prevention of HIV and sexual violence targeting young adolescent girls and boys; and provide services to prevent, detect, and respond to violence against children (including sexual and gender-based violence);
Provide educational subsidies and support, with a focus on girls’ education, in order to improve educational access, progression, and completion;
Serve as a platform for focused efforts such as the Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) Initiative that provides protective, layered interventions (e.g., schooling, economic and parenting support, and violence prevention services) targeting vulnerable adolescent girls and young women (AGYW) in order to build their resilience to HIV risk;
Provide vital social support and implement targeted household economic strengthening interventions that improve socio-economic capacity and assets among OVC families; this includes strengthening financial skills and savings among older adolescents and facilitating linkage to employment opportunities for AGYW;
Facilitate access to structural interventions (e.g., social protection) to address the social determinants of health and improve well-being outcomes among children, adolescents, and their families; and
Leverage other USAID-supported health, education, and economic strengthening programming to improve adolescent and youth resilience.
The OVC program also contributes to the accomplishment of the U.S. Government’s strategy for international assistance to children in adversity. Advancing Protection and Care for Children in Adversity: A U.S. Government Strategy for International Assistance (2019–2023) is a whole-of-government commitment and approach to investing in the development, care, dignity, and safety of the world’s most- vulnerable children and their families. USAID’s OVC programs, for example, specifically addressed APCCA objectives related to keeping children in families and to preventing violence against children.
By lessening the impact of HIV and AIDS on children and families, communities are better positioned to achieve an AIDS-free generation and sustain the response. In partnership with host country governments and other local entities, OVC programs strengthen the capacity of families, communities, and social welfare systems to provide care and deliver vital support to vulnerable children. These programs strengthen host country social service workforces who are on the frontlines serving OVC, as well as strengthen community structures and systems for child protection.
Improving access to essential services (including HIV treatment and prevention services, education services, child protection services, nutrition services, and targeted socio-economic support) for children and their caregivers strengthens child, adolescent, and family resilience. The delivery of child- and family-centered, high-quality OVC services and support is a core priority for ensuring that children living with, affected by, and vulnerable to HIV can survive, thrive, and reach their full potential. Some of our recent achievements include:
In 2023, USAID supported more than 5.6 million OVC and their families affected by HIV in 23 countries; this represents nearly 80 percent of OVC programming across PEPFAR agencies.
More than 1.3 million girls and boys aged 10-14 years accessed and completed USAID-supported, evidence-based prevention of HIV and sexual violence interventions.
442,000 children and adolescents living with HIV were enrolled in USAID’s OVC Comprehensive programs, which includes nearly 74 percent of children under 15 years enrolled in PEPFAR clinical programs where OVC programs are implemented. 95 percent of children and adolescents in USAID’s OVC Comprehensive program have a known HIV status and 100 percent of children and adolescents who are living with HIV are reported to be on treatment.