A recent study by Columbia University’s Mailman School of Public Health has revealed a dramatic decline in orphanhood rates in Rakai, Uganda, due to the scale-up of HIV treatment and prevention programs. According to the findings published in The Lancet Global Health, the availability of antiretroviral therapy (ART) has been a significant driver in reducing orphanhood, underscoring the importance of continued investment in HIV programs.
The study, titled “Incidence and prevalence of orphanhood in Rakai, Uganda: a population-based cohort study, 1995–2022”, tracked 92,441 children and adolescents under 18 years of age over 28 communities from 1995 to 2022. It showed a dramatic decrease in orphanhood prevalence from 21.5% in 2003-04 to just 6.3% in 2020-22—a reduction of approximately 70%. The rate of new orphanhood cases also saw a significant drop.
The steepest declines occurred after ART became fully available in 2015. The proportion of new orphanhood cases due to maternal HIV status decreased from 67% in 2004 to just 11% in 2022, while paternal HIV-related orphanhood fell from 71% to 12% in the same period.
Research co-lead author, Aleya Khalifa, PhD, emphasized that ART programs have not only extended the lives of parents living with HIV but have also protected children from the devastating effects of losing their caregivers. Debbie Malden, DPhil, another co-author, added that these programs have been pivotal in safeguarding children from the social and health consequences of orphanhood.
Despite these improvements, the study highlighted that a considerable burden of orphanhood still persists, particularly among adolescents. The researchers recommend that public health policies continue to prioritize HIV treatment, improve access to ART, and adjust programs to address the ongoing risks to children, especially in sub-Saharan Africa.
The Rakai Community Cohort Study, which involved several international institutions, was funded by prominent organizations including the National Institutes of Health and the Gates Foundation.
