1. Dimensions of the emerging AIDS orphan crisis in Barbados Funded by the Jacques Parisot Foundation Fellowship Grant
Alok Kumar, K R Kilaru, S Forde, I Waterman, G Kumari
School of Clinical Medicine and Research, UWI
Queen Elizabeth Hospital
Ladymeade Reference Unit, Ministry of Health, Barbados.

2. Objectives: To examine the - level and trends of AIDS orphanhood, and
differentials in AIDS orphan prevalence
in Barbados.

3. Methods A retrospective descriptive study.
Study period 1991 through 2005.
LRU caters to the ambulatory medical care and follow up of all HIV infected people.
Hospitalization and inpatient care for all PLWHA is provided at the QEH.
Majority of deaths in the HIV infected persons are recorded at the QEH.

4. Methods
Direct estimates of orphan prevalence by recording the children of all the adults who died of AIDS.
Case notes for all deaths in PLWHA was reviewed to collect data on their children, supplemented by data collected from their next of kin.

5. Methods
These data was collated by the information obtained from their LRU records.
We analyzed the trends and age-patterns in orphan prevalence.

6. Results During the period 1991 through 2005,
976 (1.8% of the under-18 pop.) children lost either one or both parents
867 (1.6% of the under -18 pop.) lost their mother and
598 (1.1% of the under-18 pop.) lost their father.

7. Number of children orphaned by AIDS in Barbados during 1991 – 2005
AIDS Orphans
Numbers
Maternal orphans
867 (89)
Paternal orphans
598 (61)
Both maternal and paternal orphans
492 (50)
Either maternal or paternal orphans
976

8. Profile of the 867 maternal AIDS orphans
Number(%)
Age at the time of maternal death
< 5
105 (12.1)
5 – 9
204 (23.5)
10 – 14
276 (31.8)
> 15
287 (33.1)
Gender
Females
411 (47.4)
Males
456 (52.6)

9. Profile of the 867 maternal AIDS orphans
HIV status at the time of maternal death
HIV infected at the time of mothers death
39 (4.5)
HIV non-infected at time of maternal death
79 (9.1)
Unknown status (not tested)
749 (86.4)
Children who have died since maternal death
22 (2.5)
Death due to HIV infection
20 (2.3)
Death due to other causes
2 (0.2)

10. Profile of the 187 maternal AIDS orphans who were < 18 years at the time of this report
Nos. (%)
Age at the time of this report
< 5
48 (25.7)
5 – 9
63 (33.7)
76 (40.6)
Gender
Female
91 (48.7)
Male
96 (51.3)

11. Health care status of 187 maternal AIDS orphans
Nos. (%)
HIV testing
HIV tested prior to maternal death
58 (31.1)
HIV tested after maternal death
37 (19.9)
Never tested for HIV
82 (43.8)
No information
11 (5.9)
HIV status of the child
HIV non-infected
84 (44.9)
HIV infected
11 (5.5)
Follow up of the 11 HIV infected orphans
Adequate follow up
7 (63.6)
None or inadequate follow up
4 (36.4)

12. Profile of the 187 maternal AIDS orphans who were < 18 years at the time of this report.
Living arrangement
With Father
29 (15.5)
With grand parents
95 (50.8)
With other relatives
38 (20.3)
With mothers friends
10 (5.3)
In public homes for children’s
4 (2.1)
No information
11 (5.9)

13. Cumulative number of AIDS orphans in Barbados.

14. Summary
To this date, nearly a thousand children have lost either or both parents to AIDS before their 18th birthday.
Half of these children had lost both parents and nearly nine-tenth were maternal orphan.

15. Summary
Over half of the maternal orphans were in the 5 – 15 age group at the time of their mother’s death.
Nearly half of the maternal orphans who were less than 15 years at the time of this report were not tested for HIV.
Half of all maternal orphans were being cared for by their grand parents.

16. Conclusions
The burden of AIDS orphans is significant and continues to rise.
The majority of them are being cared for by close relatives’ mostly maternal grandparents.