	Introduction

Since HIV/AIDS was discovered in 1981, more than 20 million people have lost their livesto the virus. Nearly 40 million people are currently living with HIV/AIDS, including nearly 2.2million children under the age of 15. Sub-Saharan Africa remains the most affected continent with 1.9 million ofthe 2.2. million infected children. (1) A joint study conducted by the U.S. Agency for InternationalDevelopment (USAID), the United Nations Children's Fund (UNICEF), and the Joint United NationsProgram on HIV/AIDS (UNAIDS) found that at the end of 2003, 15 million children under the ageof 18 had lost one or both parents to AIDS, with 12.3. million of them found in sub-SaharanAfrica. Due to the 10-year time lag between HIV infection and death,experts predict that without the availability of anti-retroviral medications orphan populations willcontinue to grow for at least two decades after a country has reached its peak HIV infection rate. Experts report that the number of orphans is only nowexpected to decline in the country, from 14.6% of Ugandan children in 2001 to a projected 9.6% in2010. (8) rate of less than 1% at the end of 2003, 5.1 million people wereliving with HIV/AIDS at that time. (10) 
Children living in high seroprevalence areas may see a decline in access to education or inthe quality of education. (15) 
The majority of children orphaned or made vulnerable by HIV/AIDS are living with asurviving parent, or within their extended family (often a grandparent). 108-25 , The United States Leadership Against HIV/AIDS,Tuberculosis, and Malaria Act of 2003 , which authorized 10% of global HIV/AIDS funds to be usedfor children orphaned or made vulnerable by the virus (OVC). In the 109th session, H.R. 1409 , Assistance for Orphans and Other VulnerableChildren in Developing Countries Act of 2005, passed the House and Senate on October 18, 2005and October 25, 2005, respectively. Ultimately, the bill was enacted on November 8, 2005. The act, P.L. 109-95 , authorized spending for orphan-related programs in FY2006 and FY2007; establisheda monitoring and evaluation system to measure the effectiveness of related assistance activities;directed the appointment of a Special Advisor for Assistance to Orphans and Vulnerable Childrenwithin USAID; and required an annual report on project implementation. (60) 

		Economic and Material Responses

This section discusses some of the initiatives that the United States and the internationalcommunity implement to serve the needs of the children affected by AIDS, and some of thechallenges that these programs face. Children who live in orphanages haveaccess to education, food, shelter, and nurturing, which they may not be able to secure on their own,advocates of orphanages say. These children may also be stigmatized and isolated, asignorance about the virus remains high. Those who offersupport to communities affected by HIV/AIDS have found that the early programs, which focusedspecifically on children whose parents died of AIDS, often missed other vulnerable children, suchas those who are at high risk of becoming orphaned by AIDS (because their parents have HIV), thosewho live in households with children orphaned by AIDS, and those who may have been orphanedfrom other causes (like war or disease) are equally vulnerable. P.L. Access to ARVs for Children. 1567 , "Debt Cancellation for HIV/AIDS Response Act" in the 107th Congress, andin the 108th Congress H.R. Similar legislation is expected to be introduced in the 109th session.
Since HIV/AIDS was discovered in 1981, more than 20 million people have lost their livesto the virus. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), nearly 40million are currently living with HIV/AIDS, including nearly 2.2 million children under the age of15. In 2004, 4.9 million people acquired the virus, and 3.1 million died from AIDS. Sub-SaharanAfrica remains the most affected region with 25.4 million people living with HIV/AIDS at the endof 2004, 1.9 million of whom were children under the age of 15. The United States Agency forInternational Development (USAID), the United Nations Children's Fund (UNICEF), and UNAIDSestimate that at the end of 2003, 15 million children under the age of 18 had lost one or both parentsto AIDS, with the majority (82%) in sub-Saharan Africa. In just two years, from 2001 to 2003, theglobal number of children orphaned by AIDS increased from 11.5 million to 15 million. By 2010,it is expected that more than 25 million children will be orphaned by this deadly virus. Due to the10-year time lag between HIV infection and death, officials predict that orphan populations willcontinue to rise for a similar period, even after the HIV rate begins to decline. Experts say onlymassive spending to prolong the lives of parents could be expected to change this trend.
The impact of HIV/AIDS on children is just beginning to be explored. Not only are childrenorphaned by AIDS affected by the virus, but those who live in homes that have taken in orphans,children with little education and resources, and those living in areas with high HIV rates are alsoimpacted. Children who have been orphaned by AIDS may be forced to leave school, engage inlabor or prostitution, suffer from depression and anger, or engage in high-risk behavior that makesthem vulnerable to contracting HIV. Children who live in homes that take in orphans may see adecline in the quantity and quality of food, education, love, nurturing, and may be stigmatized. Impoverished children living in households with one or more ill parent are also affected, as healthcare increasingly absorbs household funds, which frequently leads to the depletion of savings andother resources reserved for education, food, and other purposes.
Congress passed P.L. 108-25 ("The United States Leadership Against HIV/AIDS,Tuberculosis, and Malaria Act of 2003") in the 108th Congress, which authorizes 10% of HIV/AIDSfunds to be used for children orphaned or made vulnerable by the virus. In the 109th Congress, H.R. 1408 , "Assistance for Orphans and Other Vulnerable Children in DevelopingCountries Act of 2005," passed the House and Senate on October 18, 2005, and October 25, 2005,respectively. Ultimately, the bill was enacted on November 8, 2005. The act, P.L. 109-95 ,established a monitoring and evaluation system to measure the effectiveness of related assistanceactivities; directed the appointment of a Special Advisor for Assistance to Orphans and VulnerableChildren within USAID; and required an annual report on project implementation. This reportexplores some of the challenges facing children affected by HIV/AIDS, outlines U.S. andinternational efforts to assist those children, and outlines some key issues that may be considered byCongress in the 109th session. This report will be updated.