AIDS remains an unabated epidemic in many countries around the world.
Data released by UNAIDS indicate that in 1999 an estimated 5.4 million
adults and children became infected with the virus, bringing the worldwide
total to an estimated 50 million since the disease was first recognized in 1981.
Of that number, more than 34.3 million infected people are still alive. How-
ever, AIDS has killed 18.8 million, including 2.8 million who died in 1999
alone, a record level for any one year (UN AIDS Commission 2000).

The global and ecological catastrophe of this pandemic has given rise not
only to personal tragedies for the individuals and families facing prolonged ill-
ness and premature deaths, but also to the increase in the number of orphans
and HIV-affected children around the world, especially in sub-Saharan Africa,
South and Southeast Asia, and the Caribbean. Parental deaths from HIV/AIDS
have increased pressure on the elderly, particularly grandmothers, to care for
these vulnerable children. Yet, at the family level, loss of breadwinners to AIDS,
loss of income, impoverishment, loss of adult labor, changes in household and
family structures, and grief and bereavement have all created an environment
where it is much more difficult for the elderly to care adequately for orphaned
children's needs as well as their own needs.

One of the most tragic results of AIDS-related premature parental deaths is
the exponential rise in the number of orphaned and vulnerable children in di-

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