The Impact of the HIV/AIDS Epidemic on Kinship Resources for the Orphans of Zimbabwe

The extended family has been recognized as a major safety net for orphans in sub-Saharan Africa. But the mortality crisis associated with the HIV/AIDS epidemic may drastically reduce the number of relatives available to orphans and thus undermine traditional forms of mutual support. In this paper, a microsimulation, whose core relies on SOCSIM, is used to estimate and project quantities such as the number of living uncles, aunts, siblings and grandparents available to double orphans. The model is calibrated to the Zimbabwean setting, using data from the Demographic and Health Surveys (DHS), and estimates and projections of demographic rates from the United Nations. The paper shows that there is a lag of more than ten years between the peak in orphanhood prevalence and the highest scarcity of grandparents for orphans. The results suggest that we may expect an extended impact of the HIV/AIDS epidemic on orphans. A first wave of rapid increase in the number of orphans will be followed by a second wave of impact characterized by a steady reduction in grandparental resources for orphans. This trend is likely to shift the burden of double orphans to uncles and aunts. The availability of living uncles and aunts per double orphan has been decreasing from 1980 to 2010, but it is expected to increase progressively during the next decades. This study raises questions on the social consequences of changes in kinship structure, and on the strategies needed to address the lack of care in the context of a generalized HIV/AIDS epidemic. The HIV/AIDS epidemic has led to an unprecedented mortality crisis in the population of sub-Saharan Africa. Individuals infected with the HIV virus suffer from the direct consequences of the disease. The impact of the epidemic, however, is not limited to the people who contract the disease. The psycho-physical, emotional and economic consequences of the epidemic are felt by family members, as well as members of the extended family, and the community at large (e.g., Palloni and Lee 1992; Bor and Elford 1998; Wachter et al. 2002). Although there has been some progress in the containment of the epidemic worldwide, HIV/AIDS remains a pressing problem, especially in sub-Saharan Africa. According to UNICEF figures, in 2008 in the region of sub-Saharan Africa 22.4 million people were living with HIV, 1.9 million were newly infected with HIV, and 1.4 million died due to AIDS. The HIV/AIDS epidemic has generated a very severe orphanhood problem. UNICEF (2006) estimated that in 2005 there were about 48 million orphans (at least one parent dead) in the age group 0-17 years, across sub-Saharan Africa. That corresponds to about 12% of all children 0-17 years old in the region. Even under the optimistic scenario of a fairly rapid reduction in new HIV cases over the next decade, the number of orphans will continue to grow. That is a consequence of the fact that the transition to the orphanhood state is a cumulative process with age, and that there is a lag between the peak in adult HIV prevalence and the one in AIDS-related orphanhood prevalence. The negative indirect consequences of the HIV/AIDS epidemic are likely to become harsher and harsher on children and the elderly. Traditionally, in the setting of sub-Saharan Africa, child fosterage and other social practices based on mutual support among members of the same kin, have mitigated the impact of orphanhood. The extended family has been recognized as a very important safety net. However, it has also been noted that with the rising levels of widowhood and orphanhood, associated to the HIV/AIDS epidemic, the material basis of traditional kin relations may weaken to a point such that new forms of social relations may emerge (e.g., Palloni and Lee 1992; Merli and Palloni 2006). How much pressure will be exerted on traditional forms of care and support? How much kinship resources will be available to children? How heavy will the burden on traditional caregivers be? This paper addresses these questions. Estimates and projections of orphanhood prevalence and kinship resources available to orphans are important to evaluate alternative strategies, and the resources needed, to address the lack of care. They are also relevant for the debate on whether new forms of social relations may replace traditional ones based on kin relations. I use microsimulation to estimate and project probabilities of orphanhood and the evolution of the kinship structure in Zimbabwe for the period 1980-2050. This study is the first attempt to evaluate, in a quantitative and systematic way, overall kinship resources available to orphans in the context of sub-Saharan Africa. The geographic focus is Zimbabwe, one of the countries hit the hardest by the HIV/AIDS epidemic. On a background of poverty, economic crisis and international political isolation, the current adult HIV prevalence rate is estimated to be between 15% and 20% in Zimbabwe. After reaching a peak of almost 30% at the end of the 1990s, the adult HIV prevalence rate has been decreasing, but is still