Description
South Africa, like all of Africa, is dealing with the effects of the HIV/AIDS epidemic, particularly with what is called the third wave of the epidemic its social impact. Children bear a considerable part of the brunt of the social impact of HIV and AIDS. It is thus imperative to have well-researched information that can underpin our responses to the plight of children.

The HSRC recognises that very little is known about HIV prevalence rates among children or about the risk factors that predispose them to becoming infected. Therefore we place great importance on investigating these factors with the hope that the impact of HIV/AIDS on children is firmly placed on the regions research and programme agenda. The National Household HIV Prevalence and Risk Survey of South African Children confirms our commitment to investigating not only HIV prevalence among children and what predisposes them to HIV infection, but also the effects of the epidemic on their care and support.

This study forms part of the larger Nelson Mandela/HSRC Study of HIV/AIDS: South African National HIV Prevalence, Behavioural Risks and Mass Media Household Survey 2002. The HSRC undertook the study in collaboration with several other research institutions. The results highlight three key issues:

" Prevalence;
" The socio-cultural context; and
" Interventions in relation to sexual behaviour and HIV infection.

As with the larger survey, the childrens study was motivated by the need to monitor the national response to the HIV/AIDS epidemic. The study also serves as a baseline for monitoring future changes.

Contents
List of tables
Foreword
Preface
Acknowledgements
Contributors
Executive summary
Abbreviations

1. Introduction
1.1 HIV/AIDS in South Africa
1.2 Rationale and aims of the main study
1.3 Rationale and aims of the childrens study
1.3.1 Vertical transmission
1.3.2 Sexual abuse and premature sexual activity
1.3.3 HIV transmission through healthcare
1.3.4 Child risk for HIV infection
1.3.5 Aims
1.4 Conceptual framework

2. Methods
2.1 Study sample
2.2 Sampling
2.3 Weighting of the sample
2.4 Questionnaire development
2.5 Selection of specimen collection devices and HIV test kits
2.6 Ethical considerations
2.7 Pilot study
2.8 Data collection and quality control
2.9 Data management and analysis
2.10 Strengths and limitations of the study
2.10.1 Strengths
2.10.2 Limitations

3. Results
3.1 HIV prevalence among children 2 to 18 years
3.1.1 Discussion on HIV prevalence amongst children
3.2 Orphans
3.2.1 HIV prevalence by orphan status
3.2.2 Discussion
3.3 Child-headed households
3.3.1 Discussion
3.4 Sexual debut and sexual experience
3.5 Risk factors and risk environments for children
3.5.1 Risk environments
3.5.2 Care and protection
3.5.3 Knowledge and communication about HIV/AIDS
3.5.4 Discussion

4. Conclusions and Recommendations
HIV prevalence
Orphanhood
Child-headed households
Sexual debate and experience
Risk factors and risk environments for children
Significance and future research
References
List of tables