The AIDS epidemic in Africa puts children at risk physically, emotionally and economically. All children are indirectly affected when their communities, and the services these communities provide, are strained by the consequences of the epidemic. Nurses, doctors, teachers and others can become ill and die from AIDS, affecting health care, education and other basic services. Children are directly affected in a number of ways. They may live at high risk of HIV; they may live with a chronically ill parent or parents and be required to work or put their education on hold as they take on household and care giving responsibilities; their households may experience greater poverty because of the disease; and they can be subject to stigma and discrimination because of their association with a person living with HIV. Children can also become orphans, having lost one or both parents to AIDS-related illnesses.

In sub-Saharan Africa, AIDS is the leading cause of death among adults ages 15–59. Although the total number of orphans from all causes in Asia and in Latin America and the Caribbean since 1990 has been decreasing, the number of orphans from all causes has risen by more than 50 per cent in sub-Saharan Africa, where an estimated 12 million children age 0–17 have lost one or both parents to AIDS. This makes the region home to 80 per cent of all the children in the developing world who have lost a parent to the disease. Children are experiencing the greatest parental loss in southern Africa, where HIV prevalence rates are highest. Even where HIV prevalence stabilizes or begins to decline, the number of orphans will continue to grow or at least remain high for years, reflecting the time lag between HIV infection and death.

Children Affected by HIV/AIDS​
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There are four main categories of children affected by HIV/AIDS:​

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1. Children who live with parents infected with HIV/AIDS. They may experience neglect as a result of parental illness, suffer social stigma, be responsible for caring for sick parents and younger siblings, have experienced abandonment by one parent who leaves to escape the other's illness, or simply live with great insecurity and anxiety as they wait for their parents to become sick(er) and eventually die. Property grabbing sometimes happens even while the parents are alive, but too ill to defend themselves.
2. Children who are orphaned by HIV/AIDS. This includes maternal, paternal or double orphans. It is important to note that children living with a step parent or a co-wife can be particularly vulnerable in their own household, even if one of the parents is still alive.
3. Children who are infected with HIV/AIDS. Infected children generally live with one or both parents, but they can also be orphaned or rejected (most common for infants and youth) and end up in institutional care or in the streets. Infected children often experience social stigma that may result in their being refused access to school or other services. In addition, they have special health care needs that must be addressed.
4. Children who live away from home because of HIV/AIDS. Some children have left their homes because of the way the disease has affected their primary caretakers.