This dissertation analyses an ethnographic study of how people in a peri-urban, agricultural village in western Kenya have responded to the questions of who will care for children, and how, when those children’s parents, or other primary caregivers, have died. It examines the practical and ideological implications of wide-scale orphaning among a population that has experienced increased numbers and proportions of orphaned children mainly due to HIV/AIDS, as well as the gradual depletion of resources in terms of both the availability of middle-aged adults and the security of economic livelihoods. The research explores how specific caring relationships, as well as general sociality, have been challenged, adapted, and affirmed or rejected normatively and practically in this context. The research revealed a high degree of questioning in people’s efforts to forge responses to children’s orphaned situations. Rarely was there unambiguous consensus in the study context concerning what should be done in response to children’s orphanhood in light of families’ diminished livelihood capacities. More broadly, there was a distinctive concern with how such situations might be appraised in moral terms. The analysis therefore focuses on three main concerns, including: how to understand uncertainty as a condition of life, and the implications of this; how a shared perspective of uncertainty has spurred a concern with morality in the study context, and specifically galvanised a moral economy of kinship; and how the concern with morality affected what was deemed at stake in people’s lives.

A research report submitted to The Faculty of Health Sciences, University of Witwatersrand, in fulfillment of the requirements for the degree Of Masters in Public Health Johannesburg 2005 / ABSTRACT Swaziland is currently faced with a deepening HIV/AIDS epidemic. A systemic review of available information concerning the economic impact of HIV/AIDS on Swaziland was undertaken to collate data and document this impact in order to inform decision makers and planners. The methodology for the systematic review was based on the guidelines described in the Cochrane Reviewers’ handbook. HIV/AIDS has significantly increased the vulnerability of affected Swaziland rural households to environmental shocks. There is an increased burden of orphans due to HIV/AIDS, reduced household labour and income as adults die of AIDS. HIV/AIDS has reduced farm productivity leading to worsening of food insecurity and poverty in affected households. Due to HIV/AIDS, absenteeism in Swaziland organizations has increased by 20- fold. HIV/AIDS is currently the leading cause of death accounting for over 60 percent of all employee deaths. Organisations that have implemented HIV/AIDS workplace responses have been less affected. The micro-sector is the worst affected and it is recommended that policy makers ensure that this sector is protected from the negative impact of HIV/AIDS. The epidemic of negative impacts of HIV/AIDS in Swaziland has not yet reached the peak.

The study assesses the Lesotho government’s assistance programmes in addressing the financial implications of Education for All (EFA) at secondary school level. It does this by examining the objectives of the financial assistance programmes, their main problems and tensions in the implementation, and how they impact on the education of poor learners. This research was conducted using a qualitative methodology, which relied in part on the case study approach by focusing on two schools in the poor areas of Lesotho. The study used a multi-method data collection approach with interviews, questionnaires and document analysis. The respondents were selected on the basis of their relationship to the implementation of these government programmes. The school sample comprised two (2) principals, four (4) parents of learners targeted by such assistance programmes, and four (4) teachers working with learners who were beneficiaries of these programmes and who knew how these programmes assisted them (or not). There were two MOET officials, the bursary manager at central level, responsible for all government assistance programmes; and the district education bursary administrator responsible for the OVC programmes and entrusted with implementing the programmes in line with the regulations. The decision to get information from these respondents was because they were knowledgeable or experienced in different aspects of these government programmes, their implementation, and the impact on schools and learners. ii Using the rational and political analytical approaches, the findings reveal the limited conceptualization of the financial assistance programmes designed to widen the secondary education of poor learners as these did not address the deeper problems of Orphans and Vulnerable Children’s (OVC) problems in accessing and completing their education. The rational approach indicates poor system resources and capacity to effectively manage these programmes, as well as poor monitoring and accountability at all levels of the system. The political approach emphasises the poor implementation context of these assistance programmes due to the conflicting agendas of various programme implementers. The role of leadership is identified as crucial in interpreting and effectively mediating the operationalisation of these programmes on the ground so that the more deserving poor learners benefit. However, such leadership appears to be lacking at various levels of the implementation process. The study concludes that in order for these government assistance programmes to have a lasting and meaningful impact on OVC secondary schooling, there is a need to review their assumptions and scope to address more fully the OVC needs. Additional resource mobilization coupled with strong leadership, monitoring and evaluation are necessary for this to be realised.

O número de órfãos em decorrência da aids continuará a aumentar na próxima década, particularmente nos países onde não há tratamento efetivo e universal para a aids. No mundo, 14 milhões de crianças são órfãs devido à aids, a maioria delas vive em países em desenvolvimento; entretanto, no Brasil, o número de órfãos por aids não é conhecido. Este estudo objetivou identificar as características dos órfãos por aids em Porto Alegre e verificar os fatores associados à institucionalização destas crianças. Foi realizado um estudo de corte transversal das crianças de 0-15 anos de idade, filhos de indivíduos falecidos por aids no período de 1998-2001, residentes em Porto Alegre/RS. Os dados foram coletados em inquérito domiciliar com questionário estruturado. As crianças foram rastreadas a partir dos atestados de óbitos e dos registros dos Serviços de Saúde. A abordagem dos domicílios e cuidadores foi feita de modo a garantir absoluta privacidade, evitando discriminação e estigma para os órfãos e suas famílias. A proporção de órfãos/óbito de adulto foi 2:1. Do total de crianças localizadas (853), 70 por cento são órfãs de pai e 50 por cento , de mãe. Do total 20 por cento são órfãos duplos. São meninas 52 por cento . Quanto à cor da pele: pretas/pardas-56,5 por cento ; brancas 43 por cento . A idade mediana por ocasião do óbito paterno e materno foi 7 anos (0,00-19 P25=4 P75=11) e 8 anos (0,01-17 P25=5 P75=11), respectivamente. A idade média do pai por ocasião do óbito foi 36 anos (DP 8,0) e da mãe, 33,7 anos (DP 7,7); 64,0 por cento das mães e 72 por cento dos pais tinham ou tem diagnóstico de aids; 40,6 por cento das crianças vivem com a mãe, 24,5 por cento , com os avós (idade média 60 anos DP 7,45); 11,5 por cento , com tios e 5,1 por cento , em abrigos; 88,3 por cento dos cuidadores são do sexo feminino; 56,4 por cento estudaram menos de 5 anos; 58 por cento não possuem atividade remunerada; 10,2 por cento (54) das crianças que fizeram o teste anti-HIV são portadoras do HIV/Aids e, dessas, 32 por cento estão institucionalizadas; 45 por cento das crianças vivem separadas de seus irmãos. Com base na OR ajustada, pode-se estimar que ser portador do HIV/aids aumenta a ocorrência de crianças vivendo em instituição em 4,3 vezes; crianças órfãs de mãe, em 5,9 vezes, e órfãs duplas, em 3,7 vezes e ter mãe não branca, em 4,0 vezes. Há um número de órfãos considerável em Porto Alegre e as condições de vulnerabilidade persistem, pois, além de perderem seus pais, estão em famílias empobrecidas. Melhorar as condições de vida e evitar a institucionalização dos órfãos devido à aids requer intervenções que resultem no aumento da sobrevida das mulheres com HIV/aids e que fortaleça, econômica e psicologicamente, as famílias afetadas. A redução do estigma e da discriminação pelo HIV/aids é outro desafio que se têm que enfrentar. / The numbers of orphans due to AIDS will continue to increase over the next decade, particularly in countries where there is no effective and universal treatment for AIDS. Around the world, 14 million children have been orphaned due to AIDS. The majority of these children live in developing countries; This study aimed at identifying the characteristics of orphans due to AIDS in a city in Porto Alegre/RS and identify the factors associated with institutionalization of orphans due to AIDS. A cross-sectional study was made among children aged 0-15 years who are the children of all individuals that lived in Porto Alegre (State of Rio Grande do Sul) and died of AIDS during 1998-2001. The data were collected using a structured questionnaire. The children were traced via the death certificates and healthcare service records. The data were analyzed via Stata. Results: The ratio of orphans/adult deaths was 2:1. Of the total number of children located (853), 70 per cent were orphaned from their father and 50 per cent from their mother; 20 per cent were doubly orphaned. 52 per cent were girls. With regard to skin color, 56.5 per cent were black and 43 per cent were white. The median ages at the time of the mothers or fathers death were 7 years (0-19 P25=4 P75=11) and 8 years (0-17 P25=5 P75=11), respectively. The fathers mean age at the time of death was 36 years (SD=8.0), and the mothers 33.7 years (SD=7.7); 64.0 per cent of the mothers and 72 per cent of the fathers had or have a diagnosis of AIDS. 40.6 per cent of the children are living with their mother, 24.5 per cent with the grandparents (average age of 60 years; SD = 7.45), 11.5 per cent with uncles or aunts and 5.1 per cent in charitable homes. 88.3 per cent of the caregivers are female; 56.4 per cent have less than 5 years of schooling; 56 per cent do not have any remunerated activity. 10.2 per cent (54) of the children who did the anti-HIV test have HIV/AIDS and of these, 32 per cent are institutionalized. 45 per cent of the children live separated from their siblings. In multivariate analysis, HIV positive multiplied the childs chances of living in an institution by a factor of 4.3, losing its mother by 5.9, losing both parents by 3.7, and having a non-white mother by 4.0. Conclusions: This study provides population-based data on what has become of the children of persons dying of AIDS. Improving the quality of life and averting institutionalization of orphans due to AIDS requires interventions to promote the survival of mothers living with AIDS as well as specific interventions for child family placement. Reducing the stigma of HIV infection in children and racial discrimination present challenges in Brazil.

A epidemia da aids afeta a vida de crianças e jovens, independentemente da presença do HIV/Aids, através do adoecimento, perda dos pais, estigma, discriminação, entre outros. Este estudo teve como objetivo compreender o significado de ser órfão para jovens que perderam um ou ambos os pais em decorrência da aids e compreender os processos de estigmatização decorrentes dessa morte. Foram analisadas 19 entrevistas em profundidade realizadas com jovens órfãos, com idade entre 15 e 22 anos, residentes na cidade de São Paulo, entre os anos de 2005 e 2007. O sentido atribuído à morte e todo o ritual que a cerca é concebido como socialmente construído e a morte em decorrência da aids permeada pelo estigma que acompanha a aids desde o início da epidemia. Foram encontrados cinco significados associados à orfandade: dificuldade de falar sobre a orfandade ligada à aids; sentir falta do cuidado materno; o desafio de ser independente; não se sentir órfão e sentir tristeza em decorrência da morte. Os processos de estigmatização foram divididos em estigma sentido e efetivado e aconteceram na escola, na casa de amigos, na rua e com a namorada. Todos os relatos e cenas de estigma foram de estigma por associação, pois decorriam da causa da morte do(s) pai(s). Percebe-se que a orfandade em decorrência da aids impacta a vida dos jovens. Eles convivem com as adversidades com apoio da família, na maioria das vezes, materna. Não se conhece muito sobre os órfãos, principalmente se eles não viverem com HIV/Aids, pois os serviços de saúde perdem o contato a partir do momento que a pessoa da família que vive com aids morre. É importante que os programas de aids incorporarem as visões e as perspectivas destes jovens em seus projetos para garantir-lhes seus direitos. / The aids epidemic affects the life of children and youngs, not only because of the presence of HIV/Aids, but also because of the sickness, death of parents, stigma, discrimination, and others. This research had the main intention of understanding the meaning of being an orphan to young people that have lost one or both parents in result of aids and the stigma that is included in this process. Nineteen interviews were studied and the public included youngs between 15 and 22 years old, living in São Paulo, between 2005 and 2007. In this report, the meaning attributed to death and all the ritual involving it was concepted as social constructed and the death regarding aids was studied with the stigma that around aids since the beginning of the epidemic. It was pointed 5 issues related to orphanhood: difficulties related with speaking about parents death by AIDS; missing of mothers care; the challenges of being independent; do not feel as an orphan and feeling sadness because of death. The process of stigma was divided as felt stigma and enacted stigma and happened at school, at friends house, at the streets and with a date. All the stores and scenes of stigmas were courtesy stigma, because were related with parents death. With this report it is possible to realize that beeing an orphans in result of aids affects direct youngs living. They get used to live with adversity, family support, mainly by mothers family. Not too much is known about orphans, even less if they do not live with HIV/AIDS, because health services do not keep contact after the person in the family with AIDS dies. It is very important that aids programs includes the expectations and the way of seeing life of those people in their programs, so they can guarantee respect and theirs rights.

In the developing world, child care institutions often involve more complexity than is typically reflected by the word “orphanage.” In many instances, children do not fit the widespread definition of an orphan as one with with deceased parents. Oftentimes, institutions play a partial role in a child’s development by contributing towards childcare in collaboration with a relative, an ill parent, or nearby kin. In South Africa, the need and complexity surrounding the role of child care institutions is further amplified by the region’s longstanding HIV/AIDS epidemic. Through a primarily ethnographic study, I sought to understand and relay the nuances of a child care center in Hillbrow, an urban neighborhood in central Johannesburg known for its crime and gang proliferation. Through the developmental stages of intake and early childhood, middle childhood, and late adolesence and outward transition, I explored how children overcome traumatic pasts with the help of the center, how the center struggles with the material burdens of providing to children with a wide array of needs, and how the process of transitioning into adulthood is handled by the children and their caretakers. In conclusion, I explore the non-negotiable elements of the center’s approach to child care and make further recommendations for other institutions in a similar context as well as future academic research.

O objetivo deste estudo foi compreender o modo como ocorre a revelação (ou não) da causa morte dos pais do ponto de vista dos jovens órfãos por aids. Descreveu-se a trajetória de vida de jovens órfãos soronegativos e os sentidos da orfandade para esses jovens. O processo de revelação é emblemático do cenário compartilhado pelas pessoas afetadas pela epidemia da aids também no contexto brasileiro, profundamente marcado pelos estigmas associados à aids. A revelação expressa uma mediação intersubjetiva central ao contexto da aids, mais raro na experiência de outros agravos de saúde. Quando o tema da revelação é abordado na literatura internacional, mais frequentemente trata do modo como profissionais de saúde devem revelar a soropositividade, do modo como pessoas vivendo com aids contam o seu diagnóstico para parceiros sexuais, filhos e profissionais de saúde e, em menor frequência, como órfãos revelam a própria sorologia ou a dos pais. O estudo de desenho qualitativo analisou entrevistas realizadas com treze jovens de ambos os sexos que, no momento da entrevista, estavam majoritariamente no final da adolescência. As entrevistas abordaram sua estrutura familiar e doméstica, suas lembranças e a experiência da perda dos pais e de orfandade. Exploramos na entrevista cenas de revelação da causa morte dos pais, especialmente como lidavam, como comunicavam, ou não, sobre a causa morte por aids para outras pessoas, nomeada como revelação secundária. Nenhum dos entrevistados se identificou centralmente como órfão noção que é associada ao abandono. A trajetória de vida dos participantes indica que não estavam vivendo em condições de grande vulnerabilidade socioeconômica, quase todos trabalhavam e/ou estudavam e ninguém referiu ter sofrido discriminação na escola ou no trabalho, apesar de temerem a estigmatização e a discriminação que impede metade deles de revelar sua experiência pessoal com a aids. Observou-se que como em outros países, pais e/ou cuidadores tiveram dificuldades com a revelação do diagnóstico a seus filhos e que metade dos jovens não revelou a causa de morte dos pais por medo do estigma. A não revelação gerou o gerenciamento de um segredo de família e o desafio de dar conta de múltiplas revelações do comportamento dos pais e de outros segredos que o medo da discriminação produz / The purpose of this study was to comprehend the emotional and interpersonal effects of parents death by AIDS from seronegative young orphans point of view. Lifes trajectory of seronegative young orphans has been described, the meaning of orphanhood, their experience with AIDS diagnostic disclosure from their father, mother, or both. The disclosure process is emblematic of the shared scenario of people affected by AIDS, also in the Brazilian context marked by stigmas associated to AIDS. Disclosure expresses an intersubjective central mediation to AIDS experience, rarer in other health problems. In the literature, when the issue of disclosure is approached, it is usually about how health professionals must disclose to patients their seropositive condition, and the way people living with AIDS talk about their diagnostic to sexual partners, their children and to health professionals, rarely how orphans disclose your own, or of your parents, seropositive condition. This qualitative study interviewed a group of thirteen youth, male or female, that in the moment of interview were ending adolescence. The interview covered their familiar and domestic structure, their memories and experience of parents illness, death and orphanhood. In addition, parents death disclosure scenes were explored in the interviews, focusing on how to deal with those, how to disclose, or not, about their parents causa mortis to other people, named as secondary disclosure. Neither of interviewees has identified himself/herself as an orphan - in their perspective associated to neglect. They are not living under strong social-economic vulnerability condition. Almost all interviewees were working or studying, and anybody has reported discrimination at school or at work, although they were afraid about stigmatization and discrimination that prevented, half of them, to disclose their AIDS personal experience. Also, like in other countries, parents or caregivers had difficulties to disclosure the AIDS diagnostic to their sons and half of cohort did not disclose fearing stigma. The decision of non-disclosure produced constant management of a family secret and lead to the challenge in dealing with multiple disclosures about parents behavior and other secrets that the discrimination fear produces

Widows and their fatherless children are commonly perceived to be the most deserving category amongst the poor. The frequent exhortations in the Hebrew Scriptures of the Old Testament clearly and constantly reminded the early Christian Church of the divine expectations God had enjoined upon them in this matter. There appears to be no obstacle, theological or moral, to perceiving them as worthy recipients of Christian charity and pastoral care. Yet the results of this study show that in the early centuries of the church the fatherless family was invisible to its leadership. They were not perceived as needy people deserving support but were regarded as a problem, rather than real human beings. Ambiguous material in the Gospels and in the other writings of the New Testament, where references to them are sparse and sometimes unsympathetic, allowed creativity of interpretation to occur permitting evasion of the giving of straightforward support, and instead facilitated greater management and control by the clergy. Their informal self-organisation and methods of mutual self-help were increasingly eroded. The only extensive study of the support of the fatherless family in Roman society and the Church is the four volume habilitation thesis of Jens-Uwe Krause, Witwen und Waisen im Römischen Reich, published between 1994-1995. This large study deals with the long period 200 BCE – 600 CE diachronically. Apart from the 2009 collection of essays edited by Sabine R. Hübner and David M. Ratzan. Growing up Fatherless in Antiquity, which deals mainly with elite, political, and literary figures rather than the poor, little else has been written on the fatherless child in antiquity. The issue of whether 1 Timothy 5:3-16 and similar later material are referring to an ‘Order’ of widows, typified by Bonnie Thurston’s 1989 book, The Widows: A Women's Ministry in the Early Church, has proved a major diversion. Recent work by Steven Friesen and Bruce Longenecker reinforce the conception of the composition of the early church as being primarily that of the poor. My focus is on the neglected area of pastoral care of the poor fatherless family within the earliest church, concentrating on the first 300 years CE. The existence of the poor fatherless family created financial, social and moral difficulties for the church leadership, which forced them to devise novel ways to deal with the duties encumbering them. How could they control these sexually experienced, but vulnerable and dependent, women with their young children? One way was to re-define them as something else. The first method, and the most successful, was to split them up into two distinct groups, old people and full orphans, each requiring a different approach. Another strategy was to make widows represent someone or something other than themselves. Their alter egos will be shown to be human, literary or theological. The third trend observed was an effort towards extinguishing the voice of women. If women and fatherless children were to epitomise something else other than themselves, then their own self-perceived reality had to be kept well hidden. They could not be allowed to speak or socialise. If they did speak their words had to be rendered unheard or to be of no effect. Finally, the young fatherless children of widows have no voice and consequently have been rendered invisible. They do not appear in the Gospels. In the rest of the New Testament and the writings of the early church fathers, they receive little more than a cursory mention as part of a literary trope, or are transformed into barely mentioned full orphans.

O número de órfãos em decorrência da aids continuará a aumentar na próxima década, particularmente nos países onde não há tratamento efetivo e universal para a aids. No mundo, 14 milhões de crianças são órfãs devido à aids, a maioria delas vive em países em desenvolvimento; entretanto, no Brasil, o número de órfãos por aids não é conhecido. Este estudo objetivou identificar as características dos órfãos por aids em Porto Alegre e verificar os fatores associados à institucionalização destas crianças. Foi realizado um estudo de corte transversal das crianças de 0-15 anos de idade, filhos de indivíduos falecidos por aids no período de 1998-2001, residentes em Porto Alegre/RS. Os dados foram coletados em inquérito domiciliar com questionário estruturado. As crianças foram rastreadas a partir dos atestados de óbitos e dos registros dos Serviços de Saúde. A abordagem dos domicílios e cuidadores foi feita de modo a garantir absoluta privacidade, evitando discriminação e estigma para os órfãos e suas famílias. A proporção de órfãos/óbito de adulto foi 2:1. Do total de crianças localizadas (853), 70 por cento são órfãs de pai e 50 por cento , de mãe. Do total 20 por cento são órfãos duplos. São meninas 52 por cento . Quanto à cor da pele: pretas/pardas-56,5 por cento ; brancas 43 por cento . A idade mediana por ocasião do óbito paterno e materno foi 7 anos (0,00-19 P25=4 P75=11) e 8 anos (0,01-17 P25=5 P75=11), respectivamente. A idade média do pai por ocasião do óbito foi 36 anos (DP 8,0) e da mãe, 33,7 anos (DP 7,7); 64,0 por cento das mães e 72 por cento dos pais tinham ou tem diagnóstico de aids; 40,6 por cento das crianças vivem com a mãe, 24,5 por cento , com os avós (idade média 60 anos DP 7,45); 11,5 por cento , com tios e 5,1 por cento , em abrigos; 88,3 por cento dos cuidadores são do sexo feminino; 56,4 por cento estudaram menos de 5 anos; 58 por cento não possuem atividade remunerada; 10,2 por cento (54) das crianças que fizeram o teste anti-HIV são portadoras do HIV/Aids e, dessas, 32 por cento estão institucionalizadas; 45 por cento das crianças vivem separadas de seus irmãos. Com base na OR ajustada, pode-se estimar que ser portador do HIV/aids aumenta a ocorrência de crianças vivendo em instituição em 4,3 vezes; crianças órfãs de mãe, em 5,9 vezes, e órfãs duplas, em 3,7 vezes e ter mãe não branca, em 4,0 vezes. Há um número de órfãos considerável em Porto Alegre e as condições de vulnerabilidade persistem, pois, além de perderem seus pais, estão em famílias empobrecidas. Melhorar as condições de vida e evitar a institucionalização dos órfãos devido à aids requer intervenções que resultem no aumento da sobrevida das mulheres com HIV/aids e que fortaleça, econômica e psicologicamente, as famílias afetadas. A redução do estigma e da discriminação pelo HIV/aids é outro desafio que se têm que enfrentar. / The numbers of orphans due to AIDS will continue to increase over the next decade, particularly in countries where there is no effective and universal treatment for AIDS. Around the world, 14 million children have been orphaned due to AIDS. The majority of these children live in developing countries; This study aimed at identifying the characteristics of orphans due to AIDS in a city in Porto Alegre/RS and identify the factors associated with institutionalization of orphans due to AIDS. A cross-sectional study was made among children aged 0-15 years who are the children of all individuals that lived in Porto Alegre (State of Rio Grande do Sul) and died of AIDS during 1998-2001. The data were collected using a structured questionnaire. The children were traced via the death certificates and healthcare service records. The data were analyzed via Stata. Results: The ratio of orphans/adult deaths was 2:1. Of the total number of children located (853), 70 per cent were orphaned from their father and 50 per cent from their mother; 20 per cent were doubly orphaned. 52 per cent were girls. With regard to skin color, 56.5 per cent were black and 43 per cent were white. The median ages at the time of the mothers or fathers death were 7 years (0-19 P25=4 P75=11) and 8 years (0-17 P25=5 P75=11), respectively. The fathers mean age at the time of death was 36 years (SD=8.0), and the mothers 33.7 years (SD=7.7); 64.0 per cent of the mothers and 72 per cent of the fathers had or have a diagnosis of AIDS. 40.6 per cent of the children are living with their mother, 24.5 per cent with the grandparents (average age of 60 years; SD = 7.45), 11.5 per cent with uncles or aunts and 5.1 per cent in charitable homes. 88.3 per cent of the caregivers are female; 56.4 per cent have less than 5 years of schooling; 56 per cent do not have any remunerated activity. 10.2 per cent (54) of the children who did the anti-HIV test have HIV/AIDS and of these, 32 per cent are institutionalized. 45 per cent of the children live separated from their siblings. In multivariate analysis, HIV positive multiplied the childs chances of living in an institution by a factor of 4.3, losing its mother by 5.9, losing both parents by 3.7, and having a non-white mother by 4.0. Conclusions: This study provides population-based data on what has become of the children of persons dying of AIDS. Improving the quality of life and averting institutionalization of orphans due to AIDS requires interventions to promote the survival of mothers living with AIDS as well as specific interventions for child family placement. Reducing the stigma of HIV infection in children and racial discrimination present challenges in Brazil.

A epidemia da aids afeta a vida de crianças e jovens, independentemente da presença do HIV/Aids, através do adoecimento, perda dos pais, estigma, discriminação, entre outros. Este estudo teve como objetivo compreender o significado de ser órfão para jovens que perderam um ou ambos os pais em decorrência da aids e compreender os processos de estigmatização decorrentes dessa morte. Foram analisadas 19 entrevistas em profundidade realizadas com jovens órfãos, com idade entre 15 e 22 anos, residentes na cidade de São Paulo, entre os anos de 2005 e 2007. O sentido atribuído à morte e todo o ritual que a cerca é concebido como socialmente construído e a morte em decorrência da aids permeada pelo estigma que acompanha a aids desde o início da epidemia. Foram encontrados cinco significados associados à orfandade: dificuldade de falar sobre a orfandade ligada à aids; sentir falta do cuidado materno; o desafio de ser independente; não se sentir órfão e sentir tristeza em decorrência da morte. Os processos de estigmatização foram divididos em estigma sentido e efetivado e aconteceram na escola, na casa de amigos, na rua e com a namorada. Todos os relatos e cenas de estigma foram de estigma por associação, pois decorriam da causa da morte do(s) pai(s). Percebe-se que a orfandade em decorrência da aids impacta a vida dos jovens. Eles convivem com as adversidades com apoio da família, na maioria das vezes, materna. Não se conhece muito sobre os órfãos, principalmente se eles não viverem com HIV/Aids, pois os serviços de saúde perdem o contato a partir do momento que a pessoa da família que vive com aids morre. É importante que os programas de aids incorporarem as visões e as perspectivas destes jovens em seus projetos para garantir-lhes seus direitos. / The aids epidemic affects the life of children and youngs, not only because of the presence of HIV/Aids, but also because of the sickness, death of parents, stigma, discrimination, and others. This research had the main intention of understanding the meaning of being an orphan to young people that have lost one or both parents in result of aids and the stigma that is included in this process. Nineteen interviews were studied and the public included youngs between 15 and 22 years old, living in São Paulo, between 2005 and 2007. In this report, the meaning attributed to death and all the ritual involving it was concepted as social constructed and the death regarding aids was studied with the stigma that around aids since the beginning of the epidemic. It was pointed 5 issues related to orphanhood: difficulties related with speaking about parents death by AIDS; missing of mothers care; the challenges of being independent; do not feel as an orphan and feeling sadness because of death. The process of stigma was divided as felt stigma and enacted stigma and happened at school, at friends house, at the streets and with a date. All the stores and scenes of stigmas were courtesy stigma, because were related with parents death. With this report it is possible to realize that beeing an orphans in result of aids affects direct youngs living. They get used to live with adversity, family support, mainly by mothers family. Not too much is known about orphans, even less if they do not live with HIV/AIDS, because health services do not keep contact after the person in the family with AIDS dies. It is very important that aids programs includes the expectations and the way of seeing life of those people in their programs, so they can guarantee respect and theirs rights.