In June of nineteen eighty-one, public health officials in the United States reported on the first cases of what came to be known as AIDS. Thirty years later, there is growing progress against the epidemic of acquired immunodeficiency syndrome. But today an estimated sixteen and a half million children have lost one or both parents to AIDS. Most of these AIDS orphans live in sub-Saharan Africa. And millions more children live with adults who are sick from AIDS.Lucie Cluver from Oxford University in England has studied AIDS orphans and children living with sick adults in South Africa. She says the mental health of children in these situations can be deeply affected. For example, AIDS-orphaned children have higher levels of depression, anxiety and post-traumatic stress disorder than children whose parents have died of other causes.Lucie Cluver wrote about this problem in the journal Nature to mark the thirtieth anniversary of AIDS. She says children have to live with the stigma, the sense of shame connected to AIDS. Many are bullied at school or excluded from the community. At home, children living with a sick adult are more likely to live in poverty and face physical and emotional abuse. Also, Lucie Cluver says the children often become the caregivers. They worry and feel responsible for the health of the sick person. "They're missing school to go and get medication. They're washing the sick person. They're often taking them to the toilet, cleaning their wounds or washing their bedclothes." Close contact with sick adults can sometimes spread tuberculosis or other diseases. And Lucie Cluver's research suggests that psychological problems increase as AIDS orphans get older.Writing in Nature, she called for testing more children for tuberculosis. She also called for giving more parents the drugs needed to keep them healthy longer with HIV, the virus that causes AIDS. There are programs to help children, but Lucie Cluver says there is "far more to be done." She says interventions such as cognitive behavioral therapy and support groups are "urgently needed" for those orphaned by AIDS or living with sick adults. But the evidence for which interventions are effective "is still thin," she says.

For VOA Special English, I'm Alex Villarreal. You can learn American English and much more every day at voaspecialenglish.com.