HIV/AIDS has changed the world in profound and still-evolving ways. The last children born before HIV/AIDS emerged in the late 1970s and early 1980s are now in their mid-twenties, many with children of their own. All children born in the foreseeable future – at least for the next several decades – will be living in a world where the epidemic persists, albeit with variable consequences for each of them. Children, among the most vulnerable members of society, are bellwethers of adult leaders' willingness and capacity to respond to economic, health, and social challenges. What happens to children and adolescents now will determine not only their futures but also the futures of their families, communities, and societies.

In the first years of the HIV/AIDS epidemic, though, there was relatively little direct focus on children, particularly children who were not themselves HIV-infected but were nevertheless significantly affected by the disease. In the past decade or so the massive and growing number of orphans in Africa has received periodic media attention and many program responses. To be sure, in developed countries in North America and Europe, pediatric HIV/AIDS has become a highly sophisticated medical specialty. Treatments to reduce mother-to-child HIV transmission have succeeded extraordinarily well in these countries and are being introduced slowly in poor countries where the need is greatest. In every country affected by the epidemic, dedicated individuals and groups – most with very meager resources – serve children and families and advocate for more attention to their needs.