1. Young Carers Project Universities: Oxford, Brown, UKZN National Department of Education National Department of Heath National Department of Social Development National Department of Agriculture, Forestry and Fisheries National Action Committee for Children Affected by HIV and AIDS Tholulwazi NGO Teen Advisory Group & PLWHA

2. Methods Sites: Lamontville and Manguzi in Kwazulu-Natal, South Africa Sampling: stratified random sampling of census size enumeration areas with door-to-door household sampling using GIS Participants: N= 5238 (2619 matched child-caregiver pairs) Children aged 10-17, Caregivers aged 18+ Ethical Approval: University of Oxford and KwaZulu Natal, South African Departments of Health and Education

3. Findings on illness and functioning Self-reported impairments 36.4% reported sight impairments (“I have problems seeing properly.”) 7% reported another impairment including physical or hearing Functioning and activity limitation 13% said getting out of bed was very difficult or they were not able to do it 12% said they were limited most or all of the time in work or other activities 11% said they were unable to do activities they would normally do at work/home etc. (n=293) Out of this subset (n=293), 61% said they spent time in bed during the day; 22% said more than half of the day

4. Preliminary findings on activity limitation Carer HIV is highly correlated with carer activity limitation (as measured by WHO-ICF) (p<0.01) In households where carers have higher HIV activity limitation: children are more likely to spend time providing intimate care and health care (p<0.01) and doing housework (p<0.01) household poverty is higher and so is child reports of hunger (p<0.01) children are less likely to attend school in the past week and past year (p<0.01) Parenting and child sexual risk behaviours Poor parental supervision was associated with children's sexual activity (p<0.01) and child reports of transactional sexual exploitation (p<0.02)