Educational outcomes of family-based HIV-infected and affected children from Maharashtra,India

India is home to 0.14 million children, living with HIV. Little is known about their educational needs. The present analysis estimated educational outcomes of family-based children affected by HIV/AIDS (CABA) and impact of their HIV status on educational outcomes. A situation analysis was undertaken in four districts from Maharashtra, India. A total of 510 parents/guardians of family-based CABA were interviewed. Data of single child per household, aged 6–16 years, were analyzed. Child not infected/not tested for HIV and having one/both parents infected with HIV was defined as HIV affected. Logistic regression analysis was used to understand determinants of ‘currently out of school’ and ‘lag behind age appropriate standard’. Of the total 472 CABA, 237 and 235 were HIV infected and affected respectively, 43% were girls, 70% were below 13 years of age, 51% resided in rural area, 83% belonged to lower economic strata and 61% had lost one/both parents. Higher proportion of HIV-infected children had history of hospitalization in the past year (26%) compared with HIV affected (7%). Majority of HIV-infected children (84%) were taking ART. A total of 23 (4.87%) children were currently out of school and 43 (9.23%) lagged behind age appropriate standard. Compared to HIV-affected, HIV-infected children were more likely to be out of school (aOR = 7.16, 95% CI = 1.79–42.47) and lagged behind age appropriate standard (aOR = 2.82, 95% CI = 1.17–6.81). Children 14–16 years old had higher risk of being out of school (aOR = 11.55, 95% CI = 3.46–50.65) and lag (aOR = 3.85, 95% CI = 1.79–8.29), compared to 6–13 years old children. Having lost mother and caregiver being illiterate independently predicted the lag. Among HIV-infected children, the most common reason for discontinuation of school was child’s illness. The analysis highlights greater educational disadvantages of HIV-infected children and its possible linkage with ill health of these children.