This chapter seeks to contextualize the issues surrounding acquired immune deficiency syndrome (AIDS) orphanhood, in order that experiences may be utilized as initiatives for policy and practice. It is estimated that in the high-fertility countries in eastern Africa, for every mother dying of AIDS, three children become orphans. The pattern of high fertility in sub-Saharan countries generally means that infected women are likely to have borne several children before dying of AIDS. AIDS in Africa is a family disease, with both parents likely to be dead during the childhood of uninfected children. Throughout Africa, children orphaned by AIDS have been absorbed into extended family networks. Several principles emerge from the African experience of AIDS orphanhood. First, the community must be involved at every level in planning, implementing, and monitoring programs, building good relationships, and generating resources that are essential for an effective response to the issue of AIDS orphans.