Governments in sub-Saharan Africa have failed to address the extraordinary barriers to education faced by children who are orphaned or otherwise affected by HIV/AIDS. An estimated 43 million school-age children do not attend school in the region. HIV/AIDS has caused unprecedented rates of adult mortality, leaving millions of children without parental care to ensure their access to education. While providing limited support to community efforts that support orphans, governments have failed to address the unique disadvantages faced by AIDS-affected children, with the result that these children are less likely than their peers to enroll, attend, or advance in school. This form of de facto discrimination places AIDS-affected children-whether orphans or those whose parents are terminally ill-at higher risk of sexual exploitation, unemployment, hazardous labor, and other human rights abuses, as well as at higher risk of HIV infection. This report is based on detailed interviews with dozens of children affected by HIV/AIDS and their caregivers in three sub-Saharan African countries-Kenya, South Africa, and Uganda. Their testimonies revolve around a common theme: neglect and abuse within families, in communities, and by schools and governments have hindered AIDS-affected children's ability to enroll, remain, or advance in school. Children whose parents were terminally ill dropped out of school to act as caregivers to their parents and younger siblings. The successive death of multiple family members to HIV/AIDS led to the gradual erosion of children's extended-family safety net, resulting in inadequate financial support for schooling. Parental illness or exploitation by subsequent caregivers led children to work long hours to offset lost family income or provide basic sustenance. The stigma associated with HIV led to taunting by peers, and made it difficult for children to communicate with their teachers about illness or death in the family. Children who were themselves HIV-positive experienced prolonged absences from school due to ill-health, poor access to essential medicines, and AIDS-related stigma and discrimination.