This paper examines the evidence on access to conventional schooling for children and young people affected by HIV and AIDS in sub-Saharan Africa and makes recommendations for the further development of the SOFIE Project. The findings reveal the highly complex and context specific nature of the educational impact. In some areas broad adaptive capacities are emerging that may enable households to support a larger number of orphans whilst in other areas households are reaching the limits of their capacity to cope. In HIV-stressed households children have reduced educational access and attainment and maternal orphans are a particularly disadvantaged group in terms of schooling, even relative to other poor children. At the same time schools in high HIV prevalence areas are increasingly challenged to meet the educational and emotional needs of the children who walk in through their door and are unlikely to reach out to the young people who cannot attend regularly.

The findings imply that there is a need for educational reform to move away from the ‘one size fits all’ view of conventional schooling and to think creatively, ‘out of the box’ to develop alternative, more open and flexible, models of educational delivery and support. It is argued that such models could play a useful role in facilitating educational reform by sharing the burden faced by schools and helping to integrate responses to learners’ needs more effectively and suggestions for alternative models are put forward.The review concludes that, given the highly variable and context specific nature of the educational impact of HIV and AIDS, detailed case studies and well evaluated interventions are needed in specific social and cultural contexts to inform effective policy recommendations and practice.