New burdens on old shoulders - the impact of HIV

Grandparents often have to care for AIDS orphans in developing countries. But what other problems do they face due to the epidemic? Researchers from the MRC Programme on AIDS in Uganda talked to elderly people in a rural village in south west Uganda, where half of all deaths among adults aged 13 to 44 are HIV-related.

The researchers visited 30 adults (13 men and 17 women) aged 60 to 90 years at least once a month for a year. They found that the impact of the HIV/AIDS epidemic on older people's lives is multi-faceted:

• As sexually active adults they are vulnerable to HIV themselves.
• As parents they attempt to protect their children from HIV infection. They have to provide for the physical, emotional and economic needs of their HIV-infected children and to bury them when they die.
• As grandparents, they may have to feed, clothe and educate their orphan grandchildren and care for them if they are sick.
• As dependent old people they are deprived of any support that their deceased children might have provided.

It is possible that more than one of these situations will affect an aged individual simultaneously. Although HIV does not add many new pressures on the hard lives of the elderly, it does substantially exacerbate their existing burdens. Among the study participants:

• Most have a sound understanding of the sexual transmission of HIV and some consider themselves to be at risk of infection through having multiple sexual partners.
• 13 households have experienced an AIDS illness or death in the house or have lost support or gained dependants as a result of the disease.
• Female-headed households are more likely to be affected than those headed by men.
• Six households have taken in orphan grandchildren.

Burials create particular problems. Grandparents are obliged to bury their children and grandchildren if they die. They are also expected to attend the burials of many other relatives and friends, and every household is expected to contribute towards the costs of burials in the village.

As people age, they become increasingly dependent on their family members - primarily adult children who live nearby. Support networks do exist and are called upon in times of crisis. However, the availability of this support is declining as younger adults leave the village to look for work in urban areas. Older people find it more difficult to maintain household food security. The diversion of labour into caring for the sick or for orphans also reduces the amount of time available for agriculture.

The research revealed an urgent need for:

• self-help initiatives through which the active aged can support each other
• direct support to those frail older people whose daily needs are not being met
• national action to address these issues with the support of the international community.

Source(s):
'Multiple impacts of the HIV/AIDS epidemic on the aged in rural Uganda' by A. Williams and G. Tumwekwase, Journal of Cross-Cultural Gerontology 16 (2001)

Funded by: UK Medical Research Council; HelpAge International

id21 Research Highlight: 22 February 2002

Further Information:
Alun Williams
Indigenous Health Program
University of Queensland
Brisbane
Australia

Tel: +61 (0)7 205 55029
Fax: +61 (0)7 336 55550
Contact the contributor: a.williams@mailbox.uq.edu.au

University of Queensland, Australia

Grace Tumwekwase or Jimmy Whitworth
MRC Programme on AIDS in Uganda
c/o Uganda Virus Research Institute
PO Box 49
Entebbe
Uganda

Tel: +256 (0)41 320042/320272
Fax: +256 (0)41 321137
Contact the contributor: mrc@starcom.co.ug

Other related links:
See id21's collection of links relevant to HIV/AIDS.

HelpAge International has publications and information on international aspects of ageing.

Look at this WHO factsheet on the public health challenge of ageing.

See the ELDIS resource centre on ageing populations.