Journal of Cross-Cultural Gerontology

, Volume 22, Issue 4, pp 339–353

The Plight of Older Persons as Caregivers to People Infected/Affected by HIV/AIDS: Evidence from Uganda

Original Article


This paper describes the challenges faced by elderly persons (50 years and above) in Uganda, as parents and/or relatives of persons infected by HIV and as caregivers of the infected relatives and their uninfected children. Little is known regarding these indirect impacts of HIV/AIDS on the elderly in sub-Saharan Africa. Yet, the elderly are most often the main caregivers of HIV-infected persons and their families. Data used in this study were obtained from focus group discussions and in-depth interviews conducted among elderly respondents in 10 rural and urban communities within two Ugandan districts, Luwero and Kamuli. Findings indicate that the elderly do provide care to patients with AIDS at the terminal stage of the illness—when patients most need constant care. In most cases, the challenge of caring for the sick patients is compounded by the responsibility to care for the children affected by HIV/AIDS, which also starts when their parents are still living, not when the children become orphans. This demanding work was reported to negatively affect the elderly in various dimensions (economic, emotional, physical, and nutritional), all of which impacts their health and well-being. The responsibility for day-to-day patient care is borne primarily by elderly females, who reported a higher rate of physical ailments than male respondents—perhaps an indication of their disproportionate contribution to the care responsibilities. Most of the elderly respondents interviewed have a lot of anxiety about their future health and well-being, which they attributed in most part to the HIV/AIDS epidemic. These challenges do appear to exacerbate the aging process of the elderly whose health and well-being are already affected by the poor resource base and weak health infrastructure in this setting.


HIV/AIDS impact Elderly Caregiving Sub-Saharan Africa Uganda 


  1. Ainsworth, M. (1996). Economic aspects of child fostering in Cote d’Ivoire. Research in Population Economics, 8, 56–62.Google Scholar
  2. Barnett, A., & Blaikie, P. (1992). AIDS in Africa: Its present and future impact. London: Belhaven Press.Google Scholar
  3. Caldwell J. C. (1977). The economic rationality of high fertility: An investigation illustrated with Nigerian survey data. Population Studies, 31(1), 5–26.CrossRefGoogle Scholar
  4. Castle, S. E. (1995). Child fostering and children’s nutritional outcomes in rural Mali: The role of female status in directing child transfers. Social Science & Medicine, 40(5), 679–693.CrossRefGoogle Scholar
  5. Gilborn, L. Z., Nyonyintono, R., Kabumbuli, R., & Jagwe-Wadda, G. (2001). Making a difference for children affected by AIDS: Baseline findings from operations research in Uganda. New York: Population Council.Google Scholar
  6. Hunter, S. (1990). Orphans as a window on the AIDS epidemic in sub-Saharan Africa: Initial results and implications of a study in Uganda. Social Science & Medicine, 31, 681–690.CrossRefGoogle Scholar
  7. Isiugo-Abanihe, U. C. (1985). Child fosterage in West Africa. Population and Development Review, 11(1), 53–73.CrossRefGoogle Scholar
  8. Kespichayawattana, J., & VanLandingham, M. (2002). Health impacts of co-residence with and caregiving to persons with HIV/AIDS on older parents in Thailand. Population Studies Center Research Report, No. 02-527. Ann Arbor: University of Michigan.Google Scholar
  9. Knodel, J., & Saengtienchai C. (2005). The final safety net for adult sons and daughters with AIDS in Thailand. Journal of Family Issues, 26(5), 665–698.CrossRefGoogle Scholar
  10. Knodel, J., & VanLandingham, M. (2002). The impact of the AIDS epidemic on older persons. AIDS, 16(4), S77–S83.Google Scholar
  11. Knodel, J., & VanLandingham, M. (2003). Return migration in the context of parental assistance in the AIDS epidemic: The Thai experience. Social Science & Medicine, 57, 327–342.CrossRefGoogle Scholar
  12. Madhavan, S. (2003). Fosterage patterns in the age of AIDS: continuity and change. Social Science & Medicine, 58(7), 1443–1454.CrossRefGoogle Scholar
  13. Menon, R., Wawer, M. J., Konde-Lule, J. K., Sewankambo, N. K., & Li, C. (1998). The economic impact of adult mortality on households in Rakai district, Uganda. In M. Ainsworth, L. Fransen, & M. Over (Eds.), Confronting AIDS: Evidence from the developing world: Selected background papers from the World Bank Policy Research Report. United Kingdom: European Commission.Google Scholar
  14. Mukiza-Gapere J, & Ntozi, J. P. M. (1995). Impact of AIDS on the family and mortality in Uganda. Health Transition Review, 5(Suppl.), 191–200.Google Scholar
  15. Ntozi, J. P. M. (1997). Effect of AIDS on children: The problem of orphans in Uganda. AIDS Care, 2, 77–80.Google Scholar
  16. Ntozi, J. P. M., & Mukiza-Gapere J. (1995). Care for AIDS orphans in Uganda: Findings from focus group discussions. Health Transition Review, 5(Suppl.), 245–252.Google Scholar
  17. Ntozi, J. P. M., & Nakayiwa, S. (1999). AIDS in Uganda: How has the household coped with the epidemic? In I. O. Orubuloye, J. C. Caldwell, & J. P. M. Ntozi (Eds.), The continuing HIV/AIDS epidemic in Africa: Responses and coping strategies (pp. 155–181). Canberra: Australian National University.Google Scholar
  18. Nyambedha, E. O., Wandibba, S., & Aagaard-Hansen, J. (2003a). “Retirement Lost”—The new role of the elderly as caretakers for orphans in Western Kenya. Journal of Cross-Cultural Gerontology, 18(1), 33–52.CrossRefGoogle Scholar
  19. Nyambedha, E. O., Wandibba, S., & Aagaard-Hansen, J. (2003b). Changing patterns of orphan care due to the HIV epidemic in Western Kenya. Social Science & Medicine, 57(2), 302–311.CrossRefGoogle Scholar
  20. Oburu, P. O., & Palmerus, K. (2005). Stress related factors among primary and part-time caregiving grandmothers of Kenyan grandchildren. International Journal of Aging & Human Development, 60(4), 273–282.CrossRefGoogle Scholar
  21. Population Reference Bureau (PRB). (2002). World population data sheet. Washington, DC.Google Scholar
  22. Preble, E. A. (1990). Impact of HIV/AIDS on African children. Social Science & Medicine, 31(6), 671–680.CrossRefGoogle Scholar
  23. Stoneburner, R., & Low-Beer, D. (2004). Population-level HIV declines and behavioral risk avoidance in Uganda. Science, 30, 714–718.CrossRefGoogle Scholar
  24. Stover, J., & Bollinger, L. (1999). The economic impact of AIDS. Washington, DC.Google Scholar
  25. Taylor, L., Seeley, J., & Kajura E. (1996). Informal care for illness in rural southwest Uganda: The central role that women play. Health Transition Review, 6(1), 49–56.Google Scholar
  26. Uganda Bureau of Statisticis (UBOS) and ORC Macro. (2001). Uganda demographic and health survey 2000–2001. Calverton, MD, USA.Google Scholar
  27. Uganda Ministry of Health (2005). Uganda HIV/AIDS sero-behavioural survey 2004–05. Preliminary report. Kampala, Uganda.Google Scholar
  28. UNAIDS. (2000). Report on the global HIV/AIDS epidemic. Geneva.Google Scholar
  29. UNAIDS. (2006). Report on the global HIV/AIDS epidemic. Geneva.Google Scholar
  30. Williams, A., & Tumwekwase, G. (2001). Multiple impacts of the HIV/AIDS epidemic on the aged in rural Uganda. Journal of Cross-Cultural Gerontology, 16, 221–236.CrossRefGoogle Scholar
  31. World Health Organization (WHO). (2002). Impact of AIDS on older people in Africa: Zimbabwe case study. Geneva.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Research Triangle InstituteResearch Triangle ParkUSA

Personalised recommendations