The role of elderly carers in HIV prevention and care; the perspectives of older adults in underprivileged communities in South Africa

In many societies, the elderly take on the enormous role of being the caregivers of sick family members. Little is known about the context in which they provide HIV/AIDS-related care, and their role as caregivers is most often not documented. This study conducted interviews with 31 elderly carers to explore their care-giving activities in relation to adult children with AIDS-related illness, and to examine their perceived role in HIV prevention and management in rural communities in Mpumalanga Province, South Africa. The findings indicate that older adults who assume the natural role of caring for sick adult children live in multigenerational households. Key caring activities include the provision of physical and hygiene care, financial and emotional support, and health and nutritional care. Besides the physical caring activities, the elderly carers play a critical role in the prevention of HIV. They promoted condom use, encouraged HIV testing, and spoke openly about the HIV status of their sick adult children. Their critical role in administering antiretroviral treatment (ART) and encouraging adherence demonstrates a comprehensive understanding of the importance of adherence and the complex ART regimen. The findings underscore the need to train and incorporate older adults into adherence programmes to facilitate their role as long-term adherence partners. They are also an essential vehicle to reduce stigma and discrimination in their communities.