In countries with a high prevalence of AIDS, the epidemic decimates the young to middle-aged adult population—the backbone of the labor that supports both the national economy and the family.
In the absence of men and women of working-age, older relatives often resume the burden of being breadwinners and caretakers. More often than not, this task falls on elderly women.
One outcome in countries with high HIV/AIDS prevalence is an increase in the number of chronically poor households headed by older women, with a large number of dependents. Older women generally suffer most from chronic poverty and lack of resources. They are often in need of care themselves, but face, sometimes unaided, the costs and emotional stress of nursing terminally ill relatives, paying for burials and the financial and practical difficulties of bringing up orphans – including payment of school fees.