Older people who care for people living with HIV/AIDS or for children orphaned by HIV/AIDS are themselves at risk of infection. However, international data on infection rates does not include those older than fifty. There is little information on older people's needs and how they could contribute to the fight against HIV/AIDS.

A report from HelpAge International Tanzania presents the findings of a participatory study of older Tanzanians. Nearly two million people in Tanzania are over 60 years old. About ten percent of the population are HIV positive and one in seven children is an orphan. Many older people live in remote rural areas in extreme poverty and without access to health services. Their situation is made worse as they assume new roles as carers for orphaned children.
Researchers found that older people lack access to adequate information about HIV/AIDS, its causes, methods of transmission and treatment. The main sources of information are oral communication from health visitors, community meetings and the local radio, rather than written materials or posters. Low levels of literacy, especially among rural women and language constraints contribute to lack of information.

Older people caring for their dying children and orphaned grandchildren, especially those who are HIV-positive themselves, suffer from shame, fear and anxiety. Social isolation reduces their access to health services such as home visits and prevents them from using protective measures such as wearing gloves when caring for their sick relatives.

Researchers found that in HIV-affected households run by older people:

. Many older women are forced to abandon income-generation activities in order to take care of their grandchildren. 

. Older women are put at risk through their husbands' extra marital relationships and when poverty forces them to exchange sex for money. 

. It is difficult to pay for food, water, health care and education costs which are four to five times higher than household income. 

. School attendance of orphaned children is affected and they do not usually continue to secondary education due to lack of household resources. 

. The elderly neither have time nor any help to cope with grief, loss and stress as they have to focus on running the household. 
The Tanzanian government has launched a National Ageing Policy which recognises older people as a resource in development. Tanzania's National Strategy for Growth and Reduction of Poverty also acknowledges the need for safety nets and support for those worst hit by the epidemic.

To support this new policy at local level, HelpAge International recommends that:

. all data and information on HIV/AIDS and poverty is broken down by age 

. policymakers recognise that older people are a group at risk of infection themselves 

. older people and AIDS affected families should receive income support 

. older people must be given more home support and better information on HIV/AIDS transmission and care through non-written methods 

. older women and men must be included in developing national policy and programmes on HIV/AIDS, poverty reduction and local planning. 

Contributor(s): Loserian Sangale, Mussa Mgata and Fiona Clark
Source(s):

'The cost of love: older people in the fight against AIDS in Tanzania', Tanzania, by Loserian Sangale and Mussa Mgata, November 2004 More information.