AIDS and the missing middle

A new paper in the British Medical Journal shows how AIDS is ripping the middle generation out of family support systems in Africa. Analyzing 22 countries over 15 years, the researchers found that countries with higher AIDS mortality have more elderly people living alone or only with young children.

This relationship — which holds after other demographic factors are controlled — is consistent with another recent study, which also found more skip-generation households in AIDS-afflicted countries.

Although a recent issue of Research on Aging has attempted to expand the focus of AIDS research “from the infected to the affected,” including the elderly, children orphaned by the disease have so far received more attention than “AIDS parents,” even though most adults who die from AIDS are survived by at least one parent. And the hardest-hit countries have weak social support systems in which family care for the elderly is essential.

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