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South Africa’s HIV/AIDS epidemic poses a major public health threat with multi-faceted harmful impacts and ‘socially complex’ outcomes. While some outcomes relate to structural issues, others stem from society’s attitudinal milieu. Due to negative attitudes toward People Living with HIV/AIDS, stigmatisation mars their own experience and often extends to those close to them, in particular their caregivers. Many of the caregivers in South Africa are older women; thus, older women are the focus of this paper, which aims to examine HIV/AIDS-related stigma from their perspective. This paper explores secondary stigma as a socio-cultural impact of HIV/AIDS through repeated semistructured interviews with 60 women aged 50–75 in the MRC/Wits Rural Public Health and Health Transitions Unit research site (Agincourt), many of whom had cared for a family member with HIV/AIDS. Respondents’ narratives reveal that many older persons attribute high rates of death in their community to young persons’ lack of respect for societal norms and traditions. The findings illustrate the forms and expressions of HIV/AIDS-related secondary stigma and their impacts on older female caregivers. The types of secondary stigma experienced by the respondents include physical stigma in the form of isolation and separation from family members; social stigma in the form of voyeurism and social isolation; and verbal stigma in the form of being gossiped about, finger-pointing and jeering at them. Despite mixed reports about community responses toward infected and affected people, HIV/AIDS-related stigma remains a cause for concern, as evidenced by the reports of older women in this study.

This paper explores the financial and opportunity costs of adult morbidity and mortality for rural South African female pensioners in the era of HIV/AIDS. As mortality rates from HIV/AIDS and other causes escalate, older women are bearing the brunt of caregiving responsibilities for the sick and orphaned. They often use their state-funded non-contributory pensions to support kin during crises. Interviews conducted with 30 women aged 60-75 years in the Medical Research Council/University of the Witwatersrand Unit (Agincourt) study site in northeastern South Africa revealed that, to cover expenses incurred during crises, older women sometimes forgo spending money and time on their personal needs. They are thus negatively affected as individuals, while contributing positively to the household. Despite the additional household income from pensions, many of the study respondents still found it difficult to recover from the financial impact of these crises.

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