Foundation giving reflects a philosophy that prefers to invest in health resources for the future rather than to provide services in the present. 1 Past patterns of giving have prepared foundations poorly for confronting an infectious epidemic such as acquired immunodeficiency syndrome (AIDS). The reasons for this vary. First, chronic and endemic diseases such as cancer and juvenile diabetes that have characterized the disease burden of the recent past have allowed foundations ample time to contemplate the need for support and to await the future payoff of their investments. The AIDS crisis affords nobody the luxury of deliberateness, yet many foundations have been relatively slow to react, especially the large health-supporting foundations, several of whom have yet to begin a program of AIDS funding. Second, the predominance of chronic disease has responded well to curative medicine, in which technologically complex equipment, highly trained staff, and carefully managed delivery systems seemed most appropriate. In the case of AIDS, prevention-and specifically behavioral change-is at present the only intervention with the prospect of influencing survival. Yet the foundations have made a relatively minor commitment to public health education in AIDS prevention. Finally, foundations have traditionally avoided disease-specific giving. Although this may be sound policy in many circumstances, it seems inappropriate in the face of a crisis such as AIDS.This essay examines patterns of giving for AIDS programs by private foundations. It covers the period from 1981 to early 1987 and discusses trends in the number of grants given over the period, the categories in which the awards have been made, and the foundations participating in AIDS giving. It then examines three specific grants to illustrate giving in the area of AIDS. Finally, it discusses some problems in giving to AIDS and prospects for future foundation participation in AIDS giving.