Headship of older persons in the context of HIV/AIDS in rural South Africa

  • Enid Schatz School of Health Professions, University of Missouri, Institute of Behavioral Science, University of Colorado, Faculty of Health Science, University of the Witwatersrand
  • Sangeetha Madhavan Department of African American Studies, University of Maryland, Faculty of Health Science, University of the Witwatersrand
Keywords: Aging, South Africa, headship, HIV/AIDS, households


This paper examines older persons’ positions as heads of households in the Agincourt sub-district of Mpumalanga Province, South Africa. Older people’s access to non-contributory pensions in a context of AIDS-related chronic illness and premature death might increase their household responsibilities which, in turn, may be manifested in higher rates of household headship. We use descriptive analysis to outline the traits of household heads, compare household characteristics, in particular recent mortality experience, across headship types (male/female, pre/ post-pension eligibility). While some significant differences in household composition exist across headship types, older persons were no more likely to be heading households with a HIV/AIDS-related death over the 2000-2005 period—prior to extensive antiretroviral (ARV) rollout. This provides an important starting point for further investigations aimed at understanding the impact of HIV/AIDS on older persons’ lives, and as a baseline for measuring the effects of ARV rollout on older persons’ status in AIDS-endemic communities.