The Impact of the AIDS Epidemic on Older Persons
(with a focus on Thailand and Cambodia)

HIV/AIDS is usually viewed as a disease affecting reproductive-age adults and their infant children. Discussions rarely consider the impact on older persons and, when they do, they typically focus on those who are infected themselves. Not only can older adults contract HIV themselves but a far greater number of older persons are affected through the infection of significant others, especially their adult children and grandchildren. The pathways through which they are affected include caregiving, coresidence and providing financial and material support during the illness, paying funeral expenses, fostering orphaned grandchildren, losing current and old-age support that the child would have provide, and suffering grief and emotional stress. These in turn can have profound consequences for their economic, social, psychological, and physical well-being. At the same time, by playing a major role in caregiving, older persons make significant contributions to the well-being of their infected sons and daughters and, by assuming the role of foster parents, to the grandchildren who are left behind. Widespread availability of Anti-Retroviral Therapy has considerably reduced the burden of caregiving for parents of HIV infected persons who now often assist with treatment adherence.

A joint team of Thai and U.S. researchers from the University of Michigan, Tulane University, Chulalongkorn University, and Mahidol University studied the impact of AIDS on older persons in Thailand between 1998 and 2002 through grants from the U.S. National Institute on Aging (Grants AG15983 and AG18648). The project utilized a multi-method approach to provide a comprehensive assessment of a wide range of impacts on older Thais and their implications for understanding the impact on older persons in other settings. The research team is comprised of John Knodel, Mark VanLandingham, Wassana Im-em, Jiraporn Kespichayawattana, and Chanpen Saengtienchai.

Subsequent research on the role and impact of older persons as parents and grandparents of HIV-affected persons was extended in two major ways. The first was to conduct related research in Cambodia starting in 2003. The second was to assess how the advent and spread of Anti-Retroviral Therapy (ART) affected the role of older-age parents of HIV infected persons’ children and grandchildren in both Thailand and Cambodia starting in 2008. In Cambodia the initial research was conducted in collaboration with Sovan Kiry Kim and Sina Puck of the Sociology Department at the Royal University in Phnom Penh and was supported through grants from the National Institute on Aging (sub p/g F009700, sub p/g F010799, R01 AG20063-01). Zachary Zimmer was also a co-investigator. Research on how the spread of ART in Cambodia affected the role of older persons was conducted in collaboration with Sochanny Hak, Chandore Khuon, Dane So and John McAndrew all staff of the Analyzing Development Issues (ADI) project of the Cooperation Committee for Cambodia. In Thailand the ART related research was done in collaboration with Jiraporn Kespichayawatta and Suvinee Wiwatwanich of the Chulalongkorn University Faculty as well as Chanpen Saengtienchai. The Thai research was funded by pilot sub-grant from the National Institute on Aging grant P30 AG012846.