social, political, and economic environment from older people in other African countries. These distinctions, coupled with a very severe HIV epidemic, suggest that the impact of HIV/AIDS on older people in South Africa may be very different from that in other countries with generalized HIV epidemics.

We begin by describing some of the more important social, demographic, and economic aspects of older people’s lives in South Africa and then discuss the direct and indirect consequences of the HIV epidemic for them. The last section of the paper presents data on the living arrangements of older people in rural KwaZulu-Natal in South Africa and examines their households’ experience of adult mortality, in particular AIDS mortality.


The impact of the HIV epidemic on older people is shaped by the social, political, demographic, and economic circumstances in which they live. This section highlights some of the relevant characteristics of South African society.

South Africa Has the Highest Proportion of Older People in Africa

Population aging has commenced in most African countries as a consequence of the transition to lower levels of fertility and mortality. The population age 60 or more is projected to increase sixfold by 2050 (HelpAge International, 2000). The degree of population aging has been exceptionally large in South Africa primarily because of the early onset of fertility transition. Fertility has been falling since the 1960s, when total fertility was nearly seven births per woman, with the rate of decline accelerating in the early 1980s to reach total fertility of around 3.5 in 1996. South Africa’s total fertility is currently the lowest in mainland sub-Saharan Africa (Moultrie and Timaeus, 2002, 2003).

South Africa has a higher proportion of older people in its population than any other mainland sub-Saharan African country. In 1997, 7 percent of the population were age 60 or older (Kinsella and Ferreira, 1997). The demographic profiles of the different racial groups in South Africa are markedly different.1 In the African population, 6 percent were age 60 or older in


We regard race as a social reality produced by racism, not a biological characteristic. This paper follows South African practice and uses the term “African” to refer to the majority racial group. In South Africa, “black” has the connotation “nonwhite.” Statistical sources on South Africa usually distinguish four population groups: Africans, whites, coloreds, and Asians.

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