Working HIV care-givers in Botswana: Spill-over effects on work and family well-being

Families provide most of the care to the tens of millions of HIV-infected and -affected in Africa. Little research exists on how care-givers balance the demands of holding a job with providing care for those who have become ill or orphaned by HIV/AIDS. Using data from a large survey administered to 1,077 working care-givers in Botswana, we compared the experience of HIV care-givers with non-HIV care-givers. Compared to non-HIV care-givers, HIV care-givers were more likely to worry about routine childcare (44% vs. 31%) and sick childcare (64% vs. 49%). Amongst those working far from home, more HIV care-givers were concerned that their children were not receiving adequate academic support (39% vs. 20%) and emotional support (57% vs. 33%). Parents who were HIV care-givers were less able to spend time with their own children. Children of HIV care-givers were more likely to have physical, mental and academic problems. While HIV care-givers were more likely to take leave from work for care-giving (53% vs. 39%), and for longer periods of time (13 vs. 7.6 days), this leave is more likely to be unpaid. Strategies to support those directly and indirectly affected by HIV and to avoid economic responsibility are discussed.