Impacts of HIV and Population-Wide Treatment on the Elderly in a Simulated African Population

Samuel J. Clark, University of Washington

The HIV/AIDS pandemic is reshaping the populations of sub-Saharan Africa through increasing mortality and decreasing fertility. A two-sex, stochastic microsimulator is used to describe some of the HIV-related impacts on the structure of infected populations similar to those living in Southern Africa, with an emphasis on the consequences for the elderly and the effects of population-wide treatment. After 40 years of epidemic the growth rate is reduced to zero or below; the age structure converges on a younger shape; the number of orphans rises to 37 percent (maternal), 30 percent (paternal) and 22 percent (dual) of all children alive below age 15; and the percentage of adults aged 50 and older who have surviving grandchildren but no surviving children rises to 23 percent (females) and 13 percent (males). The impacts of preventative and antiretroviral treatment programs initiated in year 31 of the 40 year simulations are described and compared.