In Papua New Guinea (PNG), when a person falls sick with AIDS, the main site of care is home, and the main providers of care are family members. In theory there are merits to this arrangement. Being at home can be comforting for the sick person. Loved ones might be able to provide more tender attention than could hospital staff. Caring for the sick at home is also praised as ‘traditional’, and certainly repudiates the stigma often associated with HIV and AIDS. But in Papua New Guinea, perhaps the greatest virtue of care by relatives at home is necessity. Hospital beds are few, often inaccessible, and AIDS is already taxing hospital facilities in the major centres. The prevalence of HIV/AIDS is increasing, and the limited introduction of antiretroviral therapies from mid 2004 is not likely to significantly reduce AIDSrelated morbidity or mortality in the foreseeable future, particularly among adults. The growing need to support families and communities in what is called ‘community-based care’ is widely recognised. This paper reflects specifically on the gendered burdens of AIDS care within the family, and some of the difficulties of redressing them. As UNAIDS (2004) has stated in its current campaign document, “HIV and AIDS have significantly increased the burden of care for many women. Poverty and poor public services have also combined with AIDS to turn the care burden for women into a crisis with far-reaching social, health and economic consequences” (p. 4). In PNG too, AIDS increases the burden of care for women. While the consequences of this burden are many, the potential effects upon the health of women and girls alone deserves attention. Although mainstreaming gender (and HIV / AIDS) is necessary, I will argue that the gendered burden of AIDS-care highlights the prior importance of’main-themeing’ women in research upon which policy and programs can draw.

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