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This article considers the impact of AIDS on women’s roles and responsibilities within the household ‘care economy’. In particular, it emphasises that all interventions aimed at reversing the AIDS epidemic need to take into account the excessive work-load that members of the household, usually women, shoulder in responding to the needs of sick family members. Most notably, gender equality and care economy issues need to be identified by development programmes. There is also a need to implement policies that focus on issues such as treatment, prevention, education, economic empowerment and violence against women. The article argues that unless the care economy and the relations of gender inequality within the household are included in the design, implementation, monitoring and evaluation of such interventions, results will be compromised