Familial Bereavement During the HIV/AIDS Epidemic in the United States

Objectives. To estimate trends in lifetime prevalence of familial bereavement from HIV/AIDS in the United States. Methods. Combining demographic kinship modeling with cause-of-death data, we estimate Americans' exposure to family member deaths to HIV/AIDS from 1979 to 2023. We present lifetime bereavement prevalence estimates by period and cohort and separate differences by relationship type (biological children, siblings, grandchildren, cousins, nieces and nephews, and aunts and uncles). Results. As the epidemic unfolded, HIV/AIDS familial bereavement quickly became widespread, with millions of Americans experiencing the loss of 1 or more relatives, particularly male relatives. Lifetime exposure to loss was especially pronounced for cohorts born between 1940 and 1960 and has receded for more recent cohorts, although it remains high. Some HIV-related deaths were likely misclassified, implying that the scale of familial bereavement from this disease is higher. Conclusions. Although largely overlooked, familial bereavement is one long-lasting consequence of the HIV/AIDS epidemic. Stigma likely contributed to both undercounting of HIV/AIDS mortality and marginalization of family loss to this disease within public health research. Public Health Implications. Integrating familial bereavement into appraisals of epidemic impact can improve understanding of an epidemic's wide-reaching effects and inform more equitable public health responses. (Am J Public Health. Published online ahead of print October 29, 2026:e1-e8. https://doi.org/10.2105/AJPH.2026.308825).