A downward spiral of the family's welfare begins when the first adult in a household falls ill. There is increased spending for health care and decreased productivity. Food production and income drop dramatically as more adults are affected. One study in Uganda showed that 65 percent of the AIDS-affected households were obliged to sell property to pay for care. Frequently, children are forced to discontinue schooling, as the family needs help and cannot pay school expenses.
Time dedicated to child-care, hygiene, food processing and preparation is sacrificed.
When the AIDS patient dies, expenditures are incurred for the funeral and the productive capacity of household is reduced. Research in Tanzania showed that per capita food consumption dropped by 15 percent in the poorest households when an adult died. Food consumption is further affected when mothers die, since they are usually responsible for meal preparation. According to the FAO report, the loss of able-bodied adults affects the entire society's ability to maintain and reproduce itself. Agricultural skills may be lost since children are unable to observe their parents working.