CkAbstractHIV/AIDS has devastated families in rural Lesotho, leaving many children orphaned. Families have adapted to the increase in the number of orphans and HIV-positive children in ways that provide children with the best possible care. Though local ideas about kinship and care are firmly rooted in patrilineal social organization, in practice, Lixisenatide clinical trials maternal caregivers, often grandmothers, are increasingly caring for orphaned children. Negotiations between affinal kin capitalize on flexible kinship practices in order to legitimate new patterns of care, which have shifted towards a model that often favours matrilocal practices of care in the context of idealized patrilineality.Kinship in practiceWhen ‘M’e1 Lehela was six months pregnant, she became sick with AIDS. Her husband was working in South Africa, and her mother-in-law was not providing her with the care she needed, so she moved with her two children to stay with her mother, ‘M’e Matau, in the rural highlands of Lesotho. In late 2005, ‘M’e Lehela died of AIDS shortly after her son, Thato, was born, leaving three children behind with her mother; a common pattern of illness-related migration in contemporary Lesotho and elsewhere (Adato, Kadiyala, Roopnaraine, Biermayr-Jenzano Norman 2005; Urassa et al. 2001). At the time of his mother’s death, Thato had a CD4 of 16 per cent, well below the threshold for beginning antiretroviral treatment (ART).2 In addition to caring for Thato’s mother and her children, ‘M’e Matau also cared for the orphaned child of another daughter with the help of her son and daughter-in-law, who lived next door. I asked ‘M’e Matau about Thato’s paternal grandparents, since the patrilineal social organization to which Basotho ascribe Enzastaurin custom synthesis dictates that children of a married couple belong to the father’s family (Ashton 1967; Murray 1981). She said that after her daughter died, the paternal grandparents sent a letter asking for the children. However, she feared they would not take good care of them, since they had failed to do so before her daughter’s death. She also disagreed with her daughter’s in-laws about the identity of the children, who belonged to her clan and shared her last name. She said, ‘No, I didn’t agree with them because these are my children (bana ba ka) … I said, you didn’t pay likhomo [bridewealth, or, literally, cows]’. ‘M’e Matau, like many Basotho, uses ideals of patrilineality to negotiate for the care of maternal orphans.1’M’e is Sesotho for ‘Mrs’ or ‘mother’. Ntate is Sesotho for ‘Mr’ or ‘father’. All names are pseudonyms. 2CD4 is a measurement of immunodeficiency used to approximate the viral load of a person living with HIV/AIDS. Children’s CD4 is measured in percentages. Severe immunodeficiency ranges from 15 percent or less to 30 per cent or less, depending on the child’s age.BlockPageKin-based networks, though strained by AIDS, are still the primary mechanisms for orphan care in Southern Africa (Adato et al. 2005; Prazak 2012; Zagheni 2011).However, in-depth explorations of caregiver experiences are limited and we have yet to understand how extended kin have remained afloat in light of this caregiving challenge (Cooper 2012; Kuo Operario 2009). This research, which took place in the rural, mountainous district of Mokhotlong, Lesotho, provides a detailed examination of the daily struggles, negotiations, and concerns of caregivers in one of the many remote and vulnerable communities impacted by the AIDS pandemic.3 I present in-depth ethno.CkAbstractHIV/AIDS has devastated families in rural Lesotho, leaving many children orphaned. Families have adapted to the increase in the number of orphans and HIV-positive children in ways that provide children with the best possible care. Though local ideas about kinship and care are firmly rooted in patrilineal social organization, in practice, maternal caregivers, often grandmothers, are increasingly caring for orphaned children. Negotiations between affinal kin capitalize on flexible kinship practices in order to legitimate new patterns of care, which have shifted towards a model that often favours matrilocal practices of care in the context of idealized patrilineality.Kinship in practiceWhen ‘M’e1 Lehela was six months pregnant, she became sick with AIDS. Her husband was working in South Africa, and her mother-in-law was not providing her with the care she needed, so she moved with her two children to stay with her mother, ‘M’e Matau, in the rural highlands of Lesotho. In late 2005, ‘M’e Lehela died of AIDS shortly after her son, Thato, was born, leaving three children behind with her mother; a common pattern of illness-related migration in contemporary Lesotho and elsewhere (Adato, Kadiyala, Roopnaraine, Biermayr-Jenzano Norman 2005; Urassa et al. 2001). At the time of his mother’s death, Thato had a CD4 of 16 per cent, well below the threshold for beginning antiretroviral treatment (ART).2 In addition to caring for Thato’s mother and her children, ‘M’e Matau also cared for the orphaned child of another daughter with the help of her son and daughter-in-law, who lived next door. I asked ‘M’e Matau about Thato’s paternal grandparents, since the patrilineal social organization to which Basotho ascribe dictates that children of a married couple belong to the father’s family (Ashton 1967; Murray 1981). She said that after her daughter died, the paternal grandparents sent a letter asking for the children. However, she feared they would not take good care of them, since they had failed to do so before her daughter’s death. She also disagreed with her daughter’s in-laws about the identity of the children, who belonged to her clan and shared her last name. She said, ‘No, I didn’t agree with them because these are my children (bana ba ka) … I said, you didn’t pay likhomo [bridewealth, or, literally, cows]’. ‘M’e Matau, like many Basotho, uses ideals of patrilineality to negotiate for the care of maternal orphans.1’M’e is Sesotho for ‘Mrs’ or ‘mother’. Ntate is Sesotho for ‘Mr’ or ‘father’. All names are pseudonyms. 2CD4 is a measurement of immunodeficiency used to approximate the viral load of a person living with HIV/AIDS. Children’s CD4 is measured in percentages. Severe immunodeficiency ranges from 15 percent or less to 30 per cent or less, depending on the child’s age.BlockPageKin-based networks, though strained by AIDS, are still the primary mechanisms for orphan care in Southern Africa (Adato et al. 2005; Prazak 2012; Zagheni 2011).However, in-depth explorations of caregiver experiences are limited and we have yet to understand how extended kin have remained afloat in light of this caregiving challenge (Cooper 2012; Kuo Operario 2009). This research, which took place in the rural, mountainous district of Mokhotlong, Lesotho, provides a detailed examination of the daily struggles, negotiations, and concerns of caregivers in one of the many remote and vulnerable communities impacted by the AIDS pandemic.3 I present in-depth ethno.