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The family, household and community have often been identified as having a crucial role to play in HIV and AIDS-related care in developing countries. Yet few studies have sought to examine the limits to the support that such institutions can provide. This paper describes findings from a study of the care and support offered to people living with HIV and AIDS in Chiang Mai province, an area of Thailand severely affected by the epidemic. Following an initial Rapid Assessment Process (RAP), data was collected from in-depth household and individual interviews, focus group discussions and participant observation in two village communities. A number of recurrent themes emerge from the data: local beliefs and practices as factors mediating family and community responses; the impact of recent economic and social change on the social organisation of family and village life (including the role of formal village leaders and the growth of sex work); the complex interface between traditional and modern systems of care and support; differences between rich and poor in access to, and use of, health services; and the unequal burden of responsibility shouldered by women as care givers. The implications of these findings for the future provision of health care and support in this part of Thailand are discussed. [ABSTRACT FROM AUTHOR]