Intergenerational transfers and relations in sub-Saharan Africa are only poorly understood, despite the alleged importance of family networks and family resource transfers to ameliorate the implications of the HIV/AIDS epidemic and the effect of the epidemic on the availability of kin and the structure of multi-generational families. Our analyses fill an important niche in the literature by using innovative longitudinal data from rural Malawi that includes extensive information on intergenerational transfer relations across three generations living in a context characterized by high poverty, a generalized HIV/AIDS epidemic and high levels of morbidity and mortality. We estimate the age patterns of transfers and the multiple directions of transfer flows—from prime-aged respondents to their elderly parents as well as their co-residing and non-coresiding adult children age 15+. Our major findings include that: (1) Financial net transfers are strongly age-patterned and the middle generations are net providers of transfers to their adult children and elderly parents; (2) Non-financial transfers are based on mutual assistance rather than reallocation of resources to worse-off family members; and (3), Provision and receipt of transfers are generally not related to the health status of our adult respondents, including HIV+ status and perception of HIV infection despite widespread perceptions that HIV+ status is primary determinant of such transfers.