The impact of HIV/AIDS on food security and rural livelihoods is still insufficiently understood. It is evident, however, that rural development professionals need to respond to the changes that have taken place in rural areas due to the pandemic. This article explores competencies that they need in order to deal with the complex HIV/AIDS issues related to their work with farming families. Initially 45 rural development professionals from developing countries in the southern hemisphere were interviewed about these competencies, using case stories and questionnaires. Subsequently, 34 individual in-depth interviews were conducted with rural development professionals from East Africa and Zambian government officials. A focus group discussion with 15 Zambian agricultural extension workers completed the empirical part of the research. The study reveals that there is an urgent need to complement the technical competencies of rural development professionals with more social competencies, such as counselling and communication, lobbying and networking. Recommendations are formulated for competence development of rural development professionals who have to deal with the consequences of the HIV/AIDS pandemic in rural areas.