Why do 95% of the estimated 33 million people infected with HIV live in the developing world? And why are low income (gross domestic product), unequal distribution of wealth (Gini coefficient), and sex inequality strongly associated with HIV prevalence?¹ It may be argued that this confluence is coincidental. The maturity of the epidemic, different sexual practices, or biology explain why sub-Saharan Africa is home to the highest HIV rates. The fact that two thirds of the world's poorest countries are also there is a mere accident. Yet this approach ignores the current explosive epidemics in South East Asia and eastern Europe. Clearly there is no simple equation of poverty and HIV prevalence; rather a combination of conditions making a population susceptible to the HIV epidemic and vulnerable to its effects.² Without resorting to economic determinism we wish to pose questions regarding the complex interplay between uncontrolled globalisation of capital and factors that render a population susceptible to HIV.

HIV, especially in the early stages of the epidemic, spreads through commercial sex, injecting drug use, and along the routes of population movement—migration of labour, urban-rural migration, trucking, drug smuggling, and regional wars. This is exacerbated by poor access to information, sexually transmitted disease (STD) treatment, and the low status of women.

The temporal and spatial pattern of the more mature African epidemic matches the migrant labour patterns. In 1989 Hunt hypothesised that the virus spread from labour concentration areas to the migrant labour host communities.³ The highest HIV prevalence rates were in the areas of labour concentration in the Zambian copper belt and Ugandan industrial areas, with lower rates in places that provide the labour force: north east Zambia, Rwanda, Burundi, and south west Uganda.³ HIV prevalence rates 2.5–3 times greater than in non-mobile populations have been …