HIV/AIDS is very different from most epidemic diseases in the basis of its patterning at the local, national and international scales. Unlike most epidemic diseases, HIV/AIDS is not a disease directly associated with poverty and a lack of development; in Africa it disproportionately affects the wealthy, the educated and the mobile, and prevalence rates are much higher in richer Africa countries than in the poorest countries. The anomalous relationships between HIV/AIDS and poverty in Sub‐Saharan Africa are discussed to illustrate firstly, that the disease is not directly caused by extreme poverty, nor by lack of development in the region, as are most common communicable epidemic diseases, such as malaria or measles, and secondly, that it is not a disease that can be or will be eradicated or even greatly alleviated in its severity by ‘development’, as traditionally conceived in terms of rising incomes or better health services and public health.

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