This chapter examines the economic and health variables that distinguish sub-Saharan Africa from affluent countries which have lower rates of HIV. It shows the biomedical effects of economic conditions in Africa — such as poverty, inequality, lack of transport, lack of sanitary infrastructure, and lack of access to medical care — that contribute to poor health in general and consequently high rates of HIV transmission. Widespread malnutrition, malaria, schistosomiasis, and other parasitic diseases in sub-Saharan Africa contribute to higher risk of HIV transmission. This economic/biomedical conclusion implies a broad policy response for confronting HIV/AIDS in Africa, Asia, and Latin America.