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This paper aims to begin to consider the evidence for AIDS as a disease of poverty. It seeks to describe the important influence of the social and economic context of HIV/AIDS and of those behaviours associated with HIV transmission, and argues for a shift in emphasis in the conceptualization of the 'problem of AIDS'. The relationship between poverty and AIDS is explored, particularly in relation to global economic development, urbanization, homelessness and the disintegration of neighbourhoods, migration and systems of labour and production. Examples of socially-driven community-based responses to the prevention and control of the HIV epidemic in diverse cultures are discussed and the need for new outcome measures for assessing community initiatives is proposed.