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Sub-Saharan Africa contains two-thirds of the total world number of people living with AIDS. Southern Africa continues to be the worst part of the continent affected. A 2001 UNAIDS report indicated that by the end of 1999, there were an estimated 4.2 million South Africans living with HIV and AIDS (Kalipeni, Craddoc, Ghosh 59).

AIDS brings forth the gender, color, class, and national hierarchies that exist today. Racism, poverty, gender inequality, economical unsteadiness hamper AIDS prevention. In the early years of the AIDS outburst, there was a focus on risk groups, those not within the categories were considered clean. It is this "hegemonic process that helps dominant groups to maintain, reinforce, reconstruct, and obscure the workings of the established social order.(Schoepf 16)"

Socio-economic and cultural forces are driving the spread of AIDS. Ignoring failing health services, gender inequality, poverty to focus on high risk groups rather than on processes of economic empowerment and sociocultural change will lead to a standstill.

Culture plays a part in the severity of the epidemic, but more sweeping responsibility can be placed on the economic and political inequality in Africa.

Currently across the continent, AIDS is regarded as the "disease of women." A highly educated Zairian university official was interviewed in which he expressed a faulty knowledge of women as the primary carriers of the HIV virus; and, to deter further dissemination of AIDS, interning thousands of women for years would be an acceptable action. In several African countries, "free women" are made scapegoats, imprisoned, and raped. Accusations of witchery can have deep social effects and continues the demotion of women.

Some traditional healers tell older male clients to have sex with virgins in order to cleanse themselves of AIDS, promoting the idea of "sickness in the blood." Recently, new traditional healers have emerged claiming to have the ability to treat a variety of diseases and cancers. Evangelical Christian "healing churches" have claimed to heal by means of prayer and blessing. These trends are worsening the states of many AIDS infected people searching for cures and ending penniless.

The age range of the majority of AIDS cases for females is 15-24, whereas in men it is in groups above 30 years. Researchers have found that middle-aged men dislike the higher change of HIV contraction from similar aged women. This causes them to look towards pure virgins, knowing young girls 10-15 years of age are free of infection.

Homosexuality is denied in many regions of Africa. Little is known on this topic and the main transmission of virus is considered through heterosexual relations.

Condom use has two main problems. First women have little say in dictating the terms of sex. Second, condom use is unaccepted in the cultural structure at times. Men and women both perceive that condoms limit sexual pleasure (Msapato et al. 1990 65). Condoms are also seen as a sign of promiscuity in many regions of east Africa.

Economically, the gap between the poor and the rich has widened. As a result of the disorder, social violence and civil wars, there has been an increased risk of HIV infection. These economic and social factors seem to be the primary reasons of the rapid spread of HIV across the continent. In Zambia poverty is now a national problem where it is estimated that 42% of the urban population live below the poverty line (Kalumba 1990 68).

Religions are hybrid across sub-Saharan African, but all influence its followers. The set beliefs and policies held by churches can be significant. Muslim, Islam, Christianity

Some areas champion alteration of women's bodies. Whether modifications to the genitals as types of circumcision or substances used to "dry" the vagina prior to sexual intercourse, cause damages to tissues and facilitates in HIV transmission.

Education for young girls is an important effort that deserves more emphasis. Research shows that "investment in female education enables women to improve their lives, that of their families, and the country as a whole. Indeed, education empowers girls socially, economically, psychologically, and healthwise by providing them with tools to improve themselves as well as their environments (Azikiwe 1992; King 1990) 105". Sadly, adolescent girls often turn to sex to meet financial needs, including school fees, a trading license, or permission to cross a border. The trading of sexual favors out of desperation has been dubbed survival sex. ContrastThis survival sex isn't far from the young girls giving their bodies to older men (Sugar Daddies) for financial favors.

Studies indicate that abstinence is the best and safest strategy against HIV prevention