A socialist analysis of the HIV/AIDS epidemic

Capitalism produced epidemics due to European invasion of Americas and flu pandemic at end of WW I. The HIV/AIDS epidemic and responses to it are shaped by capitalist dynamics. Imperialism and post-colonial struggles shaped African AIDS epidemics by differently affecting sexual networks in different parts of class structures. Creation of homosexual subcultures by capitalism, struggles against LGBT oppression, and creation of anti-drug-user laws and policies, created sexual and drug-injection networks and social niches like shooting galleries, the 1970 gay clone scene, and some African settings where peer norms support women students’ seeking sex from older men to meet consumption needs. HIV prevention and care are shaped by capitalist ideologies' methodological individualism and varying forms in which medical care is organized. Marxist transdisciplinary thought suggests: (1) It is more useful to see HIV spread as a connected and socially-situated set of local epidemic outbreaks than as a mass of individual events. (2) These local outbreaks are based in social interaction patterns based on economic, political and social dynamics of capitalism in this historical period. (3) “Big Events” like the fall of the Soviet Union, end of South African apartheid and ousting of Indonesian dictatorship were followed by HIV outbreaks, but not all Big Events lead to epidemics. Research is needed on why these differences occur. (4) We may well not reach “the end of AIDS” given current and emerging crises that capitalism has created and is creating. Many public health issues, including climate change and HIV/AIDS, have roots deep in capitalism.