This paper reviews the nexus between poverty and HIV/AIDS in Africa using a sustainable livelihood framework. Much of the literature on HIV and AIDS has generated an almost universal consensus that the AIDS epidemic is having an immense impact on the economies of hard-hit countries, hurting not only individuals, families and firms, but also significantly slowing economic growth and worsening poverty. International evidence has concentrated on the pathways through which HIV/AIDS undermines livelihoods and raises vulnerability to future collapse of livelihoods. Yet, little attention has been paid to the role that social relations and livelihood strategies can play in bringing about risky social interaction that raises the chance of contracting HIV. Using the sustainable livelihood and social relation approaches, this article demonstrates that although AIDS is not simply a disease of the poor, determinants of the epidemic go far beyond individual volition and that some dimensions of being poor increase risk and vulnerability to HIV.