Trapped in the prison of the proximate: structural HIV/AIDS prevention in southern Africa

There is now agreement in HIV/AIDS prevention that biomedical and behavioural interventions do not sufficiently address the structural causes of the epidemic, but structural prevention is understood in different ways. The social drivers approach models pathways that link structural constraints to individuals at risk and then devises intervention to affect these pathways. An alternative political economy approach that begins with the bio-social whole provides a better basis for understanding the structural causes of HIV/AIDS. It demands that HIV/AIDS prevention in southern Africa should not be a set of discrete technical interventions but a sustained political as well as scientific project.