Globalization and interacting large-scale processes and how they may affect the HIV/AIDS epidemic

Social and economic change at the large-scale level has many impacts on people's lives and on their social interactions (Myer et al. 2003, 2004; Mann et al. 1994). These, in turn, affect how HIV/AIDS and other disease agents do or do not spread. The pathways through which all of this happens help us to understand how to reduce the damage that HIV/AIDS and other diseases do and, likewise, the history of the HIV epidemic helps us understand these large-scale social and economic processes and how we might reduce the damage that they do. In this chapter, we focus on globalization and other large-scale social and economic processes (such as wars, falling profit rates, sociopolitical transitions, global warming, migration, slummification, and social movements); what some of the pathways might be through which they come to affect different groups of human beings in distinct ways; and what this tells us about what should be done. This chapter is necessarily incomplete and, to a degree, speculative in that it makes some claims on the basis of logical extrapolation from the existing scholarship. Some of the pathways we point to have received little research attention as yet. Indeed, a few years ago (Friedman et al. 2006a), we helped write a relatively high-visibility article that drew attention to some (but by no means all) of the pathways, precisely in order to encourage research on these neglected areas. The chapter is also somewhat eclectic rather than comprehensive. The sheer need to write it as a paper rather than as a multi-volume book forces us to pick and choose which pathways to gloss over and which to spend some (but too little even there) time on.