To analyze if the spread of HIV is related to economic inequality we estimate multilevel models of the individual probability of HIV infection among young Malawian women. We find a positive association between HIV infection and inequality at both the neighborhood and district levels, but no effect of individual poverty. We also find that the HIV–inequality relationship is related to risky sex, gender violence, and return migration, though no variable completely replaces economic inequality as a predictor of HIV infections. The HIV–inequality relationship does not seem to be related to bad health, gender gaps in education or women’s market work.