The Sub-Saharan (SSA) HIV epidemic presents patterns that challenge conventional understandings of the relationships between SES and health. It has often been assumed that Africa’s status as the continent with the highest HIV infection rates is linked to endemic high poverty and a corresponding lack of access to adequate health care resources. Somewhat surprisingly, a growing number of studies show that wealthier individuals (irrespective of gender), wealthier regions (urban areas), and wealthier countries within SSA often display the highest levels of HIV infection. Despite evidence of a positive SES-HIV gradient, researchers
and policy-makers frequently assume that range of protective interventions – increasing awareness of mechanisms of HIV transmission, techniques for prevention, greater access to health care facilities, and greater availability of condoms – will reduce the likelihood of contracting HIV, even among higher SES populations. We explore the relationships between SES and a range of intervening risk factors to illuminate the complex causal processes that link SES and HIV in Cameroon. Our results show at least through 2004, any benefit that may have accrued from high SES appears to be offset by higher riskier sexual practices – including more premarital sexual activity, higher numbers of sexual partners, and higher rates of female infidelity.