The structure of susceptibility: A multi-scalar investigation of linkage between economic development, social organization and HIV susceptibility in Sub-Saharan Africa

The rapid global spread of HIV/AIDS, most notably characterized by its particularly intense diffusion within Sub-Saharan Africa has exposed the limitations of conventional development indicators to identify sources of risk and to measure susceptibility and vulnerability to systemic risk within developing societies. In its publication Emerging Systemic Risk in the 21st Century, the Organization for Economic Cooperation and Development identifies major risks in the 21st century and the challenges for societies' ability to handle these risks. As discussed by the OECD, a society's ability to manage or withstand risk (resiliency) does not necessarily coincide with its development performance as evaluated by contemporary development indicators. Sources of susceptibility and vulnerability to risk often lie undetected within populations until exposed to a threat. The ineffectiveness of the economic achievements of developing societies to minimize the threat of HIV/AIDS refocuses attention on the changing structure of social fabric within these transitioning societies. This study is organized conceptually around the theoretical framework of Richard Wilkinson and others (Kawachi, Marmot, Putnam) which evaluates the relationships linking varying levels of income inequality, economic development and social capital within developed societies to overall levels of health within those societies. This conceptual model was used to structure an investigation of similar potential relationships within developing countries in Sub-Saharan Africa to determine whether consideration of influences such as income inequality, modernization or wealth, and social capital has value for understanding the exceptional susceptibility of Sub-Saharan African countries to HIV/AIDS.