The global HIV epidemic is defined not only by the virus and medical interventions to control it, but also by social, economic and political conditions, including gender and income inequalities, human rights, and “the circumstances in which people grow, live, work and age, and the systems put in place to deal with illness,” that is, by the social determinants of health.” Social determinants are driving the HIV epidemic in different directions: reducing HIV risk and vulnerability in some populations, while ignoring or intensifying them in others, along fault lines including socioeconomic divisions, gender inequality, xenophobia and homophobia. This is known. Now, due to progress within and beyond the HIV field, much more can be done about it.