It is now over two decades since AIDS emerged as a serious problem. AIDS is now a leading cause of death in many African countries. Particular social conditions, notably poverty, migration, and war, favour the transmission of HIV. HIV and AIDS impact on the micro-level, in relation to sexual reltionships, marriage, treatment seeking, care of the sick and inheritance. On the macro-level, many African countries are struggling to cope with a workforce weakened by AIDS, a failing helath system and increasing numbers of orphans. These factors all have far reaching social consequences. In the last few years, large injections of cash from PEPFAR in the USA and from the Global Fund have created unprecendated opportunities to develop interventions to tackle AIDS. However, corruption, complacency and mismanagement have undermined HIV prevention efforts and AIDS treatment programmesin many countries. For AIDS to be effectivley tackled, social change must be factored into responses to the epidemic. In this panel we discuss the social changes that AIDS has precipitated and debate the probable direction of change in African societies over the coming decades.