This is a text about the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) and about the experience of the epidemic in small countries. The intention has been to provide a reasonably detailed picture of the impact of the epidemic and the response to it in circumstances where the countries, because of their small size, cannot afford to play host to this crippling pandemic. While it is obvious that in a small country environment the impact of an epidemic of this variety will not be insignificant, it is important to know what the scale and the nature of the impact is if the policy response is to be appropriate. Recent literature on vulnerability has highlighted the special circumstances of small states, and has pointed to the importance of building resilience as a countervailing force. The rationale for this text is that in small countries, HIV/AIDS adds another dimension to economic and social vulnerability as a result of the way in which it can disproportionately affect output and productivity, and also because of the real threat of extinction. Specifically with resilience in mind, the depiction of the impact of the epidemic in the small countries of Southern Africa, Fiji Islands and the Caribbean is policy focused. The analysis presented presumes that there have been specific responses to the epidemic, but recognises the need to strengthen the calibre of these responses by proffering a more in-depth understanding of the character and the course of the epidemic.

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