Often, the view is that gender inequalities permit men to dictate the terms of sexual intercourse and this results in unprotected sex with women being the major victims. This article offers a different view of the respective positions of men and women within the AIDS epidemic by exploring some of the less stereotyped reasons why men now seem to be driving the epidemic as well as investigating the gendered effects of socio-economic change, the implications of these for male identities, masculinities and sexualities. The results of the analysis argued that the risky conduct of men cannot be achieved without analysing masculinity and paying attention to the socioeconomic conditions under which it is constructed.