ABSTRACT

There is widespread agreement that, in absolute terms, health standards in the population as a whole have improved throughout Western Europe since the Second World War. Despite such improvements, serious social inequalities in health continue to persist (see e.g. Townsend et al., 1988; Mielck, 1994). At the start of the epidemic, HIV/AIDS offered an exception to the rule (in OECD countries) in that disproportionate numbers of middle-class men were being affected. In most European countries where there is a notable level of HIV prevalence, HIV and AIDS are largely to be found among injecting drug users and gay men. While injecting drug use is a feature of poor and marginalised groups in Europe, gay men on the other hand are often perceived as predominantly belonging to the well-to-do middle classes. That said, the gay population cannot escape the effects of the social inequalities that structure western advanced industrial societies, and it is the goal of this chapter to investigate the class-specific effect of social inequality in two European countries, France and Germany, on the prevalence of HIV among gay men. The comparative study concentrates primarily on France and Germany, but draws nevertheless on recent findings from the UK.2