In July of 2000, the UN Security Council passed Resolution 1308 stipulating that HIV poses a risk to the stability and security of the nations of the world. Since then, there has been considerable debate regarding the relationship between the AIDS pandemic and national security. According to expert analysts, the security implications of HIV’s rapid spread in Africa and other regions must be taken far more seriously by the industrialized West. One concern expressed by security analysts has been the impact of HIV on individuals critical to the maintenance of state and international security: namely, soldiers and peacekeepers. AIDS is now the leading cause of death in military and police forces in some African countries, accounting for more than half of in-service mortality. The loss of highly trained, professional soldiers is not limited to Africa. Trained soldiers are difficult and expensive to replace, and their absence interrupts the training of younger recruits. Armed forces that rely wholly or partially on conscripts face a decreasing pool of healthy recruits as HIV continues to spread. The strategic impact of high HIV prevalence on the armed forces is complex and involves other country-specific factors as well. There is growing evidence that the AIDS pandemic poses increasing challenges for the conduct of peacekeeping operations. These challenges include the spread of HIV by peacekeepers, the reduced ability of countries to contribute peacekeepers, and the decrease in willingness of some countries to accept peacekeepers who may pose a disease risk to them. Security analysts also correlate high rates of HIV infection with state instability and failure, particularly in sub-Saharan African nations. The erosion of elite populations, political leadership and skilled labor forces undermines economic growth and exacerbates social tensions. Some argue that the growing number of children orphaned by AIDS is contributing to an impoverished orphan cohort that is vulnerable to exploitation and radicalization. Even though the involvement of HIV/AIDS in state failure remains unproven and is probably indirect, the perceived linkage has propelled regions once considered “peripheral” to Western security interests into national security agendas. The impact of the HIV/AIDS pandemic on strategically important states is another major security concern. Analysts warn that a “second wave” of HIV could potentially destabilize powerful countries and regions that are critical to the US and, by extension, to global strategic interests. Particular emphasis has been placed on the effects of the worsening pandemic in Russia, India, and China, each of which has been declared a nuclear state. The security impact of HIV in these countries may not be immediate, but increased instability in any large and strategically significant state would have major economic, political and military consequences around the world. Although arguments linking HIV/AIDS to national security have helped to elevate the disease to the highest levels of international politics, it is also important to recognize that there are a number of potential risks in adopting a national security approach to combat the pandemic. An inappropriate redirection of HIV/AIDS resources toward strategically important countries or those supportive of the “War on Terror” is one possible outcome of such a focus. Strengthening the evidence of linkages between the AIDS pandemic and national security is essential for successfully negotiating these risks and ensuring that the public health–national security nexus benefits the fight against HIV/AIDS.