A specter haunts the pages of those who write of HIV in Africa, the specter of the Vulnerable Woman. As Jenny Higgins, Susie Hoffman, and Shari Dworkin, among others, have shown, a widespread tendency by researchers to ignore women in the early years of the epidemic has in the past decade or so been replaced by a “paradigm” in which the “vulnerable woman” has come to be the face of the epidemic. Women are presumed “susceptible to HIV because of biological differences in susceptibility, reduced sexual autonomy, and men’s sexual power and privilege” (“Rethinking Gender, Heterosexual Men, and Women’s Vulnerability to HIV/AIDS,” American Journal of Public Health 100 [3], 2010). For many well-intentioned activists, researchers, and policymakers, African women emblematize the plight of the vulnerable woman in whom biology and social structure combine to create the perfect victim.

Given this position of vulnerability, obviously, “empowerment” for women is the only answer—not merely for their own sake and that of their children, but to prevent the spread of HIV. Women must be empowered—economically empowered—to resist men if they are not to fall victim to the virus. In the decade or so since the idea of gender empowerment became a staple of HIV-prevention discourse, thousands of organizations have spent millions of dollars seeking to empower “vulnerable women” to protect themselves from infection. But are women at a greater risk of HIV infection because of vulnerability arising from their financial destitution? Does having more money empower women to make choices of sexual partners and relationships that lower risks of infection? Janneke Verheijen’s Balancing Men, Morals, and Money is one of a small number of in-depth studies that allows such questions to be answered.

Balancing Men, Morals, and Money sets out to deconstruct what Verheijen calls the “discourse of destitution,” both as found in the literature on “transactional sex” as a driver of HIV infection and as found in everyday contexts in a poor Malawian village. The idea that “vulnerable” women are driven to exchange sex for gifts by virtue of their economic destitution is a staple of much literature on HIV in Africa, a keystone of the “vulnerable woman” paradigm. African women, too, are keen proponents of this notion and are more than happy to inform social science interviewers about this woeful state of affairs. As Verheijen and a growing number of other researchers have noted, however, even among people who would satisfy the description of “destitute,” the gifts exchanged in return for sexual favors are frequently “luxury” items and not merely the bare necessities needed for survival. Sexual transactions in Africa, it turns out, are as complicated as they are elsewhere.

Verheijen takes the analysis of sex and discourses of destitution a step further than others who have explored “transactional sex.” She notes that the claim that women reluctantly accept proposals for sexual partnership from men in order to meet basic needs for themselves and their children is a staple of everyday moral codes governing village life. Living in a village over a long period of time, however, allowed Verheijen to observe that this ideology of desperate need is by no means the whole story:

In other words, sexual relationships between women and men are not a product merely of destitution and vulnerability, but are shaped by relations of cooperation and competition among women as well. Married women, for example, can be extremely hostile toward single women who seem predisposed to enter relationships with men who might include their husbands. Similarly, they can be dismissive of a woman who refuses to enter into a relationship with any man, denying herself thereby the possibility of extra support. Indeed, despite the prevailing ideology that places men at the center of sexual action, Verheijen’s books shows that fathers, brothers, husbands, and lovers are often at the margins when it comes to women’s decisions about sexual partnerships.

The aim of Balancing Men, Morals, and Money is to answer the question of whether more money, or as Verheijen would have it, “improved livelihood security,” will encourage women to make safer sexual choices in a context where the prevalence of HIV is high. Based on long-term field research in a poor rural village in one of the poorest countries in Africa, and the world, the book suggests the answer is: No. Women’s choices of sexual partnerships are not merely driven by destitution indicative of pervasive vulnerability.

Balancing Men, Morals, and Money is an important addition to the growing literature on love, sex, money, and AIDS in Africa that shows how African women are not merely vulnerable victims, but agents in shaping their own destinies. It deserves a wide readership.