This chapter examines some of the implications of the ʼnew variant famine’ framework, and how they compel us to re-examine a range of assumptions about the nature of famine and the trajectory of the Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) epidemic. The ʼnew variant famine’ hypothesis posits that AIDS selectively impacts upon certain key aspects of the smallholder agrarian economy, creating a new profile of vulnerability to famine and a new trajectory of failing to cope when famine does strike. A generalised HIV/AIDS epidemic in an agrarian society leads to a selective food production decline among the afflicted. Morbidity and mortality in an AIDS-related famine is likely to be different from that in a traditional drought famine. The emergence of AIDS-related food crises has important implications for demographic projections, and indeed other models of the future trajectory of the epidemic and its wider impacts.