The primary means of HIV transmission - sexual intercourse - has been known for over two decades, but that information does not prevent thousands of men and women from contracting the virus every day. The AIDS epidemic creates a high and ongoing mortality in the economic and social active sector of populations in sub-Saharan Africa. The epidemic is being driven by inequities and uneven development, exacerbating existing poverty and human misery. In hard-hit countries in sub-Saharan Africa, the AIDS epidemic sets back development with human development figures as low as it was in the 1950s. The epidemic has a severe impact on women as caregivers and on children, the most vulnerable sector of society. All eight Millennium Development Goals are directly linked to the impact of the AIDS epidemic. This article discusses the affect that HIV / AIDS has on the achievement of the targets of the Millennium Development Goals (MDGs) in sub-Sahar