This article brings together governmentality and political economic readings of security to offer a critical examination of the international HIV/AIDS programmes operated by the US Department of Defense, particularly as they focus on populations in Africa. Reaching groups often left out of national HIV/AIDS strategies and conducting research into HIV vaccines, US military HIV/AIDS programmes can be read as supportive of the broader global health effort to secure populations from HIV. However, a consideration of publicly available material shows that growing US commitment to addressing the problem of HIV/AIDS parallels, and in the case of military programmes intersects with, the idea of Africa as a locus of strategic resources, fragile states and potential terrorist threats. These ideas are furthermore articulated in terms of a neoliberal teleology, in which health programmes appear as part of an effort to help populations along the path to normal, healthy development, occluding the exploitative manner in which populations and regions highly affected by HIV have been incorporated into the global political economy. Such rationalities are problematic in that they obviate a more substantive grounding of health in ideas of peace or equity and thus provide a poor guide to a more healthy global order. While noting the contribution of US military programmes to the international response to HIV/AIDS, the article emphasises the importance of examining associations between HIV/AIDS, military forces and security in terms of the broader web of rationalities and relationships within which they are situated. [ABSTRACT FROM AUTHOR]