A central policy issue in the battle against HIV in sub-Saharan Africa (SSA) is whether and when high-prevalence countries might become autonomous in designing and implementing their own intervention policies against the disease. The aim of this research is twofold. First, it develops a framework for explaining economic development in a general equilibrium growth model with endogenous fertility and endogenous mortality forced by the threat of a persistent, deadly infectious disease, such as HIV/AIDS in SSA. Second, it aims to shed light on the interplay between foreign aid and endogenous domestic public policies in SSA countries severely afflicted by HIV. Consequently, it investigates the demographic and macroeconomic implications of an intervention against HIV/AIDS whose total amount is the sum of an exogenous component representing foreign aid and an endogenous public expenditure. On the assumption that these policies allow the same degree of HIV control, we show the emergence of quite different responses in terms of key demo-economic variables. These effects mainly pass through the fertility response to the evolving epidemic conditions.