War and Pestilence: Conflict, Refugees, and the Human Immunodeficiency Virus in Sub-Saharan Africa

Abstract

Leaders of international institutions and African states, as well as observers of international politics, have argued that conflict and HIV/AIDS are intertwined. In order to better understand this relationship, I test whether the HIV epidemic has contributed to war and violence in sub-Saharan Africa, as well as the conditions under which conflict contributes to HIV/AIDS prevalence. I test the relationship between violence and HIV using a cross-national time-series of African states and two case studies. I find little evidence to substantiate the claim that HIV/AIDS poses a risk of sparking civil war. While HIV may be associated with lower levels of violence, domestic political institutions have been remarkably resilient in coping with the epidemic. In assessing the circumstances under which conflicts contribute to the proliferation of HIV, I propose that the ethnicity of refugees will determine the extent to which war-induced migrant populations are able to mix with host populations. To test this hypothesis, I assemble original data on the ethnicity of refugee flows. I also propose that the cessation of conflict will foster the spread of HIV/AIDS due to increased population movements. I test both of these hypotheses using a time-series cross-national statistical analysis, as well as several case studies. I find that the ethnicity of refugees and conflict cessation are integral to understanding the impact of war on HIV/AIDS.