The Killing of the Fittest : A Quantitative Analysis of HIV/AIDS and Conflict

Abstract

This paper examines decisive mechanisms linking the often complex and indirect relationship between HIV/AIDS and conflict, and presents a quantitative analysis that addresses the question of how conflict involvement impacts HIV-prevalence rates. The theoretical background of the analysis draws on a social epidemiological approach (the Jaipur Paradigm). A micro-foundation is added in order to explain how macro-level factors interact with individual HIV risk behavior. Finally, the Jaipur Paradigm is enlarged by a conflict dimension and the specific mechanisms linking HIV/AIDS and conflict involvement are discussed. This analysis goes on to model a non-linear relationship between HIV-prevalence and the duration of conflict involvement as both very short and very extensive conflict involvement seem to be correlated with low HIV-prevalence. The corresponding explanation for the latter fact draws on the isolating effects of enduring conflict involvement, which limits people's exposure to the outside world and thus to carriers of the HIV-virus. A non-linear relationship is also assumed between the peace duration since last conflict involvement and HIV-prevalence rates. I hypothesize that in the short run, effects of processes related to peace and subsequent development, such as increasing levels of urbanization and income inequality result in increasing HIV-prevalence rates. However, in the long run development allows for more rapid control and effective responses and associates with lower HIV-prevalence. The final multiple linear regression analysis is based on a nearly complete sample of 197 countries and relies on the latest available and improved UNAIDS/WHO HIV-prevalence data as well as the Uppsala dataset on armed conflicts. Bivariate, multivariate and robust regression results support the main hypothesis that countries’ prior conflict involvement (between 1995 and 2002) significantly correlates with higher HIV-prevalence in 2003. Effects of the corresponding conflict measures are much stronger compared to the effects of other control variables. This holds true even when low HIV-estimates are used. In addition, countries’ own conflict involvement exerts a much stronger effect on HIV-prevalence compared to the much weaker and negative effect found for neighboring war involvement on HIV-prevalence in bordering countries. Preliminary support is also found for the assumed non-linear relationships between the peace time since last conflict involvement or the duration of conflict involvement and HIV-prevalence. Based on these and other results, I conclude that it is rather extensive conflict involvement (in terms of duration) than intense conflict involvement (in terms of battle deaths) which has a significant, non-linear effect on HIV-prevalence. Finally, it is rather the duration of conflict involvement instead of the type of conflicts involved (wars, intermediate or minor conflicts) which is important in regard to HIV. I conclude with some policy implications and a summary on data limitations as well as limitations of this study.