In most of sub-Saharan Africa, HIV/AIDS is driven by endemic structural problems such as unemployment, poverty, forced migration, sexual exploitation, and concurrent sexual partnerships. In the Niger Delta of Nigeria, the epidemic is exacerbated by recurring regional conflict and negative environmental externalities resulting from 50 years of oil exploration. This article seeks to identify and analyze potential barriers to HIV/AIDS prevention and treatment from oil pollution and other environmental stressors in Nigeria's Niger Delta. We develop a conceptual framework to understand how oil politics and economic systems affect HIV risks in Nigeria. We then evaluate evidence of how environmental exposures can amplify risks. Using 10 semi-structured interviews, with 85 focus group participants, we test the argument that HIV transmission in the Niger Delta is related to a manipulative "divide and rule" power dynamic that characterizes multinational oil companies' role in shaping conflict contours in oil communities. Oil exploration destroys livelihoods, institutions, and values and forces impoverished and illiterate girls and women to migrate or be trafficked to urban centers as child laborers and sex workers. The elevated HIV/AIDS risk in the Niger Delta brings into focus the political economy of resource extraction, globalization, and indigenous, minority rights and struggles.