Climate change could fuel the global AIDS epidemic, particularly in sub-Saharan Africa. Enough to compromise the achievement of the Sustainable Development Goals (SDGs), which plan to end the epidemic by 2030.
A long neglected aspect of the fight against climate change, the health effects of global warming are plethora. In addition to mortality linked to heat waves and natural disasters, it could promote malnutrition (due to a drop in agricultural production), mental health problems, but also various infectious diseases. Among them, those of a vector nature, as well as those related to water or food.
A source of food insecurity and financial precariousness, global warming could also have deleterious effects on the AIDS epidemic in developing countries. (1). A phenomenon about which UNAIDS, the UN body in charge of the global fight against AIDS, has been concerned since 2008. In a report (2)he warns against the synergy of the two crises, health and climate, which could be particularly devastating in Africa (where 67% of HIV+ people reside) and in Southeast Asia, two areas very vulnerable to global warming.
Since this report remained without echo, new works have come to confirm the climatic threat which weighs on the fight against AIDS. Published in May 2014, an American study carried out in 19 African countries found that recent exposure to drought is linked to an 11% increase in the risk of HIV infection in rural areas. In January 2019, another study even revealed an 80% increase in young women in Lesotho who had experienced a drought. (3).
Destined to become more frequent and more intense, droughts are not the only climatic threat to the AIDS epidemic. In a study published in September, Jason Nagata of the Department of Pediatrics at the University of California (San Francisco) and his colleagues show the similar impact of extreme rainfall and flooding (4). Conducted on the 2005-2017 demographic data of 21 countries in sub-Saharan Africa, for a total of 288,333 people, it shows that each year of exposure to floods increases the risk of HIV infection by 14%. Ditto for the risk of sexually transmitted infection (risk increased by 11% for any year of flooding) as well as for the number of sexual partners.
Already suggested during studies on drought, several mechanisms seem to be involved in the association between flooding and the risk of HIV infection. “Floods wipe out agricultural production, and food insecurity is associated with increased sexual risk through prostitution, and difficulty in negotiating safer sex”, explain the researchers. This hypothesis is supported by the fact that the effect of floods is more marked in rural areas (+25% HIV risk per year of extreme rainfall), where food is more often local.
These climatic events could also encourage rural exodus. Once in town, climate refugees are plunged into a precarious situation conducive to HIV infection, through prostitution or drug use. Finally, the floods could cut people’s access to healthcare (cut off roads, damaged hospitals, etc.), and therefore reduce access to screening and treatment. In 2008, UNAIDS was concerned about another risk: global warming, a new geopolitical priority, could relegate global health to the background, at the risk of drying up funding devoted to the fight against AIDS.
This article was written by Romain Loury and originally published on MediQuality.