The American epidemiologist Andrea low, author of the new study published in the journal "PLoS one", suggested in an interview with "liberation" that "climate change could lead to an increase in the risk of HIV infection" in southern Africa.
The health consequences of climate change are now being better documented. Multiplication of food crises, resurgence of certain epidemics and cardiovascular diseases, thermal stresses generated by heat waves: climate change is even considered by scientists as "the greatest global threat to public health in the 21st century. "
In areas particularly affected by climate instability – in Africa for example – and where major pandemics such as malaria or HIV are rampant, these risks are taken very seriously. Indeed, after-study study, scientists have seen an increase in the number of HIV contamination at extreme events related to climate instability. New works published in the journal PLoS one in mid-January go in this direction. Their author, the American epidemiologist Andrea low, highlights the highest prevalence of the virus for young women in drought waves in southern Africa and calls for these results to be taken into account in adaptation policies to climate change to contain the epidemic, particularly among the most vulnerable populations in rural communities.
What are the effects of climate change on the HIV epidemic, according to your work?
Many work shows that climate change can lead to behavioural changes that increase the risk of HIV infection. For example, Marshall Burke attributes 11% of HIV infections in sub-Saharan Africa to intense rainfall or severe droughts in rural areas where the epidemic is rampant. These new infections may be the result of increasing the use of tariffed sex in displaced populations but also of giving up health coverage for food. I came across this study at the same time as I was travelling for a project to investigate the epidemic (population-based HIV impact assessment) on populations in southern Africa. It was in 2015 and 2016: the drought that struck this area was terrible. So I wondered if we could assess the impact on behaviours, the prevalence of HIV in the population and the treatment, even though in these areas many people living with the virus are taking antiretroviral drugs and the number of new contamination is decreasing.
What was your investigative method?
For this study, I crossed the geospatial data of two years of drought (2014-2016) in Lesotho with the results of the national survey of the HIV epidemic between 2016 and 2017, which takes into account, in particular, recent infections and the undetectability of the viral load. In particular, I wanted to see if the impoverishment caused by low rainfall could be associated with higher risk taking and greater vulnerability, especially among young women in rural communities.
Have we underestimated the consequences of the climate crisis on large pandemics like that of HIV?
My results do not suggest that drought is the direct cause of the observed facts. That said, many studies argue that climate change will lead to significant migratory flows. These population movements could have serious consequences on the dynamics of the epidemic, if whole sections of populations suddenly no longer have access to the care and treatment of the disease and if the contamination increase – what other studies have shown. This will be crucial for the control of the epidemic in southern Africa where the prevalence of HIV is quite high.
What response can be made?
Ideally, Governments and international organizations could ensure that these populations have access to the health care system, as well as prevention tools such as Prep [preventive HIV treatment]. And drugs like antiretrovirals. In a perfect world, this could translate into a kind of regional system of universal access to care financed by different countries concerned. We also need to be able to innovate to better reach migrants in prevention and screening.