Does climate change threaten delivery of HIV care in resource-limited settings?

Abstract

Purpose of review: Extreme weather events (EWEs) pose a challenge to achieving UNAIDS goal of eliminating HIV as a public health threat by 2030. This review summarizes recent findings describing the disruption of HIV services by EWEs and discusses strategies for a resilient HIV care programme in resource-limited settings.

Recent findings: EWEs impact each component of the continuum of care - HIV testing, linkage to treatment, viral suppression and other HIV prevention services. EWEs disrupt healthcare provision either through impacting the ability of the healthcare system to deliver care because of infrastructure damage and increased workload or by limiting people's ability to seek healthcare because of access challenges and forced displacements. This culminates in disengagement from care, poor treatment adherence and increase in HIV disease progression with more vulnerable groups such as women and young people being more adversely impacted.

Summary: Most people affected by or at risk of HIV reside in resource-poor settings which are the region with the least capacity to adapt to climate change. Few recent studies with very limited geographical coverage show that EWEs affect the delivery of HIV care in this setting. Climate adaptation and mitigation policies are required to protect health in resource-limited settings.