As we commemorate the 40th anniversary of the discovery of Human Immunodeficiency Virus (HIV) while fighting the ongoing COVID-19 pandemic, another global crisis - climate change - is threatening the progress achieved so far in the global fight against HIV/AIDS. The climate emergency is anticipated to generate dire health consequences worldwide in the coming decades. While the pathways that link climate change and different disease areas are better understood, the connection between climate change and HIV/AIDS is still yet to be recognized both in research and practice. In this review, we update one of the frameworks on the HIV-climate nexus described in earlier literature.

Four major pathways have been identified: extreme weather events; sea level rise; changes in precipitation and temperature; and increased air pollution. These pathways impact the spectrum of HIV/AIDS-related outcomes through changes in social systems, healthcare disruption, and other climate-sensitive diseases, influenced by the social determinants of health. We also reflect on the significance of this updated framework for the Philippines, a country that is both highly vulnerable to the climate crisis and facing a rising HIV/AIDS epidemic. The framework can aid countries like the Philippines in filling gaps in research, policy, and program design to mount climate-adaptive HIV/AIDS responses. The HIV/AIDS and climate justice movements must also join forces in calling for accelerated worldwide decline in greenhouse gas emissions from all sectors to stabilize the global climate - this will benefit not just people affected by HIV/AIDS but everyone.

Introduction

While the world is still wrestling with the COVID-19 pandemic, this year, 2021, also marks the 40th anniversary since the first cases of human immunodeficiency virus (HIV) were reported as a cluster of Pneumocystis carinii pneumonia among previously healthy gay men in Los Angeles. Since then, there have been 36 million who have died of acquired immunodeficiency syndrome (AIDS) globally with 38 million living with it today. Global efforts to halt HIV transmission have achieved significant progress in terms of decreasing new HIV infections, AIDS-related deaths, and costs for antiretroviral therapy (ART). However, the burden of HIV in some countries still remains significantly high due to limited availability of HIV prevention programs, testing services, and treatment. In addition to COVID-19, the global HIV/AIDS epidemic also persists against the backdrop of another global crisis - climate change.

The climate emergency is anticipated to generate dire health consequences worldwide in the coming years and decades. While the pathways that link climate change and different disease areas are better understood, the connection between climate change and HIV/AIDS is still yet to be recognized both in research and practice. Over the past decade, there have been a few attempts to describe the linkages between climate change and HIV/AIDS. Overall, the pathways linking the two are more indirect, as there is neither plausible explanation nor evidence of climate change's direct influence on the virus itself, unlike its impacts on the behavior of pathogen-bearing mosquitoes for instance. Moreover, the previously described frameworks either presented more generic pathways, such as how extreme weather events can lead to forced displacement of populations which can hamper access to HIV/AIDS treatment, or described only a select number of linkages and missed other important ones. In this review, we provide an update of the earlier frameworks described in previous academic papers and reports in gray literature that were published during the past decade. In particular, we elaborate on the framework described by Lieber et al. and add new pathways and more granular information based on recent scientific literature and emerging discourses [5]. We also reflect on the relevance of our newly-constructed framework to the Philippines, which is one of the world's most climate-vulnerable countries with the fastest rate of new HIV cases in the World Health Organization's Western Pacific Region.

Read more here. This article was published in Malays J Med Sci.