Climate change is an HIV story. Here’s how to report it

In South Africa, there are more individuals living with HIV than in any other nation, making the country more susceptible to the intensifying effects of climate change. Although climate change does not directly alter the virus, severe weather events such as floods, droughts, and hotter temperatures can disrupt access to health clinics, displace people, and alter daily routines that help maintain HIV treatment.

In a worst-case warming scenario, the number of people living with HIV in sub-Saharan Africa could increase by 25-37% by 2050. Disasters, like the 2022 Durban floods, have resulted in individuals losing their HIV medication, identification documents, or even a means to restock their medication. Such breaks in treatment can allow the virus to begin multiplying, causing sickness and enabling transmission to others.

Ida Jooste explains in her latest newsletter how climate change is an HIV story. The following is her account, detailing the connections between climate change and HIV, the implications of the situation, and the experts to consult for more information.

On April 12, 2022, Mfundo Shezi awoke to a relentless downpour in KwaZulu-Natal, South Africa. The 32-year-old, who typically sleeps in a park in Umbilo, Durban, fled to safety, abandoning all his belongings. Upon returning the following morning, he discovered that the flood had taken everything, including his ID and his monthly supply of antiretroviral (ARV) treatment for HIV.

Shezi had been taking the medication consistently since starting treatment in 2021. Missing a dose for the first time, he panicked and sought help at the local clinic, only to be unable to due to the loss of his ID and the absence of a transfer letter from his regular clinic, which would have enabled him to receive medication.

Experts in the field caution that a changing climate may bring more frequent and severe weather events like this flood, which resulted in over 450 deaths. However, the flood itself would not alter the infectiousness or severity of Shezi's HIV. Instead, the disruption caused by the disaster - such as the destruction of roads, loss of treatment records, and inability to prove his identity - were the factors that impacted his ability to receive treatment.

Between 2010 and 2023, new HIV infections in Africa decreased by nearly 60%, meaning that for every 10 people who contracted HIV in 2010, only four contracted the virus in 2023. However, as climate shocks intersect with diminishing HIV funding, the gains made in curbing the epidemic could be jeopardized.

Christopher Jack, deputy director of the Climate System Analysis Group at the University of Cape Town, and Coceka Nogoduka, a public health expert who has contributed to improving South Africa's approach to HIV and tuberculosis for 18 years, discussed the links between climate change and HIV with journalists during a Bhekisisa webinar. Here are seven key connections they uncovered:

1. Climate change does not make HIV more infectious. Extreme heat, rain, or drier conditions do not increase the virus's infectiousness or make those living with HIV sicker. However, it can influence human behavior and healthcare access.

2. A warmer world could lead to a rise in HIV cases. If greenhouse gas emissions continue at their current rate, global temperatures could rise by 5°C by 2050 compared to where they were around 150 years ago. This could result in 25-37% more people in sub-Saharan Africa living with HIV than would have been anticipated without such significant global warming, according to a modeling study.

3. Bad droughts could lead to an increase in HIV infections. In rural areas of Africa, where many individuals already have HIV, a drought that results in less than 20% of the expected rainfall could cause HIV infections to increase by 11%.

4. Heavy rainfall and flooding can have significant consequences on HIV treatment. During the 2022 Durban floods, people lost their HIV medication, identification documents, or means to restock their medications. These discontinuities in treatment can enable the virus to begin multiplying, causing illness and enabling transmission to others.