Editing IPCC:AR6/WGII/Chapter-9 (section)

===== 9.10.2.2.2 HIV =====

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Observed impacts

Although levels of new HIV infections declined sharply during the last decade, still more than a million adults and children become infected each year ( [[#UNAIDS--2020|UNAIDS, 2020]] ). Climate influences on HIV are predominately indirect such as through heightened migration due to climate variability, or extreme weather events leading to increased transactional sex to replace lost sources of income. Changes in climate affect each of the main drivers of HIV transmission in women, including poverty, inequity and gender-based violence ( [[#Burke--2015a|Burke et al., 2015a]] ; [[#Loevinsohn--2015|Loevinsohn, 2015]] ; [[#Fiorella--2019|Fiorella et al., 2019]] ).

Projected risks

‘Oscillating’ or ‘circular’ migration for migrant workers in urban and mining centres drove HIV transmission in the 1990s and 2000s ( [[#Lurie--2006|Lurie, 2006]] ), and climate-related displacement may have similar effects (See Box 9.7; [[#Gray--2012|Gray and Mueller, 2012]] ; [[#Loevinsohn--2015|Loevinsohn, 2015]] ; [[#Low--2019|Low et al., 2019]] ). Food insecurity and nutritional deficiencies, projected to increase with increasingly variable climates, has been shown to increase sexual risk-taking and migration, as well as increase susceptibility to other infections ( [[#Lieber--2021|Lieber et al., 2021]] ). Projected increases in exposure to infectious diseases pose considerable threats to HIV-infected people who may already have compromised immune function. Additionally, reduced lung function in people with HIV from previous tuberculosis infection may put them at high risk for morbidity and death during extreme heat ( [[#Abayomi--2014|Abayomi and Cowan, 2014]] ). Moreover, extreme weather events accompanied by damage to health system infrastructure could compromise the continuity of antiretroviral treatment ( [[#Weiser--2010|Weiser et al., 2010]] ; [[#Pozniak--2020|Pozniak et al., 2020]] ).

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