"Climate disruptions could lead to an increased risk of HIV infection"

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The health consequences of climate change are now better documented. Multiplication of food crises, resurgence of some epidemics and cardiovascular diseases, heat stress caused by heat waves: climate breakdown is also considered by scientists as "The biggest global public health threat in the 21st centuryis century. "

In areas particularly affected by climate instability – for example in Africa – and where major pandemics such as malaria or HIV are spread, these risks are taken very seriously. Indeed, study after study, scientists observed an increase in the number of HIV infections during extreme events related to climate instability. New work published in the magazine Plos One mid-January go in this direction. Their author, the American epidemiologist Andrea Low, highlights the highest prevalence of the virus for young women during the drought spells in southern Africa and asks that these results be taken into account in the policies of adaptation to changes climate. contain the epidemic, especially among the most vulnerable populations of rural communities.

What do you think are the effects of climate change on the HIV epidemic?

Many studies show that climate breakdown can lead to behavioral changes that increase the risk of HIV infection. Marshall Burke [professeur adjoint au département de la science du système Terre à Stanford, ndlr] for example, it allocates 11% of HIV infections in Sub-Saharan Africa to intense rainfall or severe drought in rural areas affected by the epidemic. These new infections may be the consequence of the increase in the use of paid sex in displaced populations, but also the renunciation of health coverage to feed themselves. I came across this study while I was traveling on a project to investigate the epidemic ("Impact assessment on population-based HIV", in English) on the populations of southern Africa. It was 2015 and 2016: the drought that affected this region was terrible. So I asked myself if we could evaluate the impact on behavior, the prevalence of HIV in the population and the treatment, even if in these areas many people living with the virus take antiretrovirals and the number of new contaminations are in decline.

What was your method of investigation?

For this study, I met the two-year drought geospatial data (2014-2016) in Lesotho with the results of the national survey on the HIV epidemic between 2016 and 2017, which specifically takes into account of infections. and the non-observability of viral load. In particular, I wanted to see if the impoverishment caused by poor rainfall could be associated with greater risk and vulnerability assumption, particularly among young women in rural communities.

Have we underestimated the impact of the climate crisis on major pandemics such as HIV?

My results do not allow us to say 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 for the dynamics of the epidemic, if whole sections of the population suddenly do not have access to treatment and treatment of the disease and if the contamination increases – which other studies have clock. This will be crucial for controlling the epidemic in southern Africa, where the prevalence of HIV is quite high.

What answer can be given?

Ideally, governments and international organizations could ensure that these populations have good access to the health system, but also prevention tools such as the Prep [un traitement préventif du VIH]. and drugs like antiretrovirals. In a perfect world, this could translate into a sort of regional system of universal access to care funded by different countries. We must also be able to innovate to better reach migrants in terms of prevention and screening.

Florian Bardou

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