Areas throughout the United States at high risk for extreme weather exacerbated by climate change have higher rates rate of HIV and often experience difficulty accessing treatment, according to a new analysis from the Center for American Progress (CAP).

 

Using data from the Ending the HIV Epidemic in the U.S. (EHE) initiative and the Federal Emergency Management Agency national risk index, the report found that half of people with HIV live in places at high risk for extreme weather and climate disasters.

Extreme weather events can negatively affect health outcomes in myriad ways, especially for people with chronic health conditions, such as HIV. The EHE initiative aims to lower new HIV rates by 75% by 2025 and by 90% by 2030. This would amount to fewer than 3,000 HIV cases a year.

The strategy for reaching these benchmarks involves investing federal funding and resources in the 57 key states, counties and cities (referred to as jurisdictions) that together account for 50% of new HIV cases. These jurisdictions include 48 counties nationwide plus Washington, DC; San Juan, Puerto Rico; and seven rural states with high HIV burdens (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina). To learn more about the initiative, read an overview at HIV.gov and visit the official web page at HRSA.org.

“It is not surprising that those most at risk live in areas particularly vulnerable to extreme weather and climate events. That is true for many other climate-sensitive health outcomes,” Kristie Ebi, PhD, MPH, a professor of global health at the University of Washington, who reviewed the analysis, told The 19th. “The poor and marginalized are generally at higher risk and often live in less desirable locations that are less desirable because of vulnerability to extreme weather and climate events.”

 

For people living with HIV, extreme weather and disastrous climate events can make it difficult—sometimes impossible—to access medical care and adhere to HIV treatment. Poor treatment adherence can result in drug resistance, causing meds to stop working as effectively and possibly limiting future treatment options.

 

Wildfires, flooding and hurricanes can hinder access to medical care. In addition to unstable housing, food insecurity and economic insecurity, such climate disasters can give rise to mental and emotional distress that can impact adherence to treatment.

 

Another barrier to care is HIV stigma. For people experiencing an already stressful, potentially life-changing event, disclosing their HIV status may exacerbate this stress.

 

“There’s still a lot of fear with HIV, and so many clients don’t disclose their status,” Vatsana Chanthala, director of the New Orleans Health Department’s Ryan White HIV/AIDS Program, told The 19th. “And so they find ways to hide their medications, and if they’re around people, they’re less likely to take those medications out.”

 

Experts and policymakers urge people with HIV to follow hurricane preparedness protocol and prioritize refilling their prescriptions early when possible. What’s more, the Department of Human and Health Services recently updated its clinical guidance for providers who need to care for displaced individuals with HIV. Guidelines such as these are vital to help protect people with HIV from climate change and natural disasters.

For more, go to POZ’s Health Basics on HIV Treatment Adherence.