HIV Management Within Changing Social-Ecological Systems

After decades of research on the HIV/AIDS epidemic, there remain critical gaps in understanding how HIV-positive people manage their health through their interactions with dynamic and coupled social-ecological systems. During the course of the 2014–2016 El Niño, multiple climate shocks occurred in Southern Africa, which is home to the largest HIV-positive population in the world. Using mixed method longitudinal techniques, we find statistically significant relationships between HIV-positive households and decreased dietary consumption due to a lack of food during and following climate shocks. During the El Niño years, HIV-positive households were more likely to draw on secondary plant collection to manage disease progression, underscoring an important and understudied ecological impact from the epidemic. This demonstrates clear evidence that climate shocks amplify food insecurity vulnerabilities during the El Niño years, likely mediated by changes within coupled social-ecological systems. Knowledge on the direct relationships between HIV management and climate shocks is needed to better inform global responses to the HIV/AIDS epidemic under regimes of increasing uncertainty.