Climate change, flooding, and HIV transmission in Africa: Potential relationships and a call for action.

The increasing effects of climate change have intensified floods globally, especially in Africa, where millions of people live in poverty and are highly vulnerable to flooding. Climate change disproportionately affects the vulnerable, who are least equipped to handle its consequences, by exacerbating their situation. One such consequence is the potential for increased human immunodeficiency virus (HIV) transmission. Africa has been disproportionately affected by the HIV epidemic. It now faces the additional challenge of a changing climate and floods, which are capable of increasing HIV transmission in Africa through several pathways. They can force population displacement and migration, leading to the expansion of sexual networks among people living with HIV (PLWHIV). They may also create conditions conducive to the spread of other infections. Floods can cause food insecurity, which can result in various sexual behaviors that expose people to HIV infection. As global warming is linked to a decrease in African food production capacity, the effect of food insecurity on HIV may be prominent in countries where transactional sexual means is a major route of HIV transmission. Floods can also hinder the provision of HIV services, such as pre- and postexposure prophylaxis and antiretroviral therapy distribution, which may worsen the health outcomes of PLWHIV and promote HIV transmission, particularly in rural and remote communities. It is crucial to develop a climate-resilient framework, including education, sustained access to HIV services, and promotion of social welfare for HIV prevention and treatment, to address the complex relationship between HIV, floods, and climate change.