Toronto, ON – New research published earlier this month in AIDS and Behavior highlights links between extreme weather events, such as drought and flooding, and increased HIV vulnerabilities among sex workers and sexually diverse men in Nairobi, Kenya.
While there has been growing attention to the impacts of climate change on HIV vulnerabilities, past research has largely overlooked key populations, such as sex workers and gay, bisexual, and other men who have sex with men (gbMSM), comprising a critical knowledge gap.
"Climate shocks and extreme weather events are already known to exacerbate poverty and resource scarcity, which can amplify HIV risk. Sex workers and gbMSM may be particularly vulnerable to these adversities because of the compounding impacts of stigma and social marginalization," says lead author Carmen Logie, a Professor at the University of Toronto's Factor-Inwentash Faculty of Social Work (FIFSW) and an Adjunct Professor at the United Nations University Institute for Water, Environment, and Health.
Researchers from the University of Toronto in partnership with Kenyan community-based collaborators conducted a multi-method qualitative study with 21 sex workers and 15 gbMSM to examine their lived experiences navigating climate change, extreme weather events, resource insecurities (such as a lack of food or water), and HIV vulnerabilities.
Participants described numerous interrelated connections between extreme weather events and HIV vulnerabilities. For example, drought and flooding led to food and water insecurity, which resulted in participants enacting coping strategies that may increase HIV risk, including increased transactional sex where there is often less agency to negotiate condom use.
Participants also described facing increased risks of sexual violence when having to travel longer distances to access water, another pathway by which resource scarcity can increase HIV vulnerability.
"Our findings align with emerging research on the links between climate change-related resource insecurities and HIV vulnerabilities through numerous pathways, including transactional sex, sexual violence, and reduced condom efficacy," says co-author Andie MacNeil, a PhD student at FIFSW. "Combined, this research underscores the urgent need to address resource scarcities, particularly among vulnerable populations in climate-affected areas."
Participants also shared how LGBTQ stigma contributed to broader issues of economic precarity that were worsened by extreme weather events and resulting resource scarcities. While the impacts of climate change are widespread, the interplay of stigma and social marginalization creates particular challenges for sex workers and gbMSM.
"Intersecting stigmas related to sex work and LGBTQ status intensify the harmful impacts of extreme weather events," says co-author Humphres Evelia, Executive Director of the Centre for the Study of Adolescence in Nairobi, Kenya. "The participants in our study described reduced access to care and increased risks of criminalization due to their identities, compounding the effects of extreme weather."
The researchers are hopeful that this study can help inform strategies to mitigate HIV risk in the context of climate change.
"Interventions to reduce resource scarcities are paramount to addressing HIV vulnerability," says Logie. "There is a need for further development and evaluation of climate-informed HIV interventions, such as long acting PrEP and mobile pharmacies, with particular consideration for reducing stigma and ensuring these services are tailored for sex workers and gbMSM."
