Drought may increase females' HIV risk in developing nations

A modeling study suggests that females in developing nations are especially vulnerable to the effects of drought and food shortages. The social, economic, and medical consequences may disproportionately increase their risk of contracting HIV.

When HIV emerged in the 1980s and 90s, males were more likely than females to contract the virus. However, globally, the majority of adults living with HIV are now females, according to United Nations data.

The Joint United Nations Program on HIV/AIDS (UNAIDS) report that HIV is the leading cause of death in females aged 30–49 years and the third leading cause of females in females aged 15–29 years globally.

The relative rates of males and females contracting HIV vary widely between countries, but data from the World Bank suggest that in Sub-Saharan Africa, for example, more than 60% of all those living with HIV are females.

Females aged 15–24 in this region of Africa are more than twice as likely as males in the same age bracket to become HIV positive, according to UNAIDS.

What makes females in developing countries so much more vulnerable to contracting HIV than males?

Research by Kelly Austin, associate professor of sociology at Lehigh University in Bethlehem, PA, and her colleagues suggests that droughts are one contributory factor.

Their study, which appears in the journal Social Indicators Research, found that food insecurity resulting from droughts has a disproportionate effect on females’ risk of contracting HIV.

Modeling infection rates

They used a statistical technique called structural equation modeling to explore the relationship between HIV infection rates and socioeconomic and environmental factors — including drought and food insecurity — in 91 developing nations.

According to the researchers, females in these societies have little autonomy and are often responsible for raising children, growing and harvesting food, collecting firewood, and fetching water. This makes them uniquely vulnerable to droughts and the ensuing food shortages.

The researchers identified four ways in which food insecurity exposes females to a greater risk of contracting HIV:

  • Malnutrition, which weakens immune defenses to HIV, and increased vulnerability to other illnesses, such as malaria, may also indirectly increase susceptibility to HIV.
  • Exacerbation of gender inequalities in terms of access to education and healthcare, including birth control services, which could protect females against HIV.
  • Early marriage of daughters for financial reasons, resulting in exposure to sexually transmitted illnesses at a younger age.
  • Financial motivation to become sex workers.

“Women in less developed countries disproportionately bear the burden in terms of ill health when facing food insecurity or a shock or disaster like drought that impacts the ability to get food or harvest food,” says Austin.

“This information would be useful for policymakers and people working in international development and disaster response.”

Climate change

The findings are particularly concerning in light of the climate emergency, say the authors. The Food and Agriculture Organization of the United Nations (FAO) predict that climate change will increase the frequency, severity, and duration of droughts in the coming years.

The authors conclude:

“[D]uring times of drought and hardship special attention should be made to ensuring the safety and participation of young women in schooling, medical care, and other activities that ensure their well-being […] a holistic approach must be taken that not only emphasizes conventional approaches, [such as] expanding access to medical care, but also prioritizing women’s empowerment and environmental resilience and sustainability.”

A possible limitation of the research was that it relied on structural equation modeling. Some researchers have criticized this technique, which is popular in the social sciences, for creating models that oversimplify highly complex real-world situations.

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