Economic, social and demographic impacts of drought on treatment adherence among people living with HIV in rural South Africa: A qualitative analysis

Kingsley Orievulu; Sonja Ayeb-Karlsson; Nothando Ngwenya; Sthembile Ngema; Hayley McGregor; Oluwafemi Adeagbo; Mark J. Siedner; Willem Hanekom; Dominic Kniveton; Janet Seeley; Collins Iwuji

doi:10.1016/j.crm.2022.100423

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Economic, social and demographic impacts of drought on treatment adherence among people living with HIV in rural South Africa: A qualitative analysis

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Economic, social and demographic impacts of drought on treatment adherence among people living with HIV in rural South Africa: A qualitative analysis

Kingsley Orievulu, Sonja Ayeb-Karlsson, Nothando Ngwenya, Sthembile Ngema, Hayley McGregor, Oluwafemi Adeagbo, Mark J. Siedner, Willem Hanekom, Dominic Kniveton, Janet Seeley, …

Climate risk management, Vol.36, p.100423

2022

DOI: 10.1016/j.crm.2022.100423

PMCID: PMC7614312

PMID: 36923966

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Abstract

The 2015 El Niño-triggered drought in Southern Africa caused widespread economic and livelihood disruption in South Africa, imposing multiple physical and health challenges for rural populations including people living with HIV (PLHIV). We examined the economic, social and demographic impacts of drought drawing on 27 in-depth interviews in two cohorts of PLHIV in Hlabisa, uMkhanyakude district, KwaZulu-Natal. Thematic analysis revealed how drought-enforced soil water depletion, dried-up rivers, and dams culminated in a continuum of events such as loss of livestock, reduced agricultural production, and insufficient access to water and food which was understood to indirectly have a negative impact on HIV treatment adherence. This was mediated through disruptions in incomes, livelihoods and food systems, increased risk to general health, forced mobility and exacerbation of contextual vulnerabilities linked to poverty and unemployment. The systems approach, drawn from interview themes, hypothesises the complex pathways of plausible networks of impacts from drought through varying socioeconomic factors, exacerbating longstanding contextual precarity, and ultimately challenging HIV care utilisation. Understanding the multidimensional relationships between climate change, especially drought, and poor HIV care outcomes through the prism of contextual vulnerabilities is vital for shaping policy interventions.

Climate change

Drought

HIV treatment adherence

Migration

Poverty

Social vulnerability

South Africa

Details

Title: Subtitle: Economic, social and demographic impacts of drought on treatment adherence among people living with HIV in rural South Africa: A qualitative analysis
Creators: Kingsley Orievulu - Africa Health Research Institute
Sonja Ayeb-Karlsson - Brighton and Sussex Medical School
Nothando Ngwenya - Africa Health Research Institute
Sthembile Ngema - Africa Health Research Institute
Hayley McGregor - University of Sussex
Oluwafemi Adeagbo - Africa Health Research Institute
Mark J. Siedner - Harvard University
Willem Hanekom - Africa Health Research Institute
Dominic Kniveton - University of Sussex
Janet Seeley - Africa Health Research Institute
Collins Iwuji - Africa Health Research Institute
Resource Type: Journal article
Publication Details: Climate risk management, Vol.36, p.100423
DOI: 10.1016/j.crm.2022.100423
PMID: 36923966
PMCID: PMC7614312
NLM abbreviation: Clim Risk Manag
ISSN: 2212-0963
eISSN: 2212-0963
Publisher: Elsevier B.V
Language: English
Date published: 2022
Academic Unit: Community and Behavioral Health
Record Identifier: 9984274820802771

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