The interplay between environment and sexual health: Investigating the association of climate change and HIV in vulnerable populations of sub-Saharan

环境与性健康之间的相互作用：调查撒哈拉以南地区弱势群体中气候变化与艾滋病毒的关系

• 批准号: 2725110
• 金额: --
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2725110
• 关键词: interplay; between; environment; sexual; health

HIV and climate change are both long-term adversities which exacerbate poverty, gender inequalities and exploitation of children. Additionally, marginalised individuals such as teenage girls, young women, migrants, sexual and gender minorities, as well as individuals with limited resources are often affected the most. Finally, both phenomena are difficult to tackle due to issues with political engagement and a large and spatially heterogenous distribution. HIV and climate change affect certain regions of the globe at different levels, with sub-Saharan Africa being the region the most heavily affected by both phenomena. As countries strive to achieve new UNAIDS 95-95-95 goals established in December 2020, climate change-related events could jeopardise epidemic control. This can hence drive the synergistic relationship between environment, human behaviours, vulnerabilities and HIV transmission, incidence and severity. There is very limited statistical evidence on the associations between environment and HIV. There are currently only four existing studies which looked at this relationship. All those studies confirm that environmental changes might have a negative impact on HIV incidence. However, those studies do not provide a comprehensive overview of all the potential variables associated with climate change and HIV. They also focus on only one weather event (such as warm weather, drought or heavy rainfall), mostly focus on regional data and only on adults. The links between climate change and HIV severity remain completely unexplored. The main aim of this project is to identify a potential relationship and understand the complex pathways between climate change and HIV by creating and analysing a range of quantitative model to discover which mediators have the greatest impact on that relationship. The secondary aim is to decide whether vulnerable individuals (such as deprived individuals, women, children) suffer from the impact of climate change on HIV more than the rest of the population at household and regional levels. Based on the proposed aims, a number of research questions will be investigated:1) How does climate change impact HIV seroconversion rates in sub-Saharan Africa?2) Is the impact of climate change on HIV seroconversion exacerbated in vulnerable populations in sub-Saharan Africa?3) How does climate change impact HIV severity in HIV-positive patients in sub-Saharan Africa?4) Is the impact of climate change on HIV severity in HIV-positive patients exacerbated in vulnerable populations in sub-Saharan Africa?To answer the research questions, PHIA datasets will be used. They are nationally representative, weighted surveys of HIV incidence in 13 sub-Saharan African countries which can be extrapolated to cases on the national level. They contain the largest numbers of new HIV infections in sub-Saharan Africa to date. Across 13 countries, data from 143,853 households is available. In the datasets, there are 368,373 individuals with HIV status biomarker available. Environmental data will be used from a number of sources: monthly rainfall will be extracted from Climate Hazards group InfraRed Precipitation with Station data and temperature data will be extracted from The Climate Data Store Copernicus data.Bayesian multilevel modelling will be conducted to assess conditional indirect effects (moderated mediation analysis). The data analytical approach will consist of two steps. The first step will estimate the indirect association between the environmental variables and HIV serostatus/severity (Research Questions 1 and 3) through a number of mediators (such as food insecurity, inadequate drinking water, inadequate living conditions, limited healthcare access, sexual violence, transactional sex, drug abuse and risky sexual behaviours). The second step will involve integrating previously named parameters with the addition of the moderators (gender, age, education) in separate distinct models (Research Qs, 2&4)

艾滋病毒和气候变化都是长期逆境，加剧了贫困，性别不平等和对儿童的剥削。此外，少年女孩，年轻妇女，移民，性和性别少数群体以及资源有限的人通常受到最大影响。最后，由于政治参与和大型和空间异质分布，这两种现象都难以解决。艾滋病毒和气候变化会影响不同层次的某些地区，撒哈拉以南非洲是受这两种现象最严重影响的地区。随着各国努力实现2020年12月建立的新UNAID 95-95-95目标，与气候变化相关的事件可能会危害流行病控制。因此，这可能会推动环境，人类行为，脆弱性以及艾滋病毒传播，发病率和严重性之间的协同关系。关于环境与艾滋病毒之间关联的统计证据非常有限。目前只有四项研究这种关系。所有这些研究证实，环境变化可能会对艾滋病毒发病率产生负面影响。但是，这些研究并未提供与气候变化和艾滋病毒相关的所有潜在变量的全面概述。他们还专注于一个天气事件（例如温暖的天气，干旱或大雨），主要集中在区域数据上，而仅关注成年人。气候变化与艾滋病毒严重程度之间的联系仍然完全没有探索。该项目的主要目的是通过创建和分析一系列定量模型来发现哪些调解人对这种关系产生最大的影响，从而确定潜在的关系并了解气候变化和艾滋病毒之间的复杂途径。次要目的是决定脆弱的人（例如被剥夺的个人，妇女，儿童）是否比在家庭和地区级别上的其他人口更多地受到气候变化对艾滋病毒的影响。基于提议的目的，将研究许多研究问题：1）气候变化如何影响撒哈拉以南非洲以下的艾滋病毒血清转化率？2）气候变化对艾滋病毒血清转化的影响是否加剧了萨哈拉以南非洲的易受伤害人群中易受伤害的人群的易受伤害的气候变化对HIV危机的影响如何？撒哈拉以南非洲脆弱人群的艾滋病毒阳性患者的艾滋病毒严重程度加剧了回答研究问题，将使用PHIA数据集。他们是撒哈拉以南非洲国家的全国代表性，加权艾滋病毒发病率的调查，可以将其推断为国家一级的案件。迄今为止，它们包含撒哈拉以南非洲地区最多的新艾滋病毒感染。在13个国家 /地区，可提供来自143,853户家庭的数据。在数据集中，有368,373名具有HIV状态生物标志物的人。环境数据将从多个来源使用：将从气候危害组红外降水中提取带有站数据的每月降雨，并且将从气候数据存储库哥copernicus数据中提取温度数据。将进行Bayesian多层次建模，以评估有条件的间接效应（调度中介分析）。数据分析方法将由两个步骤组成。第一步将通过许多调解人（例如饮食不安全，饮用水不足，生活条件不足，医疗保健途径有限，性暴力，性暴力，滥用性，滥用性行为和冒险的性行为）来估计环境变量与HIV血清/严重性（研究问题1和3）之间的间接关联。第二步将涉及将先前命名的参数与主持人（性别，年龄，教育）的添加（研究QS，2＆4）中的添加（性别，年龄，教育）集成。