COMMENTARY
Open Access

Addressing the Impact of Climate Change on Sexual and Reproductive Health Among Adolescent Girls and Young Women in Low- and Middle-Income Countries

Paul A. Burns and Clive Mutunga
Global Health: Science and Practice February 2024, 12(1):e2300374; https://doi.org/10.9745/GHSP-D-23-00374

Key Findings

  • Adolescent girls and young women (AGYW) residing in low- and middle-income countries (LMICs) are particularly vulnerable to climate-related sexual and reproductive health (SRH) challenges, placing them at increased risk of poverty, food insecurity, school dropout, transactional sex, sexual violence, sexually transmitted infections, early marriage, and early childbearing.

  • There is an urgent need for increased research and climate financing to ensure adequate investments toward advancing climate adaptation and innovation to address the sexual and reproductive needs of AGYW living in LMICs.

  • Applying a rights-based, multilevel, multisectoral, and gendered approach to climate action can strengthen National Adaptation Plans of Action and improve the health and well-being of adolescent girls and young women living in LMICs and resource-constrained settings.

  • Leveraging community engagement through the inclusion of diverse stakeholders, such as national governments, multilaterals, policymakers, health care providers, researchers, and nongovernmental organizations and youth, in climate-related SRH research and policy can lead to more meaningful participation, deeper trust, and sustainable climate-related SRH solutions in LMICs.

INTRODUCTION

Adolescents and youth are particularly vulnerable to the effects of climate change due to the numerous biological, emotional, and sociocultural developmental changes occurring during the transition from childhood to adulthood.1 Climate change affects adolescents’ health and well-being in several domains, including physical health (e.g., brain development, lung conditions, and nutrition), mental health, education, and sexual and reproductive health (SRH).2 In addition to having direct effects due to extreme weather, climate change has indirect and long-term consequences on adolescents’ psychological functioning, educational and employment opportunities, and a sense of security about their futures. While the effects of climate change negatively impact all adolescents and youth, those residing in low- and middle-income countries (LMICs) are most vulnerable to those impacts due to exposures generated by extreme weather and exacerbated by rapid urbanization, poor infrastructure, unplanned slums and informal settlements, and political and economic insecurity. Adolescent girls and young women (AGYW) bear a double burden due to their gender and age, placing them at increased risk of poverty, food insecurity, school dropout, transactional sex, sexual violence, sexually transmitted infections (STIs), early marriage (leading to nonconsensual or unwanted but expected sexual activity), or early childbearing due to a lack of access to and use of prevention methods (e.g., contraceptive methods).3–11

Globally, there are approximately 880 million AGYW aged 15–24 years.12 Despite accounting for 12% of the world’s population, their voices are often left out of policy conversations that impact their SRH. Moreover, there is a dearth of research examining the role of climate change on adolescent SRH, especially AGYW in LMICs. A scoping review exploring the impacts of climate-driven migration on SRH found only 10 studies that met the inclusion criteria, underscoring a general lack of attention to SRH in climate research.13 The original United Nations Framework Convention on Climate Change (UNFCCC) that outlined the global priorities to mitigate the impacts of climate did not mention women and girls or SRH.14 The word “health” appears only twice in the entire 25-page, 8,496-word document. However, more recent UNFCCC policy documents have highlighted the importance of gender equity in addressing climate change.15–17 It was not until 2002, at the 52nd Session of the Intergovernmental Panel on Climate Change, that the Panel adopted the Gender Policy and Implementation Plan.17,18 Then, in 2018, the Guttmacher-Lancet Commission published a report that called for the adoption of a more comprehensive integrated approach to sexual and reproductive rights as well as the recognition of the importance of addressing climate change in the context of SRH.19

Although there has been an increasing recognition linking climate change and SRH, there is limited research, programs, and policies that address this issue at the national level in LMICs. In 2002, the National Adaptation Plan of Action (NAP) was established by the UNFCCC under the Cancun Adaptation Framework20 and reemphasized in the Paris Agreement21 the need to address vulnerability to climate change by building climate adaptative capacity and the integration of adaptation into new and existing policies and programs.22 Under the UNFCCC, NAPs are funded through a mechanism managed by the Global Environment Facility to assist LMICs in their efforts to adapt to climate impacts. NAPs provide: (1) a useful vehicle for countries to set climate change priorities, identify medium- and long-term adaptation goals, and develop implementation strategies for action; (2) a systematic approach toward the development of evidence-based findings to support climate adaptive programming and policies; and (3) an opportunity to coordinate and harmonize national adaptation efforts across sectors by including diverse actors, such as government agencies, the private sector, civil society, and other relevant stakeholders, to achieve climate adaptation goals. However, only a few NAPs focus on health, with even fewer addressing the impacts of climate change on SRH. A recent World Health Organization assessment of NAPs submitted to NAP Central, the UNFCCC NAP portal, found all NAPs highlight health as a high-priority sector vulnerable to climate change, but none addressed SRH.23 Additionally, another review examining NAP quality found that many countries are not taking a multisectoral approach, which can negatively impact the overall success of the process and outcomes.24

EXAMINING THE IMPACTS OF CLIMATE CHANGE ON SEXUAL AND REPRODUCTIVE HEALTH

Extreme Weather Events

Climate change poses detrimental impacts on broader ecosystems, exacerbating pressures on global food security, water resources, and livelihoods. Vulnerable populations who contribute least to the climate change crisis are often more impacted.25–27 According to the 2020 Lancet Countdown report, climate-induced extreme weather events and rising sea levels will increase human migration and displacement, posing severe risks to human health, including SRH.25,28,29 Climate-induced droughts increase food and water insecurity, disrupting livelihoods and ways of life and displacing millions of vulnerable people, particularly in LMICs.30–34 Extreme weather events and climate change can often lead to short- and long-term migration, which has been associated with poverty and increased engagement in transactional sex and sexual exploitation (e.g., early sexual debut and child marriage).33

Several socioecological frameworks have been developed to explain how climate-induced resource scarcity (e.g., water and food insecurity) is linked to SRH outcomes (e.g., HIV and STIs). Leiber et al. developed a model to conceptualize pathways and mechanisms for understanding the impact of climate change on SRH, particularly HIV (Figure).35 Extreme weather events, such as drought and infrastructure erosion, can reduce access to SRH services36; increase rates of sexual risk behavior, including condomless sex and transactional sex37,38; and lead to early sexual debut,39 higher prevalence of infectious diseases (e.g., dengue, chikungunya, and malaria) due to changes in season duration,40–42 and migration-related sexual abuse and exploitation.39,43

Extreme weather events can reduce access to SRH services, increase rates of sexual risk behavior, and lead to early sexual debut, higher prevalence of infectious diseases, and sexual abuse and exploitation.

FIGURE
FIGURE

Conceptual Framework for Explaining Links Between Sexual Reproductive Health and Climate Changea

Abbreviation: FP, family planning; STI, sexually transmitted infection.

a Adapted from Lieber et al.35

The uprooting of communities due to climate-related migration can also disrupt access to and provision of lifesaving SRH services and programs. A growing body of work has linked climate change and extreme weather events to increased risk of HIV and other STIs, particularly for AGYW in LMICs. A study of 21 sub-Saharan African countries comprising nearly 300,000 respondents examining the impacts of long-term temperature increases on HIV found long periods of droughts were associated with increased HIV prevalence. The study also showed droughts were more likely to impact those people living in rural areas, younger age groups, and increased engagement in transactional sex.43 In another study of 19 sub-Saharan African countries, Burke et al. found a rainfall shock was associated with an 11% increase in HIV prevalence among rural populations.39 Also, a study in Lesotho found adolescent girls who lived in areas that experienced drought in the last 2 years were more likely to have earlier sexual debut and be HIV-positive.37 It is also important to note many parents often view their migration-related decisions as protective against the impacts of climate change and not as catalysts for the development of a new set of risks.

Food Insecurity

Food insecurity has been linked to several adverse health outcomes, including HIV-related clinical outcomes.44–46 Several studies have documented an association between climate-related food insecurity and HIV vulnerability through sexual risk behavior pathways (e.g., survival sex and transactional sex) and mental health (e.g., depression and substance disorders), which can increase exposure to HIV. In sub-Saharan Africa, food insecurity has been linked to sexual risk behavior and transactional sex among HIV-positive youth.47,48 In addition, food insecurity has been shown to reduce condom use among adults and condom efficacy among adolescents.49,50 Food insecurity is associated with diminished psychosocial coping resources, leading to greater psychological distress, which may impact a youth’s ability to engage in safer sex practices, including condom use and negotiating condom use with their partners.

Water Insecurity

Moreover, drought has been linked to HIV vulnerability through its impact on livelihoods through reduced income.51–54 A study in Western Kenya found water insecurity was associated with lower odds of viral suppression and increased odds of acquisition of AIDS-defining illnesses among adults.55 Also, lack of access to water may limit an individual’s ability to effectively engage in hygiene and sanitation practices, such as consistent handwashing and bathing.56,57 Evidence suggests water insecurity may also lead to dehydration and fatigue and increase the risk of opportunistic infections from waterborne infections, such as diarrheal or skin diseases.58,59 Exposure to climate-induced AIDS-defining illnesses and infections may, in turn, limit an individual’s ability to maintain adherence to antiretroviral therapy and engagement in HIV care, resulting in lower odds of viral suppression. Water insecurity may also increase stress and worsen mental health outcomes,60–65 leading to lower antiretroviral therapy adherence, engagement in care, and viral load suppression.47,57 In addition, several studies have shown an association between water insecurity and mental health outcomes (e.g., depression and substance use).58,62,63 Further, the opportunity costs and injuries associated with acquiring water in low-resource settings may limit an individual’s health-seeking behavior as it relates to HIV care.64,65 Climate change also has complex relationships with HIV, particularly for persons living with HIV. Evidence suggests the effects of climate change can compromise the immune systems of people living with HIV, increasing exposure to infectious diseases, disruptions in access to health care, and food insecurity.47,66–72

Family Planning and Population Health

One of the key goals of climate adaptation policies is to limit human-derived greenhouse gas emissions. Evidence suggests climate change may exacerbate factors (e.g., socioeconomic mobility, education, employment, and land tenure) associated with uptake and access to family planning services. Population growth exacerbates the threats posed by climate change as a result of natural resource depletion, economic and food insecurity, and poorer health outcomes. However, family planning and SRH within climate adaptive plans are largely ignored, particularly in LMICs.73 Through investments in SRH and health literacy programs, we can enhance climate resilience and adaptive capacity at the individual, community, and structural levels. Improving access to effective voluntary modern contraceptive methods can be an important component of a multisectoral approach to climate change adaptation. Although there should be increased investments to address unmet family planning needs in LMICs, these efforts must be in concert with countries in high-income countries (HICs). For example, we must be cognizant of the disproportionate impact of family planning decisions (i.e., unintended pregnancies) in HICs.74 Estimates suggest the wealthiest 10% of the global population contributes 50% of greenhouse emissions compared to the poorest 50% contributing only 10% of emissions.75 Given the U.S. and UK carbon emissions per capita are more than 150 and 80 times greater, respectively, than most countries in sub-Saharan Africa, any successful climate adaptation policy must be done in concert with climate adaptation plans that address climate change issues in HICs.

POLICY RECOMMENDATIONS TO MITIGATE THE IMPACT OF CLIMATE CHANGE ON SEXUAL AND REPRODUCTIVE HEALTH

There is an urgent need to increase investments in integrated SRH and climate adaptive approaches to mitigate the impacts of climate change on the SRH of young women and girls. We hope the following 5 recommendations will be useful to governments, multilateral institutions, public health officials, the private sector, civil society, climate advocates, and community leaders in their efforts to design and implement climate adaptive programs and policies, such as the NAPs.

There is an urgent need to increase investments in integrated SRH and climate adaptive approaches to mitigate the impacts of climate change on the SRH of young women and girls.

1. Incorporate Sexual and Reproductive Health Into National Adaptive Plans

National governments play a pivotal role in mitigating the effects of climate change. National adaptation planning was designed to provide national governments with an evidence-based, coordinated, and systematic approach to developing and implementing climate preparedness initiatives. However, recent evaluations suggest great variation in their design, content, and implementation. Also, few NAPs include public health initiatives, and none address the SRH of AGYW. We call on national governments to incorporate innovative, multilevel programs and policies that directly address the impacts of climate change on SRH of AGYW living in LMICs.

2. Apply a Rights-Based, Gendered Approach to Climate Adaptation

Rights-based climate-related programs and policies centering the lives and SRH needs of AGYW are needed to promote women’s empowerment, economic growth, resilience, and capacity-building. Research has shown extreme weather events due to climate change disproportionately affect women and girls in LMICs, impacting their ability to perform everyday tasks, such as collecting water, cooking, and planting food. Food and water insecurity and loss of livelihoods create the conditions where AGYW are forced to drop out of school, to engage in transactional sex, or to enter into child marriages, which may increase rates of gender-based violence and exposure to HIV and STIs.

NAPs must take a rights-based, gender-responsive approach to climate change by creating inclusive policies in education, employment, laws, land tenure, and health, including SRH and rights, particularly the right to make informed decisions about their sexuality and reproduction, access to SRH services, equal access to educational and career opportunities, and decision-making about their lives and future. More inclusive, rights-based, gender-responsive climate policies promoted by international institutions and national governments can lead to more effective and sustainable climate solutions that reduce environmental harm. The Box lists climate adaptive policies and resources for advancing policy dialogue and policy action around gender and SRH for AGYW in LMICs.14,17,76,77

BOX

Gender, Sexual and Reproductive Health, and Climate Change Resources

  • The United Nations Framework Convention on Climate Change14 is the parent treaty of the 2015 Paris Agreement.21

  • The Gender Action Plan Plan17 provides objectives and activities to advance knowledge and understanding of gender-responsive climate action and its coherent mainstreaming in climate adaptive plans and policies.

  • Climate Change 2023: Synthesis Report76 provides an overview of the state of knowledge concerning the science of climate change referencing sexual and reproductive health.

  • Making the Connection: Population Dynamics and Climate Compatible Development77 provides approaches and opportunities for advancing policy dialogue and policy action to include population dynamics, with an emphasis on family planning, into climate-compatible development.

3. Build Capacity for Integrated Climate Change and Sexual and Reproductive Health

Mitigating climate risks will require multilevel, multisector coordination, improvements in data quality and collection methods, monitoring and evaluation of SRH targets, and inclusive and diverse stakeholder engagement, especially women and girls. In addition, empowering women as agents of social change can improve mitigation and adaptation policies and the design and implementation of gender-responsive climate-related interventions and programs that address impacts on their SRH. The Table provides some examples of initiatives that integrate gender, SRH, and climate change approaches. For example, in Southern Africa, Building Capacity for Integrated Family Planning & Reproductive Health and Population, Environment and Development Action uses a gender-responsive approach to climate adaptation. The project aims to strengthen the capacity of individuals and institutions through population, health, and environment approaches and to boost political and financial commitment to family planning and integrated population health and environment approaches that increase gender equality and youth empowerment.

View this table:
TABLE.

Selected Integrated Sexual and Reproductive Health and Climate Change Initiatives

4. Leverage Community Engagement for Gender-Responsive Climate Change Adaptive Policies

Community engagement is vital for the planning and implementation of effective NAPs. To be successful, governments need to create an enabling environment that supports climate adaptation by making commitments to engage a diverse set of stakeholders (e.g., government ministries, elected officials, health care workers, and community members, particularly AGYW) to generate public engagement and attention toward the development of gender-responsive policies to mitigate the impacts of climate change. For example, in the Philippines, PATH implemented a program called Empowering Rural Youth with Population Health Environment and Enterprise Development Know-How that engaged a diverse group of stakeholders (e.g., national government, civil society, community leaders, and local youth) to implement integrated family planning and climate change initiatives, including voluntary family planning campaigns, coastal conservation, and economic development activities that would reduce dependency on fishing. These engagements must be inclusive, values-oriented, and framed to incorporate indigenous knowledge, capacities, and the lived experiences of all citizens, particularly those most impacted by climate change in LMICs.

5. Accelerate Financing for Integrated Family Planning and Climate Adaptive Action

Donor countries contribute the bulk of the climate financing through a trust fund administered by the World Bank, serving as the Global Environment Facility Trustee. As of September 30, 2022, 28 donors pledged and signed Contribution Agreements amounting to more than US$1,971.46 million. A recent analysis conducted by UNFCCC found that the financing needs of nationally determined contributions of 78 countries amounted to around US$5.8 trillion until 2030 (or about US$600 billion per year). We call on multilateral organizations, HICs, and the private sector to increase funding to ensure adequate funding for advancing innovation and research—including private-sector financing to ensure effective environmental preparedness and long-term sustainable climate adaptive policies—that addresses the needs of vulnerable countries and populations, particularly, the SRH needs of AGYW residing in LMICs.

CONCLUSIONS

Despite growing recognition of the relationship between climate change and health, there is limited research examining the links between climate change and SRH among AGYW in LMICs. Additionally, few NAPs address the climate-related SRH needs of AGYW in LMICs. Using the evidence-based findings from the literature and models presented in this article, we call on national governments, international institutions, policymakers, civil society, and private sector actors to: (1) apply a multilevel gendered approach to climate action; (2) employ a rights-based, gendered approach to climate adaptation; (3) build capacity for integrated climate change and SRH; (4) leverage community engagement for gender-responsive climate change adaptive policies; and (5) accelerate financing for integrated family planning and climate adaptive action.

Acknowledgments

We owe a special debt of gratitude to several people for their support of the project and critical review of the article, especially Mihira Karra, Tabitha Sripipatana, Kevin Peine, Erika Houghtaling, Samuel Sellers, and Lindsey Swisher at the U.S. Agency for International Development, Bureau for Global Health, Office of Population and Reproductive Health and Tamara Lewis-Johnson at the National Institutes of Health/National Institute of Mental Health/Women’s Mental Health Research Program.

Funding

This article was supported by the Science and Technology Policy Fellows Program of the American Association for the Advancement of Science and the U.S. Agency for International Development Bureau for Global Health, Office of Population and Reproductive Health, Division of Research, Technology and Utilization.

Disclaimer

The content is solely that of the authors and does not necessarily represent the official views of the American Association for the Advancement of Science, the U.S. Agency for International Development, the African Institute for Development for Policy, or other individuals named here.

Author contributions

PB and CM contributed to the concept and design of the article. Both contributed to the writing of the article.

Competing interests

Paul Burns and Clive Mutanga have received funding from the U.S. Agency for International Development.

Notes

Peer Reviewed

First published online: February 17, 2024.

Cite this article as: Burns PA, Mutunga C. Addressing the impact of climate change on sexual and reproductive health among adolescent girls and young women in low- and middle-income countries. Glob Health Sci Pract. 2024;12(1):e2300374. https://doi.org/10.9745/GHSP-D-23-00374

  • Received: September 3, 2023.
  • Accepted: January 23, 2024.
  • Published: February 28, 2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-23-00374

REFERENCES

  1. 1.↵
    2. Pereira T,
    3. Freire T
    . Positive youth development in the context of climate change: a systematic review. Front Psychol. 2021;12:786119. doi:10.3389/fpsyg.2021.786119. pmid:34887822
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Verma S,
    2. Peterson AC
    Sanson AV, Wachs TD, Koller SH, Salmela-Aro K. Young people and climate change: the role of developmental science. In: Verma S, Peterson AC, eds. Developmental Science and Sustainable Development Goals for Children and Youth. Social Indicators Research Series, Vol. 74. Springer; 2018:115–138. doi:10.1007/978-3-319-96592-5_6
    OpenUrlCrossRef
  3. 3.↵
    2. Baada JN,
    3. Baruah B,
    4. Sano Y,
    5. Luginaah I
    . Mothers in a “strange land”: migrant women farmers” reproductive health in the Brong-Ahafo region of Ghana. J Health Care Poor Underserved. 2021;32(2):910–930. doi:10.1353/hpu.2021.0071. pmid:34120984
    OpenUrlCrossRefPubMed
  4. 4.
    2. Lindvall K,
    3. Kinsman J,
    4. Abraha A, et al
    . Health status and health care needs of drought-related migrants in the horn of Africa-a qualitative investigation. Int J Environ Res Public Health. 2020;17(16):5917. doi:10.3390/ijerph17165917. pmid:32824046
    OpenUrlCrossRefPubMed
  5. 5.
    2. Pardhi A,
    3. Jungari S,
    4. Kale P,
    5. Bomble P
    . Migrant motherhood: maternal and child health care utilization of forced migrants in Mumbai, Maharashtra, India. Child Youth Serv Rev. 2020;110:104823. doi:10.1016/j.childyouth.2020.104823
    OpenUrlCrossRef
  6. 6.
    2. Haque MR,
    3. Parr N,
    4. Muhidin S
    . The effects of household’s climate-related displacement on delivery and postnatal care service utilization in rural Bangladesh. Soc Sci Med. 2020;247:112819. doi:10.1016/j.socscimed.2020.112819. pmid:32018115
    OpenUrlCrossRefPubMed
  7. 7.
    United Nations Population Fund, East and Southern Africa Regional Office (UNFPA-ESARO). SRHR, Gender and Climate Change Resilience Symposium, 26-28, August 2019, Future Africa Campus, University of Pretoria. UNFPA-ESARO; 2020. Accessed January 25, 2024. https://esaro.unfpa.org/en/publications/srhr-gender-and-climate-change-resilience-symposium
  8. 8.
    World Health Organization (WHO). Gender, Climate Change and Health. WHO; 2014. Accessed January 25, 2024. https://www.who.int/publications/i/item/9789241508186
  9. 9.
    CARE. Evicted by Climate Change: Confronting the Gendered Impacts of Climate-Induced Displacement. CARE; 2020. Accessed January 25, 2024. https://careclimatechange.org/wp-content/uploads/2020/07/CARE-Climate-Migration-Report-v0.4.pdf
  10. 10.
    International Planned Parenthood Federation (IPPF). The Climate Crisis and Sexual and Reproductive Health and Rights. IPPF Position Paper. IPPF; 2021. Accessed January 25, 2024. https://www.ippf.org/resource/ippf-position-paper-climate-crisis-and-sexual-and-reproductive-health-and-rights
  11. 11.↵
    2. D’souza V
    . Integrating SRHR and making young people resilient to climate change. Arrow. December 5, 2018. Accessed January 25, 2024. https://arrow.org.my/integrating-srhr-and-making-young-people-resilient-to-climate-change
  12. 12.↵
    2. Haque MR,
    3. Parr N,
    4. Muhidin S
    . Climate-related displacement and antenatal care service utilization in rural Bangladesh. Int Perspect Sex Reprod Health. 2020;46:175–185. doi:10.1363/46e9620. pmid:32985989
    OpenUrlCrossRefPubMed
  13. 13.↵
    2. van Daalen KR,
    3. Dada S,
    4. Issa R, et al
    . A scoping review to assess sexual and reproductive health outcomes, challenges and recommendations in the context of climate migration. Front Glob Womens Health. 2021;2:757153. doi:10.3389/fgwh.2021.757153. pmid:34816251
    OpenUrlCrossRefPubMed
  14. 14.↵
    United Nations (UN). United Nations Framework Convention on Climate Change. UN; 1992. Accessed January 25, 2024. https://unfccc.int/resource/docs/convkp/conveng.pdf
  15. 15.↵
    United Nations Commission on the Status of Women (CSW). Financing for Gender Equality and the Empowerment of Women. CSW; 2008. Accessed February 4, 2024. https://www.unwomen.org/sites/default/files/Headquarters/Attachments/Sections/CSW/52/CSW52_E_FINAL.pdf
  16. 16.
    Intergovernmental Panel on Climate Change. Climate Change 2022: Impacts, Adaptation, and Vulnerability: Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press; 2023. doi:10.1017/9781009325844
    OpenUrlCrossRef
  17. 17.↵
    United Nations Framework Convention on Climate Change (UNFCC). Report of the Conference of the Parties on Its Twenty-Fifth Session, Held in Madrid From 2 to 15 December 2019. Part Two: Action Taken by the Conference of the Parties at Its Twenty-Fifth Session. Accessed February 4, 2024. https://unfccc.int/topics/gender/the-big-picture/introduction-to-gender-and-climate-change/the-gender-action-plan-1
  18. 18.↵
    Gender. Intergovernmental Panel on Climate Change. Accessed January 25, 2024. https://www.ipcc.ch/about/gender
  19. 19.↵
    2. Starrs AM,
    3. Ezeh AC,
    4. Barker G, et al
    . Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher– Lancet Commission. Lancet. 2018;391(10140):2642–2692. doi:10.1016/S0140-6736(18)30293-9. pmid:29753597
    OpenUrlCrossRefPubMed
  20. 20.↵
    United Nations Framework Convention on Climate Change (UNFCC). Report of the Conference of the Parties on Its Sixteenth Session, Held in Cancun From 29 November to 10 December 2010. Part Two: Action Taken by the Conference of the Parties at its Sixteenth Session. UNFCCC; 2011. Accessed February 4, 2024. https://unfccc.int/event/cop-16#decisions_reports
  21. 21.↵
    United Nations Framework Convention on Climate Change (UNFCC). Report of the Conference of the Parties on Its Twenty-First Session, Held in Paris From 30 November to 13 December 2015. Part One: Proceedings. UNFCCC; 2016. Accessed February 4, 2024. https://unfccc.int/documents/9096
  22. 22.↵
    2. Mullan M,
    3. Kingsmill N,
    4. Kramer AM,
    5. Agrawala S
    . National Adaptation Planning: Lessons from OECD Countries. OECD Environment Working Papers No. 54. OECD; 2013. doi:10.1787/5k483jpfpsq1-en
    OpenUrlCrossRef
  23. 23.↵
    World Health Organization (WHO). Health in National Adaptive Plans: Review. WHO; 2021. Accessed January 25, 2024. https://www.who.int/publications/i/item/9789240023604
  24. 24.↵
    2. Woodruff SC,
    3. Regan P
    . Quality of national adaptation plans and opportunities for improvement. Mitig Adapt Strategies Glob Change. 2019;24(1):53–71. doi:10.1007/s11027-018-9794-z
    OpenUrlCrossRef
  25. 25.↵
    2. Watts N,
    3. Amann M,
    4. Arnell N, et al
    . The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. Lancet. 2019;394(10211):1836–1878. doi:10.1016/S0140-6736(19)32596-6. pmid:31733928
    OpenUrlCrossRefPubMed
  26. 26.
    2. Francis D,
    3. Cohen G,
    4. Bhatt J,
    5. Brask C,
    6. Devnani M,
    7. Surgenor G
    . How healthcare can help heal communities and the planet. BMJ. 2019;365:l2398. doi:10.1136/bmj.l2398. pmid:31209177
    OpenUrlFREE Full Text
  27. 27.↵
    2. Mendelsohn R,
    3. Dinar A,
    4. Williams L
    . The distributional impact of climate change on rich and poor countries. Environ Dev Econ. 2006;11(2):159–178. doi:10.1017/S1355770X05002755
    OpenUrlCrossRef
  28. 28.↵
    2. Logie CH,
    3. Okumu M,
    4. Kibuuka Musoke D, et al
    . Intersecting stigma and HIV testing practices among urban refugee adolescents and youth in Kampala, Uganda: qualitative findings. J Int AIDS Soc. 2021;24(3):e25674. doi:10.1002/jia2.25674. pmid:33713571
    OpenUrlCrossRefPubMed
  29. 29.↵
    2. Singh NS,
    3. Aryasinghe S,
    4. Smith J,
    5. Khosla R,
    6. Say L,
    7. Blanchet K
    . A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises. BMJ Glob Health. 2018;3(2):e000682. doi:10.1136/bmjgh-2017-000682. pmid:29736272
    OpenUrlAbstract/FREE Full Text
  30. 30.↵
    2. Zhao M,
    3. Running SW
    . Drought-induced reduction in global terrestrial net primary production from 2000 through 2009. Science. 2010;329(5994):940–943. doi:10.1126/science.1192666. pmid:20724633
    OpenUrlAbstract/FREE Full Text
  31. 31.
    2. Lobell DB,
    3. Burke MB,
    4. Tebaldi C,
    5. Mastrandrea MD,
    6. Falcon WP,
    7. Naylor RL
    . Prioritizing climate change adaptation needs for food security in 2030. Science. 2008;319(5863):607–610. doi:10.1126/science.1152339. pmid:18239122
    OpenUrlAbstract/FREE Full Text
  32. 32.
    2. Austin KF,
    3. Noble MD,
    4. Berndt VK
    . Drying climates and gendered suffering: links between drought, food insecurity, and women’s HIV in less-developed countries. Soc Indic Res. 2021;154(1):313–334. doi:10.1007/s11205-020-02562-x
    OpenUrlCrossRefPubMed
  33. 33.↵
    2. Weine SM,
    3. Kashuba AB
    . Labor migration and HIV risk: a systematic review of the literature. AIDS Behav. 2012;16(6):1605–1621. doi:10.1007/s10461-012-0183-4. pmid:22481273
    OpenUrlCrossRefPubMed
  34. 34.↵
    2. McMichael C,
    3. Barnett J,
    4. McMichael AJ
    . An ill wind? Climate change, migration, and health. Environ Health Perspect. 2012;120(5):646–654. doi:10.1289/ehp.1104375. pmid:22266739
    OpenUrlCrossRefPubMed
  35. 35.↵
    2. Lieber M,
    3. Chin-Hong P,
    4. Whittle HJ,
    5. Hogg R,
    6. Weiser SD
    . The synergistic relationship between climate change and the HIV/AIDS epidemic: a conceptual framework. AIDS Behav. 2021;25(7):2266–2277. doi:10.1007/s10461-020-03155-y. pmid:33452659
    OpenUrlCrossRefPubMed
  36. 36.↵
    2. Pozniak A,
    3. Atzori A,
    4. Marotta C,
    5. Di Gennaro F,
    6. Putoto G
    . HIV continuity of care after Cyclone Idai in Mozambique. Lancet HIV. 2020;7(3):e159–e160. doi:10.1016/S2352-3018(20)30045-X. pmid:32142712
    OpenUrlCrossRefPubMed
  37. 37.↵
    2. Low AJ,
    3. Frederix K,
    4. McCracken S, et al
    . Association between severe drought and HIV prevention and care behaviors in Lesotho: a population-based survey 2016–2017. PLoS Med. 2019;16(1):e1002727. doi:10.1371/journal.pmed.1002727. pmid:30640916
    OpenUrlCrossRefPubMed
  38. 38.↵
    2. Robinson J,
    3. Yeh E
    . Transactional sex as a response to risk in Western Kenya. Am Econ J Appl Econ. 2011;3(1):35–64. doi:10.1257/app.3.1.35
    OpenUrlCrossRef
  39. 39.↵
    2. Burke M.
    3. Gong E,
    4. Jones, K
    . Income shocks and HIV in Africa. Econ J (Lond). 2015;125(585):1157–1189. doi:10.1111/ecoj.12149
    OpenUrlCrossRef
  40. 40.↵
    2. Coates SJ,
    3. Norton SA
    . The effects of climate change on infectious diseases with cutaneous manifestations. Int J Womens Dermatol. 2021;7(1):8–16. doi:10.1016/j.ijwd.2020.07.005. pmid:32838014
    OpenUrlCrossRefPubMed
  41. 41.
    2. Flahault A,
    3. de Castaneda RR,
    4. Bolon I
    . Climate change and infectious diseases. Public Health Rev. 2016;37(1):21. doi:10.1186/s40985-016-0035-2. pmid:29450063
    OpenUrlCrossRefPubMed
  42. 42.↵
    2. Baker RE
    . Climate change drives increase in modeled HIV prevalence. Clim Change. 2020;163(1):237–252. doi:10.1007/s10584-020-02753-y
    OpenUrlCrossRef
  43. 43.↵
    2. Nagata JM,
    3. Hampshire K,
    4. Epstein A, et al
    . Analysis of heavy rainfall in sub-Saharan Africa and HIV transmission risk, HIV prevalence, and sexually transmitted infections, 2005-2017. JAMA Netw Open. 2022;5(9):e2230282. doi:10.1001/jamanetworkopen.2022.30282. pmid:36074468
    OpenUrlCrossRefPubMed
  44. 44.↵
    2. Aibibula W,
    3. Cox J,
    4. Hamelin AM,
    5. Mamiya H,
    6. Klein MB,
    7. Brassard P
    . Food insecurity and low CD4 count among HIV-infected people: a systematic review and meta-analysis. AIDS Care. 2016;28(12):1577–1585. doi:10.1080/09540121.2016.1191613. pmid:27306865
    OpenUrlCrossRefPubMed
  45. 45.
    2. Frega R,
    3. Duffy F,
    4. Rawat R,
    5. Grede N
    . Food insecurity in the context of HIV/AIDS: a framework for a new era of programming. Food Nutr Bull. 2010;31(4):S292–S312. doi:10.1177/15648265100314S402. pmid:21214035
    OpenUrlCrossRefPubMed
  46. 46.↵
    2. Anema A,
    3. Vogenthaler N,
    4. Frongillo EA,
    5. Kadiyala S,
    6. Weiser SD
    . Food insecurity and HIV/AIDS: current knowledge, gaps, and research priorities. Curr HIV/AIDS Rep. 2009;6(4):224–231. doi:10.1007/s11904-009-0030-z. pmid:19849966
    OpenUrlCrossRefPubMed
  47. 47.↵
    2. Weiser SD,
    3. Young SL,
    4. Cohen CR, et al
    . Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS. Am J Clin Nutr. 2011;94(6):1729S–1739S. doi:10.3945/ajcn.111.012070. pmid:22089434
    OpenUrlAbstract/FREE Full Text
  48. 48.↵
    The Lancet HIV. The syndemic threat of food insecurity and HIV. Lancet HIV. 2020;7(2):e75. doi:10.1016/S2352-3018(20)30004-7. pmid:32027852
    OpenUrlCrossRefPubMed
  49. 49.↵
    2. Logie CH,
    3. Lys CL,
    4. Mackay K,
    5. MacNeill N,
    6. Pauchulo A,
    7. Yasseen AS III.
    . Syndemic factors associated with safer sex efficacy among Northern and indigenous adolescents in Arctic Canada. Int J Behav Med. 2019;26(4):449–453. doi:10.1007/s12529-019-09797-0. pmid:31218560
    OpenUrlCrossRefPubMed
  50. 50.↵
    2. Tsai AC,
    3. Hung KJ,
    4. Weiser SD
    . Is food insecurity associated with HIV risk? Cross-sectional evidence from sexually active women in Brazil. PLoS Med. 2012;9(4):e1001203. doi:10.1371/journal.pmed.1001203. pmid:22505852
    OpenUrlCrossRefPubMed
  51. 51.↵
    2. Miller JD,
    3. Frongillo EA,
    4. Weke E, et al
    . Household water and food insecurity are positively associated with poor mental and physical health among adults living with HIV in Western Kenya. J Nutr. 2021;151(6):1656–1664. doi:10.1093/jn/nxab030. pmid:33709134
    OpenUrlCrossRefPubMed
  52. 52.
    2. Young SL,
    3. Boateng GO,
    4. Jamaluddine Z, et al
    . The Household Water InSecurity Experiences (HWISE) Scale: development and validation of a household water insecurity measure for low-income and middle-income countries. BMJ Glob Health. 2019;4(5):e001750. doi:10.1136/bmjgh-2019-001750. pmid:31637027
    OpenUrlAbstract/FREE Full Text
  53. 53.
    2. Brewis A,
    3. Workman C,
    4. Wutich A,
    5. Jepson W,
    6. Young S
    ; Household Water Insecurity Experiences - Research Coordination Network (HWISE-RCN). Household water insecurity is strongly associated with food insecurity: evidence from 27 sites in low‐ and middle‐income countries. Am J Hum Biol. 2020;32(1):e23309. doi:10.1002/ajhb.23309. pmid:31444940
    OpenUrlCrossRefPubMed
  54. 54.↵
    2. Coates J,
    3. Swindale A,
    4. Bilinsky P
    . Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide. Version 3. FHI 360, Food and Nutrition Technical Assistance III Project; 2007. Accessed January 25, 2024. https://www.fantaproject.org/monitoring-and-evaluation/household-food-insecurity-access-scale-hfias
  55. 55.↵
    2. Nagata JM,
    3. Miller JD,
    4. Cohen CR, et al
    . Water insecurity is associated with lack of viral suppression and greater odds of AIDS-defining illnesses among adults with HIV in Western Kenya. AIDS Behav. 2022;26(2):549–555. doi:10.1007/s10461-021-03410-w. pmid:34373987
    OpenUrlCrossRefPubMed
  56. 56.↵
    2. West BS,
    3. Hirsch JS,
    4. El-Sadr W
    . HIV and H2O: tracing the connections between gender, water and HIV. AIDS Behav. 2013;17(5):1675–1682. doi:10.1007/s10461-012-0219-9. pmid:22660934
    OpenUrlCrossRefPubMed
  57. 57.↵
    2. Hannah DM,
    3. Lynch I,
    4. Mao F,
    5. Miller JD,
    6. Young SL,
    7. Krause S
    . Water and sanitation for all in a pandemic. Nat Sustain. 2020;3(10):773–775. doi:10.1038/s41893-020-0593-7
    OpenUrlCrossRef
  58. 58.↵
    2. Wutich A,
    3. Brewis A,
    4. Tsai A
    . Water and mental health. WIREs Water. 2020;7(5):e1461. doi:10.1002/wat2.1461
    OpenUrlCrossRef
  59. 59.↵
    2. Geere JAL,
    3. Hunter PR,
    4. Jagals P
    . Domestic water carrying and its implications for health: a review and mixed methods pilot study in Limpopo Province, South Africa. Environ Health. 2010;9(1):52. doi:10.1186/1476-069X-9-52. pmid:20796292
    OpenUrlCrossRefPubMed
  60. 60.↵
    2. Venkataramanan V,
    3. Geere JL,
    4. Thomae B, et al
    . In pursuit of ‘safe’ water: the burden of personal injury from water fetching in 21 low-income and middle-income countries. BMJ Glob Health. 2020;5(10):e003328. doi:10.1136/bmjgh-2020-003328. pmid:33115862
    OpenUrlAbstract/FREE Full Text
  61. 61.
    2. Rosinger AY,
    3. Young SL
    . The toll of household water insecurity on health and human biology: current understandings and future directions. WIREs Water. 2020;7(6):e1468. doi:10.1002/wat2.1468
    OpenUrlCrossRef
  62. 62.↵
    2. Boateng GO,
    3. Workman CL,
    4. Miller JD,
    5. Onono M,
    6. Neilands TB,
    7. Young SL
    . The syndemic effects of food insecurity, water insecurity, and HIV on depressive symptomatology among Kenyan women. Soc Sci Med. 2022;295:113043. doi:10.1016/j.socscimed.2020.113043. pmid:32482382
    OpenUrlCrossRefPubMed
  63. 63.↵
    2. Workman CL,
    3. Ureksoy H
    . Water insecurity in a syndemic context: understanding the psycho-emotional stress of water insecurity in Lesotho, Africa. Soc Sci Med. 2017;179:52–60. doi:10.1016/j.socscimed.2017.02.026. pmid:28254659
    OpenUrlCrossRefPubMed
  64. 64.↵
    2. Meason B,
    3. Paterson R
    . Chikungunya, climate change, and human rights. Health Hum Rights. 2014;16(1):105–112. pmid:25474599
    OpenUrlPubMed
  65. 65.↵
    2. Talman A,
    3. Bolton S,
    4. Walson JL
    . Interactions between HIV/AIDS and the environment: toward a syndemic framework. Am J Public Health. 2013;103(2):253–261. doi:10.2105/AJPH.2012.300924. pmid:23237167
    OpenUrlCrossRefPubMed
  66. 66.↵
    2. Voeten HACM,
    3. Vissers DCJ,
    4. Gregson S, et al
    . Strong association between in-migration and HIV prevalence in urban sub-Saharan Africa. Sex Transm Dis. 2010;37(4):240–243. doi:10.1097/OLQ.0b013e3181c3f2d0. pmid:19959971
    OpenUrlCrossRefPubMed
  67. 67.
    2. Thomas E,
    3. Ekperi L,
    4. LeBlanc TT, et al
    . Vulnerabilities associated with post-disaster declines in HIV-testing: decomposing the impact of Hurricane Sandy. PLoS Curr. 2018;10. pmid:30210933
    OpenUrlPubMed
  68. 68.
    2. Mason JB,
    3. Chotard S,
    4. Bailes A
    . Impact of drought and HIV on child nutrition in eastern and southern Africa. Food Nutr Bull. 2011;32. doi:10.1177/15648265100313s301. pmid:21049842
    OpenUrlCrossRefPubMed
  69. 69.
    2. Kwenti TE
    . Malaria and HIV coinfection in sub-Saharan Africa: prevalence, impact, and treatment strategies. Res Rep Trop Med. 2018;9:123–136. doi:10.2147/RRTM.S154501. pmid:30100779
    OpenUrlCrossRefPubMed
  70. 70.
    2. Rothan HA,
    3. Bidokhti MRM,
    4. Byrareddy SN
    . Current concerns and perspectives on Zika virus co-infection with arboviruses and HIV. J Autoimmun. 2018;89:11–20. doi:10.1016/j.jaut.2018.01.002. pmid:29352633
    OpenUrlCrossRefPubMed
  71. 71.
    2. Patterson KP,
    3. Mogelgaard K,
    4. Kabiswa C,
    5. Ruyoka R
    . Building resilience through family planning and climate adaptation finance: systematic review and opportunity analysis. Lancet Planet Health. 2019;3(Special Issue 1):S12. doi:10.1016/S2542-5196(19)30155-X
    OpenUrlCrossRef
  72. 72.↵
    2. Haakenstad A,
    3. Angelino O,
    4. Irvine CMS, et al
    . Measuring contraceptive method mix, prevalence, and demand satisfied by age and marital status in 204 countries and territories, 1970–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022;400(10348):295–327. doi:10.1016/S0140-6736(22)00936-9. pmid:35871816
    OpenUrlCrossRefPubMed
  73. 73.↵
    2. Bradshaw CJA,
    3. Brook BW
    . Human population reduction is not a quick fix for environmental problems. Proc Natl Acad Sci USA. 2014;111(46):16610–16615. doi:10.1073/pnas.1410465111. pmid:25349398
    OpenUrlAbstract/FREE Full Text
  74. 74.↵
    Oxfam. Extreme Carbon Inequality: Why the Paris Climate Deal Must Put the Poorest, Lowest Emitting and Most Vulnerable People First. Oxfam; 2015. Accessed January 25, 2024. https://oi-files-d8-prod.s3.eu-west-2.amazonaws.com/s3fs-public/file_attachments/mb-extreme-carbon-inequality-021215-en.pdf
  75. 75.↵
    Least Developed Countries Fund - LDCF. Global Environment Facility. November 28, 2023. Accessed January 25, 2024. https://www.thegef.org/what-we-do/topics/least-developed-countries-fund-ldcf
  76. 76.↵
    Intergovernmental Panel on Climate Change (IPCC). AR6: Climate Change 2023: Synthesis Report. IPCC; 2023. Accessed February 4, 2024. https://www.ipcc.ch/report/ar6/syr/
  77. 77.↵
    Population Reference Bureau (PRB). Making the Connection: Population Dynamics and Climate Compatible Development Recommendation From an Expert Working Group. PRB; 2014. Accessed February 4, 2024. https://www.prb.org/wp-content/uploads/2014/12/12012014-PHP-population-climate-full-paper.pdf
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Addressing the Impact of Climate Change on Sexual and Reproductive Health Among Adolescent Girls and Young Women in Low- and Middle-Income Countries
Paul A. Burns, Clive Mutunga
Global Health: Science and Practice Feb 2024, 12 (1) e2300374; DOI: 10.9745/GHSP-D-23-00374
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