Submission ID 131520
| Issue/Objective | Climate change-induced flooding poses a growing threat to health systems in low-income, flood-prone settings, with disproportionate impacts on vulnerable populations such as people living with chronic diseases like HIV/AIDS. In Uganda, recurrent flooding in districts such as Kasese disrupts healthcare infrastructure, service delivery, and access to essential HIV services. Continuity of antiretroviral therapy is critical for viral suppression and long-term health outcomes, yet climate-related disruptions increasingly undermine treatment adherence, service access, and health system resilience. This narrative review aimed to synthesise existing evidence on the impacts of flooding on service delivery, access to care, coping mechanisms among people living with HIV, and institutional responses in flood-prone settings. |
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| Methodology/Approach | This narrative review synthesised peer-reviewed literature, policy reports, and grey literature published between 2015 and 2025. The review focused on flood-prone, low-resource settings, with particular relevance to Uganda and sub-Saharan Africa. Included literature was analysed thematically, focusing on four domains: flood-related damage to health services, disruption of HIV care, patient-level coping strategies, and health authority responses. Findings were synthesised narratively, with attention to gender. |
| Results | The reviewed literature consistently indicated that flooding disrupts HIV service delivery by damaging health facilities, interrupting ART supply chains and limiting physical access to care. These disruptions contribute to missed clinic appointments, treatment interruptions, reduced adherence, and increased risks of opportunistic infections. Evidence suggests that women living with HIV face heightened barriers due to caregiving roles, mobility constraints, and increased exposure to stigma during displacement, while men may delay care due to gender norms. Women are particularly affected by transport and cost barriers. Coping mechanisms include reliance on social networks, community health workers, herbal medicine, and temporary relocation. Institutional responses remain largely reactive, with limited integration of HIV-specific preparedness into flood response frameworks. |
| Discussion/Conclusion | The findings highlight critical gaps in climate-resilient HIV service delivery, particularly, gender-responsive interventions. Strengthening HIV programme resilience through integrated climate-health planning, and targeted support for women is essential. |
| Presenters and Affiliations | Karen Helmy Ademun Makerere University Karen Helmy Ademun Makerere University Karen Helmy Ademun Makerere University Caroline Aboda Makerere University Karen Helmy Ademun Makerere University |
