BACKGROUND Extreme weather events pose a risk to health and disproportionately affect vulnerable groups, such as people living with HIV. We aimed to investigate the effects of extreme weather events on HIV testing uptake, HIV treatment and care, and HIV transmission. METHODS For this systematic review, we searched PubMed, Web of Science, and PsycINFO for peer-reviewed studies published between database inception and Aug 31, 2023. Eligible studies were English-language qualitative, quantitative observational (retrospective, prospective, cross-sectional, longitudinal, case-control, and cohort), and mixed-method studies, and randomised controlled trials related to HIV and extreme weather events. We excluded reviews, mathematical models, and case reports. After exporting the search results, two authors independently screened the titles and abstracts of identified articles, reviewing the full text of those that met the inclusion criteria. We used systems thinking to develop a framework linking extreme weather events and HIV and summarised the results using thematic narrative synthesis. FINDINGS Of the 6126 studies identified by the search, 27 met the inclusion criteria and were eligible for analysis, of which 19 were quantitative, six were qualitative, and two were mixed-method studies. We identified five main themes linking extreme weather events to HIV: economic and livelihood conditions (12 studies), psychosocial factors (19 studies), infrastructure damage and operational challenges (17 studies), migration and displacement (ten studies), and associated medical conditions and health-care needs (12 studies). We showed how these themes interact in complex ways, resulting in a reduction in uptake of HIV testing, interruption of HIV care and subsequent disease progression, altered risk behaviours, and an increased prevalence of HIV. INTERPRETATION Extreme weather events are associated with disruptions to HIV services. Owing to the design of the included studies, we could not establish a causal relationship between extreme weather events and HIV incidence, highlighting a research gap. Appropriate adaptations and mitigation policies that protect the health and wellbeing of people living with HIV during and after extreme weather events are warranted. Such actions will be crucial to achieving the UNAIDS goal of ending HIV as a public health threat by 2030. FUNDING None.

中文翻译：

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极端天气事件和 HIV 服务中断：系统评价。


背景 极端天气事件对健康构成风险，对 HIV 感染者等弱势群体的影响尤为严重。我们旨在调查极端天气事件对 HIV 检测接受、HIV 治疗和护理以及 HIV 传播的影响。方法 对于本系统综述，我们在 PubMed、Web of Science 和 PsycINFO 中检索了从数据库建立到 2023 年 8 月 31 日发表的同行评审研究。符合条件的研究是英语定性、定量观察性（回顾性、前瞻性、横断面、纵向、病例对照和队列）和混合方法研究，以及与 HIV 和极端天气事件相关的随机对照试验。我们排除了综述、数学模型和病例报告。导出检索结果后，两位作者独立筛选了已确定文章的标题和摘要，并审查了符合纳入标准的文章的全文。我们使用系统思维开发了一个将极端天气事件与 HIV 联系起来的框架，并使用主题叙述综合总结了结果。结果 在检索确定的 6126 项研究中，27 项符合纳入标准并符合分析条件，其中 19 项是定量研究，6 项是定性研究，2 项是混合方法研究。我们确定了将极端天气事件与 HIV 联系起来的五个主要主题：经济和生计条件（12 项研究）、社会心理因素（19 项研究）、基础设施破坏和运营挑战（17 项研究）、迁移和流离失所（10 项研究）以及相关的医疗条件和医疗保健需求（12 项研究）。 我们展示了这些主题如何以复杂的方式相互作用，导致 HIV 检测的接受率降低、HIV 护理中断和随后的疾病进展、风险行为的改变以及 HIV 患病率的增加。解释 极端天气事件与 HIV 服务中断有关。由于纳入研究的设计，我们无法建立极端天气事件与 HIV 发病率之间的因果关系，这凸显了研究空白。有必要采取适当的调整和缓解政策，在极端天气事件期间和之后保护 HIV 感染者的健康和福祉。这些行动对于实现联合国艾滋病规划署（UNAIDS）到2030年消除艾滋病毒这一公共卫生威胁的目标至关重要。资金 无。