Perceived challenges of ambient temperatures and water scarcity on antiretroviral (ARV) adherence for people living with HIV in Greater Gaborone, Botswana

Keywords: HIV, antiretroviral therapy adherence, climate variability, water shortages, water rationing
Session Type: Virtual Paper Abstract
Day: Saturday
Session Start / End Time: 2/26/2022 08:00 AM (Eastern Time (US & Canada)) - 2/26/2022 09:20 AM (Eastern Time (US & Canada))
Room: Virtual 68

Abstract

Countries with the highest human immunodeficiency virus (HIV) prevalence, Botswana, Eswatini, Lesotho and South Africa are also experiencing an increase in climate variability, rising temperatures and drought. This study purpose was to investigate perceived challenges of high temperatures and water scarcity/rationing on monthly clinic attendance and antiretroviral (ARV) adherence for people living with HIV in Greater Gaborone, Botswana. A systematic random sample of adult women [n=419], including 67 pregnant women and mothers, and men [n=239] attending 21 HIV clinics were surveyed. Health care workers [n=84] were interviewed. Close-ended and open -ended questions were analyzed using logistic and multilevel models and content analysis. Women and men reporting exposure to high temperatures were at increased odds of ARV non-adherence, especially in rural areas; missing clinic appointments due to heat in rural areas and water rationing in peri-urban and rural areas increased the odds of ARV non-adherence; almost half of respondents reported water rationing negatively affected their health; and perceptions of available clinic services during water shortages, differed for some men and health care providers. Infrastructural and health education messaging improvements are needed in HIV clinics, particularly in rural villages to adapt to climate variability and ensure ARV adherence for people living with HIV in these areas.