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‘It never rains, but it pours’ – disasters triggered by natural hazards, sexual risk-taking behaviour, and the role of health systems: a worldwide ecological analysis - 20/07/22

Doi : 10.1016/j.joclim.2022.100158 
Cato Dambre 1, 2, Nick Julien Baumgart 3, Sarah Feron 4, Ofer Engel 5, Hamed Seddighi 1, 5, Olivier Degomme 6, Valentina Gallo 1,
1 Department of Sustainable Health, Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands 
2 Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium 
3 Bachelor degree of Global Responsibility and Leadership, Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands 
4 Department of Knowledge Infrastructure, Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands 
5 Department of Governance and Innovation, Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands 
6 International Centre for Reproductive Health, University of Ghent, Ghent, Belgium 

Correspondence to: Associate Professor, Campus Fryslân, University of Groningen, Wirdumerdijk 34, 8911 CE Leeuwarden, NetherlandsAssociate Professor, Campus FryslânUniversity of GroningenWirdumerdijk 34, 8911 CE Leeuwarden, Netherlands

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Abstract

Background

: Natural hazards have become more frequent and more severe as a result of climate change. Their increasing impact has a negative effect on people's health, including mental health. The aim of this ecological study is to investigate the association between exposure to disasters triggered by natural hazards and higher sexual risk-taking behavior as measured by one of its consequences, increased human immunodeficiency virus (HIV) incidence, at the country-level, worldwide.

Methods

: All data were extracted from publicly available sources. Crude and adjusted linear regression models were built to explore the association between the proportion of people affected by natural hazards and HIV incidence. Multivariable models included socio-demographic variables (literacy, income and age), and therapy coverage and the healthcare access and quality index.

Results

: In the crude regression model, the total number of people affected by natural hazards over a 5 year time period is positively associated with HIV incidence. For every 10 new people per 100,000/year affected by natural hazards, the HIV incidence in the country was 1.5 higher per 1,000 uninfected. However, when adjusting for socio-demographic variables, the association is lost. In the fully adjusted multivariable model, only antiretroviral therapy coverage and health care access and quality were significantly positively and negatively associated with HIV incidence. No interaction was found by income groups, world regions or categories of high and low HIV prevalence.

Conclusion

: Globally, no association between exposure to natural hazards and increased sexual risk-taking behavior at country level worldwide was detected after accounting for socio-demographic variables. Nonetheless, countries with a higher proportion of the population affected by disasters triggered by natural hazards were also those witnessing a higher incidence rate of HIV, possibly through the mediating effect of disrupted health system coverage, highlighting the coexistence of different vulnerabilities for public health.

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Keywords : Disasters triggered by Natural Hazards, Risk-taking Behavior, Sexual Risk-taking Behavior, HIV Incidence, Ecological Analysis, Public Health, health systems


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© 2022  Publié par Elsevier Masson SAS.
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