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other·public health, epidemiology, infectious disease, psychiatry, family medicine·PMC10209556

Extreme weather events and HIV: development of a conceptual framework through qualitative interviews with people with HIV impacted by the California wildfires and their clinicians

BMC Public Health · 5 authors, 3 centres

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TL;DR

Semi-structured qualitative interviews were conducted with 15 people with HIV and 7 clinicians impacted by Northern California wildfires to explore health effects and mitigation strategies. Wildfires were found to compound HIV-related trauma through five main pathways—healthcare access, mental health, physical health, social/economic impacts, and nutrition and exercise—and a conceptual framework was developed to guide future preparedness.

Full summary

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Researchers conducted individual semi-structured qualitative interviews between October 2021 and February 2022 with 15 people with HIV (PWH) and 7 clinicians in Northern California who were impacted by wildfires. The study identified five main routes by which wildfires negatively impacted health: access to healthcare, mental health, physical health, social/economic impacts, and nutrition and exercise. A conceptual framework was devised acknowledging wildfire impacts at community, household, and individual levels.

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other

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public health

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ORIGINAL PAPER

PMC10209556

Extreme weather events and HIV: development of a conceptual framework through qualitative interviews with people with HIV impacted by the California wildfires and their clinicians

BMC Public Health

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ABSTRACT

Abstract Background People with HIV (PWH) are disproportionately vulnerable to the impacts of wildfires, given the need for frequent access to healthcare systems, higher burden of comorbidities, higher food insecurity, mental and behavioral health challenges, and challenges of living with HIV in a rural area. In this study, we aim to better understand the pathways through which wildfires impact health outcomes among PWH. Methods From October 2021 through February 2022, we conducted individual semi-structured qualitative interviews with PWH impacted by the Northern California wildfires and clinicians of PWH who were impacted by wildfires. The study aims were to explore the influence of wildfires on the health of PWH and to discuss measures at the individual, clinic, and system levels that helped to mitigate these impacts. Results We interviewed 15 PWH and 7 clinicians. While some PWH felt that surviving the HIV epidemic added to their resilience against wildfires, many felt that the wildfires compounded the HIV-related traumas that they have experienced. Participants outlined five main routes by which wildfires negatively impacted their health: (1) access to healthcare (medications, clinics, clinic staff), (2) mental health (trauma; anxiety, depression, or stress; sleep disturbances; coping strategies), (3) physical health (cardiopulmonary, other co-morbidities), (4) social/economic impacts (housing, finances, community), and (5) nutrition and exercise. The recommendations for future wildfire preparedness were at the (1) individual-level (what to have during evacuation), (2) pharmacy-level (procedural, staffing), and (3) clinic- or county-level (funds and vouchers; case management; mental health services; emergency response planning; other services such as telehealth, home visits, home laboratory testing). Conclusions Based on our data and prior research, we devised a conceptual framework that acknowledges the impact of wildfires at the community-, household-, and individual-level with implications for physical and mental health outcomes among PWH. These findings and framework can help in developing future interventions, programs, and policies to mitigate the cumulative impacts of extreme weather events on the health of PWH, particularly among individuals living in rural areas. Further studies are needed to examine health system strengthening strategies, innovative methods to improve access to healthcare, and community resilience through disaster preparedness. Trial registration N/A. Keywords: HIV, Extreme weather events, Climate change, Wildfire, Mental health, Qualitative research, Intersection, California

CITATION EXPORT

Parya Saberi, Kristin Ming, Emily A Arnold et al.. Extreme weather events and HIV: development of a conceptual framework through qualitative interviews with people with HIV impacted by the California wildfires and their clinicians. BMC Public Health. (2023). https://doi.org/10.1186/s12889-023-15957-5

AUTHORS

5 · 3 CENTRES

Parya Saberi, Kristin Ming, Emily A Arnold, Anna M Leddy, Sheri D Weiser

1Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA USA
2Division of pulmonary and critical care medicine, University of California, San Francisco, San Francisco, CA USA
3Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA USA