Grant: Project Grant

THE ISSUE: Climate change impacts are increasing, including through extreme weather events such as heat, floods and drought, and affect the most marginalized communities. HIV also affects marginalized communities, in particular gay, bisexual, and other men who have sex with men (gbMSM). Knowledge gaps persist regarding how extreme weather events (EWE) impact HIV prevention outcomes with gbMSM in high HIV prevalence and climate-affected contexts such as Kenya. OUR IDEA: This innovative study focuses on gbMSM in Kenya to better understand pathways from climate change-related factors such as EWE to HIV prevention outcomes. OUR APPROACH: This 3-year mixed-methods study is a collaboration with community-based agencies and clinics engaged in HIV prevention with gbMSM in Kenya. We hypothesize that extreme weather events will affect HIV prevention outcomes via pathways of: migration, stigma, and health practices. We will examine pathways between: a) structural factors and resource insecurity (food insecurity, water insecurity); b) resource scarcity and HIV prevention; and c) protective factors that mitigate the effects of climate change on HIV prevention outcomes. Ultimately findings will inform climate-resilient HIV prevention strategies tailored for gbMSM. Phase 1: PREPARE: we will conduct qualitative research to develop and pilot test surveys. Phase 2: UNDERSTAND: We will conduct a prospective longitudinal cohort study with gbMSM in Nairobi and Mombasa. We will conduct surveys at 3 timepoints, at 6-month intervals, including during a rainy and a dry season, complimented by longitudinal qualitative interviews. Phase 3: MOBILIZE: We will conduct mixed-methods integration, followed by a Designation which is a problem-solving event to meaningfully engage gbMSM in developing climate-informed HIV prevention. IMPACT: New knowledge of pathways and mechanisms through which climate change-related factors shape HIV prevention needs among gbMSM in HIV and climate-affected regions.