What has environment to do with AIDS? Maybe because so many people cannot see the links, there is little research on the environmental impacts on AIDS, and AIDS' impact on the environment. Trees used for coffins, and fire wood due to lack of income for widows not being allowed to inherit their deceased men, urbanisation, decreased production of crops, increased condom use threat etc. In this perspective I present some of the impacts of AIDS from an environmental angle.

The Environmental Perspective

12. The Environmental Perspective

In general, the coverage of environmental issues has increased; but little attention is paid to links between AIDS and the environment. In countries where the HIV prevalence rate is well over 20 percent, and AIDS deaths is massive, there are concerns over the effects on the professional classes, with losses of teachers, lawyers and administrators. However, a cut in the available labour force can also result in a potential for food shortages, with decreased productivity and supply chain related issues.
The age profile of people dying from AIDS shapes the pandemic's effects on a household level. In developing countries, where AIDS deaths are concentrated to prime working ages, particularly the 25-to-45 age group, the loss of a productive household member can be especially devastating to households already living in poverty.

Local natural resources are important means of sustenance and income-generation in many rural areas of developing countries. The health of the local environment can also shape individual vulnerability to HIV/AIDS in at least two ways. First, resource scarcity often deepens poverty in natural resource-dependent regions, as in much of rural sub-Saharan Africa. Research has demonstrated that desperate economic circumstances can heighten the risk of HIV infection by forcing individuals, particularly women and girls, to engage in "transactional sex" for material goods, sometimes to meet daily sustenance needs. Studies in Africa also reveal that when "Sugar Daddy" relationships involve large age differences or a substantial amount of assistance, women are more likely to engage in unsafe sex. Although transactional sex has not yet been linked to environmental context directly, local resource scarcity and risky sex behaviour are both clearly associated with a strong intermediary: poverty. Secondly, natural resource scarcity may lead to food insecurity and inadequate diet, which can further undermine the immune system of People Living With HIV or AIDS (PLWHA), as malnutrition increases the susceptibility of PLWHA to opportunistic infections. Research in Singapore also suggests that malnutrition may reduce the effectiveness of HIV or AIDS treatments. It has also been indicated that malnutrition increasing the risk of HIV transmission from mother to baby.

HIV and AIDS also shapes household use of the local environment, when it deprives families of the labour performed by household members, who are disabled or have died as a result of the disease. The labour shortage is also exacerbated when caregivers are drawn away from every day household chores. These are elements that influence decisions about the use of land resources, as highlighted above, a key component of many rural livelihoods. The Food and Agriculture Organisation (FAO) demonstrated evidence of these associations in a three-country study. The study found that agricultural productivity declined in AIDS-affected households. For example, in Kenya AIDS-affected households cultivated less area because less labour was available. And in South Africa, AIDS-affected households failed to weed their cultivated plots, reducing the all over agricultural productivity.

Larger areas of lands are also used for burying people. The impact on the environment depends on the tradition of the funeral. If the body is buried in a wooden coffin, or if it is first burned or cremated in a coffin and then buried, the environmental impact will differ, as well as if the ashes just are spread. Also the rituals surrounding the death has an impact in the environment, and mourning rituals in many rural areas of Africa require fires to be kept burning for up to five days. Related questions would be what happen to the soil, will it be contaminated, and what happens in a region where there are many AIDS deaths?
The consequences for the environment are not just that food productive land are used for cemeteries but also the depletion of treats, which takes place as a result of deaths.
In countries worst affected by AIDS, particularly in sub-Saharan Africa, poor nutrition means that people whose immune systems are damaged by HIV are more likely to get infections. Increasing numbers of AIDS orphans could be multiple affected as traditional knowledge about land use and livestock management may not be passed on to them from parents and other family members. Where only children and old people remain, what are their chances to continue the farming? (See the Financial Perspective.)
In the Environmental perspective there is also the migration from rural to urban areas. When people abandon the countryside and move to cities, the water and sewage systems are put on strain with waste and water contamination as consequences. Migration movements to urban from rural areas or displacement due to natural disasters or food shortages, is thus linked to both AIDS and environmental impacts. Cities will have more infected people, and wider sexual networks, increasing the risk of infection for those looking for work or trying to rejoin their families. When rural families leave or are no longer able to work the fields, land becomes ever more degraded and unproductive.

Steps are being taken to address the environmental impact of AIDS. Organisations such as the World Wildlife Fund support community-level interventions, with action on poverty being seen as a key component. In Brazil, the Natex condom factory in Xapuri pays an "environmental premium" to rubber tappers who conserve the forest and thus protecting the environment while providing 100 million condoms a year. The almost patented, non-reflected exhortations to use condoms, could in the long run, affect the land available producing crops. If everyone used condoms all the time having sex, the need for rubber trees would bee enormous, and could affect the landscape when crops for food is replaced by these rubber trees.

Even basic access to land may be lost because of AIDS illness and death, particularly in regions where women and children have access to land only through their husbands and fathers. In Kenya, the death of a male household head may cause women and children to lose possession of land rights because inheritance is patriarchal. Land is inherited or held in trust by male relatives, threatening access of female relatives to this essential component of rural livelihoods.

Local natural resources not only serve dietary needs, but are often used for energy as well. Additional evidence from South Africa suggests that impoverished households affected by adult mortality are more likely than other households to use wood rather than electricity or paraffin for cooking, as well as poor families are more likely to use firewood an others. Such intensified resource dependence can increase local environmental degradation, particularly in areas already overharvested (in some cases connected to coffins production).

Although operating at multiple levels and in many ways, the environmental dimensions of AIDS have received little attention in the policy arena. Few bridges exist between public health and environmental dialogue and policymaking, as evidenced by the lack of discussion of this intersection at the 2006 HIV/AIDS conference in Toronto. At the conference, the natural environment found a place on the program primarily within the context of food security. Although clearly a critical topic, food security is but one of many dimensions of the pandemic’s effect on the natural environment.

Recognising the associations between AIDS and the natural environment can contribute to the well-being of both human populations and local environments, particularly in regions characterised by high prevalence of HIV and natural resource dependence and scarcity.

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