Associations Between Extreme Weather Events, Resource Insecurities, and HIV Vulnerabilities Among Adolescent Girls...

Extreme weather events (EWE) may elevate HIV risk across Sub-Saharan Africa by worsening resource insecurities, yet limited research has included adolescent girls and young women (AGYW). We examined associations between EWE exposure, resource insecurities, and HIV vulnerabilities among AGYW in Kenya. We conducted a community-based cross-sectional survey with a purposive sample of AGYW aged 16-24 in Nairobi and Kisumu. We used latent profile analysis (LPA) to identify resource insecurity profiles based on food, water, and sanitation access; multinomial logistic regression to assess associations between past-year EWE exposure and profile membership; and multivariable regression to assess associations between profile membership and HIV vulnerabilities (transactional sex, intimate partner violence [IPV], adolescent sexual and reproductive health stigma [ASRH-S], sexual relationship power [SRP]). LPA categorized participants (n = 597; mean age: 20.13 years) into three profiles: mild, moderate, and severe insecurity. Multiple EWE exposure (vs. 1 EWE) was associated with increased odds of moderate (2-4 EWEs: Adjusted Relative Risk Ratio [aRRR]: 1.71, 95% Confidence Interval [CI] = 1.03-2.83; > 5 EWEs: aRRR: 2.24, 95%CI: 1.10-4.53) and severe insecurity (≥ 5 EWEs: aRRR: 6.55, 95%CI: 1.78-24.05). The severe resource insecurity group reported increased transactional sex (aOR = 4.72; 95%CI: 2.45-9.07), IPV (aOR = 3.02; 95%CI: 1.22-7.48), and ASRH-S (aβ = 1.88; 95%CI: 0.45-3.30), and lower SRP (aβ = -3.16; 95%CI: -5.85, -0.47), than those with mild insecurity. EWE exposure is associated with heightened resource insecurities, which are linked to HIV vulnerabilities among AGYW in Kenya. Findings highlight the need for climate-responsive, gender and youth-tailored interventions to address multiple resource insecurities and strengthen HIV prevention with climate-affected Kenyan AGYW.