Contribution of Water, Sanitation and Hygiene (WASH) Interventions to Reducing Mortality among People Living with HIV in Mozambique

The HIV response in Mozambique requires an approach that links clinical care with the social, economic and environmental determinants of health. INSIDA 2021 estimated a national HIV prevalence of 12.5% among adults aged 15 and over, corresponding to about 2.097 million people, and a viral load suppression rate of 64.1% among adults living with HIV. In this context, access to safe water, adequate sanitation and hygiene conditions, collectively known as WASH, may play a complementary role in preventing infections and clinical complications. This article analyses the extent to which WASH interventions can contribute to reducing mortality among people living with HIV (PLHIV), drawing on INSIDA 2021 data, the National Strategic Plan for the HIV and AIDS Response 2021–2025 (PEN V) and the available scientific evidence. The analysis shows that PEN V establishes the reduction of AIDS-related deaths and the strengthening of health and community systems as priorities, although it does not present WASH as a specific intervention within its response package. International literature indicates that water treatment and safe storage can reduce episodes of diarrhoea among PLHIV; however, data on the direct effect of WASH interventions on mortality remain inconclusive. It is concluded that WASH may contribute indirectly to preventing deaths associated with infectious complications, but this effect cannot be quantified for Mozambique with the evidence identified.Keywords: WASH; HIV; mortality; opportunistic infections; safe water; sanitation; hygiene; Mozambique.