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.