This report compares the impact of El Niño-induced climate events in Southern Africa during the 2015/2016 and 2023/2024 cycles, with a focused lens on HIV, sexual and reproductive health and rights (SRHR) and related vulnerabilities including gender-based violence (GBV), food insecurity and displacement. The analysis highlights how climate shocks intensified existing HIV and SRHR challenges, despite specific improvements and applied learnings between the two time periods. An action brief is also available.