The role of context in shaping HIV testing and prevention engagement among urban refugee and displaced adolescents and youth in Kampala, Uganda: findings from a qualitative study. Issue 5 (2nd March 2021)

• Record Type: Journal Article
• Authors: Logie, Carmen H.; Okumu, Moses; Kibuuka Musoke, Daniel; Hakiza, Robert; Mwima, Simon; Kacholia, Vibhuti; Kyambadde, Peter; Kiera, Uwase Mimy; Mbuagbaw, Lawrence
• Other Names: Bandow Grace investigator.; Chang Aileen investigator.; Chua Ser‐Ling investigator.; Dlova Ncoza investigator.; Enbiale Wendemagegn investigator.; Forrestel Amy investigator.; Fuller Claire investigator.; Griffiths Christopher investigator.; Hay Rod investigator.; Hughes Jenny investigator.; Khan Sidra investigator.; Knapp Alexia investigator.; Linos Eleni investigator.; Logie Carmen investigator.; Lwin Su investigator.; Maatouk Ismael investigator.; Maurer Toby investigator.; Morrone Aldo investigator.; Muttardi Kayria investigator.; Olabi Bayanne investigator.; Padovese Valeska investigator.; Sethi Aisha investigator.; Wanat Kari investigator.; Williams Tori investigator.
• Is Part Of: Tropical medicine & international health. Volume 26:Issue 5(2021)
• Page Start: 572
• Page End: 581
• Publication Date: 2021-03-02
• Subjects: refugee and internally displaced -- HIV testing -- HIV self‐testing -- stigma -- Uganda -- adolescent and youth; Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.13560
• Languages: English
• ISSNs: 1360-2276

Abstract

Abstract: Objective: To explore experiences, preferences and engagement with HIV testing and prevention among urban refugee and displaced adolescents and youth in Kampala, Uganda, with a focus on the role of contextual factors in shaping access and uptake. Methods: This qualitative community‐based study with urban refugee and displaced youth aged 16–24 living in Kampala's informal settlements involved five focus groups (FG), including two with young women, two with young men, and one with sex workers from March to May 2019. We also conducted five in‐depth key informant interviews. We conducted thematic analysis informed by Campbell and Cornish's conceptualisation of material and symbolic contexts. Results: Refugee/displaced youth participants ( n = 44; mean age: 20.25, SD: 2.19; men: n = 17; women: n = 27) were from the Democratic Republic of Congo ( n = 29), Rwanda ( n = 11), Burundi ( n = 3) and Sudan ( n = 1). Participant narratives reflected material and symbolic contexts that shaped HIV testing awareness, preferences and uptake. Material contextual factors that presented barriers to HIV testing and prevention engagement included transportation costs to clinics, overcrowded living conditions that limited access to private spaces, low literacy and language barriers. Symbolic contexts that constrained HIV testing engagement included medical mistrust of HIV testing and inequitable gender norms. Religion emerged as an opportunity to connect with refugee communities and to address conservative religious positions on HIV and sexual health. Conclusion: Efforts to increase access and uptake along the HIV testing and prevention cascade can meaningfully engage urban refugee and displaced youth to develop culturally and contextually relevant services to optimise HIV and sexual health outcomes.