TY - JOUR
T1 - Sexually transmitted infection testing awareness, uptake and diagnosis among urban refugee and displaced youth living in informal settlements in Kampala, Uganda
T2 - A cross-sectional study
AU - Logie, Carmen Helen
AU - Okumu, Moses
AU - Mwima, Simon
AU - Kyambadde, Peter
AU - Hakiza, Robert
AU - Kibathi, Irungu Peter
AU - Kironde, Emmanuel
N1 - Funding Information:
Funding The study was supported by funding from the Canadian Institutes of Health Research (CIHR) and the Canada Foundation for Innovation. Funders played no role in study design or interpretation of findings. C. Logie was also supported by funding from the Ontario Ministry of Research & Innovation Early Researcher Award and the Canada Research Chairs Program.
Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background Sexually transmitted infection (STI) prevention needs among urban refugee and displaced youth are understudied. The study objective was to explore factors associated with the STI prevention cascade (STI services awareness, testing, diagnosis) among urban refugee and displaced youth in Kampala, Uganda. Methods We implemented a cross-sectional survey with youth aged 16-24 years in informal settlements in Kampala. We conducted bivariate and multivariable logistic regression analyses to identify social ecological (intrapersonal, interpersonal, community) level factors associated with STI testing services awareness, lifetime STI testing, and lifetime STI diagnosis. Results Participants (n=445; mean age 19.3, SD 2.6, years) included young women (n=333, 74.8%) and young men (n=112, 25.2%). Less than half (43.8%) were aware of community STI services. One-quarter (26.1%) reported lifetime STI testing. Of these, 39.5% reported a lifetime STI diagnosis. In multivariable analyses among young women, age, lifetime sex partners, and lower adolescent sexual and reproductive health (SRH)-related stigma were associated with STI services awareness; and age, lower adolescent SRH-related stigma, and food security were associated with STI testing. Among young men, time in Uganda and lower HIV-related stigma were associated with STI services awareness; and age, condom self-efficacy, and increased adolescent SRH-related stigma were associated with testing. Lifetime sex partners, lower condom self-efficacy, and lower adolescent SRH-related stigma were associated with lifetime STI diagnosis. Conclusions Social ecological factors including stigma (adolescent SRH-related, HIV-related) were associated with STI testing and diagnosis among young urban refugees. Gender, age and stigma-tailored strategies can advance the STI prevention cascade among urban young refugees.
AB - Background Sexually transmitted infection (STI) prevention needs among urban refugee and displaced youth are understudied. The study objective was to explore factors associated with the STI prevention cascade (STI services awareness, testing, diagnosis) among urban refugee and displaced youth in Kampala, Uganda. Methods We implemented a cross-sectional survey with youth aged 16-24 years in informal settlements in Kampala. We conducted bivariate and multivariable logistic regression analyses to identify social ecological (intrapersonal, interpersonal, community) level factors associated with STI testing services awareness, lifetime STI testing, and lifetime STI diagnosis. Results Participants (n=445; mean age 19.3, SD 2.6, years) included young women (n=333, 74.8%) and young men (n=112, 25.2%). Less than half (43.8%) were aware of community STI services. One-quarter (26.1%) reported lifetime STI testing. Of these, 39.5% reported a lifetime STI diagnosis. In multivariable analyses among young women, age, lifetime sex partners, and lower adolescent sexual and reproductive health (SRH)-related stigma were associated with STI services awareness; and age, lower adolescent SRH-related stigma, and food security were associated with STI testing. Among young men, time in Uganda and lower HIV-related stigma were associated with STI services awareness; and age, condom self-efficacy, and increased adolescent SRH-related stigma were associated with testing. Lifetime sex partners, lower condom self-efficacy, and lower adolescent SRH-related stigma were associated with lifetime STI diagnosis. Conclusions Social ecological factors including stigma (adolescent SRH-related, HIV-related) were associated with STI testing and diagnosis among young urban refugees. Gender, age and stigma-tailored strategies can advance the STI prevention cascade among urban young refugees.
KW - chlamydia
KW - education and training
KW - ethnic minority and cultural issues
KW - sexually transmitted infections
KW - teenagers
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U2 - 10.1136/bmjsrh-2019-200392
DO - 10.1136/bmjsrh-2019-200392
M3 - Article
C2 - 31871133
AN - SCOPUS:85077019080
SN - 2515-1991
VL - 46
SP - 192
EP - 199
JO - BMJ Sexual and Reproductive Health
JF - BMJ Sexual and Reproductive Health
IS - 3
ER -