TY - JOUR
T1 - The role of context in shaping HIV testing and prevention engagement among urban refugee and displaced adolescents and youth in Kampala, Uganda
T2 - findings from a qualitative study
AU - the Migrant Health Dermatology Working Group
AU - Logie, Carmen H.
AU - Okumu, Moses
AU - Kibuuka Musoke, Daniel
AU - Hakiza, Robert
AU - Mwima, Simon
AU - Kacholia, Vibhuti
AU - Kyambadde, Peter
AU - Kiera, Uwase Mimy
AU - Mbuagbaw, Lawrence
AU - Bandow, Grace
AU - Chang, Aileen
AU - Chua, Ser Ling
AU - Dlova, Ncoza
AU - Enbiale, Wendemagegn
AU - Forrestel, Amy
AU - Fuller, Claire
AU - Griffiths, Christopher
AU - Hay, Rod
AU - Hughes, Jenny
AU - Khan, Sidra
AU - Knapp, Alexia
AU - Linos, Eleni
AU - Logie, Carmen
AU - Lwin, Su
AU - Maatouk, Ismael
AU - Maurer, Toby
AU - Morrone, Aldo
AU - Muttardi, Kayria
AU - Olabi, Bayanne
AU - Padovese, Valeska
AU - Sethi, Aisha
AU - Wanat, Kari
AU - Williams, Tori
N1 - Funding Information:
We acknowledge all of the peer navigators and participants, as well as collaborating agencies: Ugandan Ministry of Health, Office of the Prime Minister, Young African Refugees for Integral Development (YARID), Most At Risk Populations Initiative (MARPI) and InterAid Uganda. Funding: Canadian Institutes of Health Research Project Grant. CHL also supported by the Canada Research Chairs Program, Canada Foundation for Innovation and Ontario Ministry of Research & Innovation.
Publisher Copyright:
© 2021 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd
PY - 2021/5
Y1 - 2021/5
N2 - 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.
AB - 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.
KW - HIV self-testing
KW - HIV testing
KW - Uganda
KW - adolescent and youth
KW - refugee and internally displaced
KW - stigma
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U2 - 10.1111/tmi.13560
DO - 10.1111/tmi.13560
M3 - Article
C2 - 33560587
AN - SCOPUS:85101943050
SN - 1360-2276
VL - 26
SP - 572
EP - 581
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 5
ER -