HIV Vulnerabilities Associated with Water Insecurity, Food Insecurity, and Other COVID-19 Impacts Among Urban Refugee Youth in Kampala, Uganda: Multi-method Findings.

Autor: Logie CH; Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada. carmen.logie@utoronto.ca.; United Nations University Institute for Water, Environment, and Health, Hamilton, ON, Canada. carmen.logie@utoronto.ca.; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. carmen.logie@utoronto.ca.; Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada. carmen.logie@utoronto.ca., Okumu M; School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL, USA., Admassu Z; Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada., Perez-Brumer A; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Ahmed R; Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada., Luna ML; Department of Geography and Planning, University of Toronto, Toronto, ON, Canada., MacKenzie F; Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada., Kortenaar JL; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Berry I; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Hakiza R; Young African Refugees for Integral Development (YARID), Kampala, Uganda., Katisi B; Young African Refugees for Integral Development (YARID), Kampala, Uganda., Musoke DK; International Research Consortium, Kampala, Uganda., Nakitende A; International Research Consortium, Kampala, Uganda., Batte S; Organization for Gender Empowerment and Rights Advocacy (OGERA) Uganda, Kampala, Uganda., Kyambadde P; National AIDS Control Program, Ministry of Health, Kampala, Uganda.; Most At Risk Population Initiative Clinic, Mulago Hospital, Kampala, Uganda., Taing L; United Nations University Institute for Water, Environment, and Health, Hamilton, ON, Canada., Giordana G; World Food Programme East Africa, Nairobi, Kenya., Mbuagbaw L; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada.; Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon.; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2024 Feb; Vol. 28 (2), pp. 507-523. Date of Electronic Publication: 2023 Dec 04.
DOI: 10.1007/s10461-023-04240-8
Abstrakt: Food insecurity (FI) and water insecurity (WI) are linked with HIV vulnerabilities, yet how these resource insecurities shape HIV prevention needs is understudied. We assessed associations between FI and WI and HIV vulnerabilities among urban refugee youth aged 16-24 in Kampala, Uganda through individual in-depth interviews (IDI) (n = 24), focus groups (n = 4), and a cross-sectional survey (n = 340) with refugee youth, and IDI with key informants (n = 15). Quantitative data was analysed via multivariable logistic and linear regression to assess associations between FI and WI with: reduced pandemic sexual and reproductive health (SRH) access; past 3-month transactional sex (TS); unplanned pandemic pregnancy; condom self-efficacy; and sexual relationship power (SRP). We applied thematic analytic approaches to qualitative data. Among survey participants, FI and WI were commonplace (65% and 47%, respectively) and significantly associated with: reduced SRH access (WI: adjusted odds ratio [aOR]: 1.92, 95% confidence interval [CI]: 1.19-3.08; FI: aOR: 2.31. 95%CI: 1.36-3.93), unplanned pregnancy (WI: aOR: 2.77, 95%CI: 1.24-6.17; FI: aOR: 2.62, 95%CI: 1.03-6.66), and TS (WI: aOR: 3.09, 95%CI: 1.22-7.89; FI: aOR: 3.51, 95%CI: 1.15-10.73). WI participants reported lower condom self-efficacy (adjusted β= -3.98, 95%CI: -5.41, -2.55) and lower SRP (adjusted β= -2.58, 95%CI= -4.79, -0.37). Thematic analyses revealed: (1) contexts of TS, including survival needs and pandemic impacts; (2) intersectional HIV vulnerabilities; (3) reduced HIV prevention/care access; and (4) water insecurity as a co-occurring socio-economic stressor. Multi-method findings reveal FI and WI are linked with HIV vulnerabilities, underscoring the need for HIV prevention to address co-occurring resource insecurities with refugee youth.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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