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

H Logie, Carmen, Okumu, Moses, Admassu, Zerihun, Perez-Brumer, Amaya, Ahmed, Rushdia, Lahai Luna, Marianne, MacKenzie, Frannie, Kortenaar, Jean-Luc, Berry, Isha, Hakiza, Robert, Katisi, Brenda, Kibuuka Musoke, Daniel, Nakitende, Aidah, Batte, Shamilah, Kyambadde, Peter, Taing, Lina, Giordana, Gio and Mbuagbaw, Lawrence, (2023). HIV Vulnerabilities Associated with Water Insecurity, Food Insecurity , and Other COVID-19 Impacts Among Urban Refugee Youth in Kampala, Uganda: Multi-method Findings. AIDS and Behavior, 28 507-523

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  • Sub-type Journal article
    Author H Logie, Carmen
    Okumu, Moses
    Admassu, Zerihun
    Perez-Brumer, Amaya
    Ahmed, Rushdia
    Lahai Luna, Marianne
    MacKenzie, Frannie
    Kortenaar, Jean-Luc
    Berry, Isha
    Hakiza, Robert
    Katisi, Brenda
    Kibuuka Musoke, Daniel
    Nakitende, Aidah
    Batte, Shamilah
    Kyambadde, Peter
    Taing, Lina
    Giordana, Gio
    Mbuagbaw, Lawrence
    Title HIV Vulnerabilities Associated with Water Insecurity, Food Insecurity , and Other COVID-19 Impacts Among Urban Refugee Youth in Kampala, Uganda: Multi-method Findings
    Appearing in AIDS and Behavior
    Volume 28
    Publication Date 2023-12-04
    Place of Publication N/A
    Publisher Springer Nature
    Start page 507
    End page 523
    Language eng
    Abstract 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.
    Keyword Condom efficacy
    Transactional sex
    Food insecurity
    Water insecurity
    Refuges
    Youth
    Uganda
    Copyright Holder Springer Nature
    Copyright Year 2024
    Copyright type All rights reserved
    DOI 10.1007/s10461-023-04240-8
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    Created: Fri, 27 Sep 2024, 02:36:44 JST by Haideh Beigi on behalf of UNU INWEH