Contextualizing HIV testing experiences within the HIV prevention cascade: qualitative insights from refugee youth in Bidi Bidi refugee settlement, Uganda

Logie, Carmen Helen, Okumu, Moses, Loutet, Miranda, Coelho, Madelaine, McAlpine, Alyssa, MacKenzie, Frannie, Odong Lukone, Simon, Kisubi, Nelson, Kalungi, Hakim, Lukone, Okello Jimmy and Kyambadde, Peter, (2024). Contextualizing HIV testing experiences within the HIV prevention cascade: qualitative insights from refugee youth in Bidi Bidi refugee settlement, Uganda. BMC Public Health, 24 2599, (2024)-n/a

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  • Sub-type Journal article
    Author Logie, Carmen Helen
    Okumu, Moses
    Loutet, Miranda
    Coelho, Madelaine
    McAlpine, Alyssa
    MacKenzie, Frannie
    Odong Lukone, Simon
    Kisubi, Nelson
    Kalungi, Hakim
    Lukone, Okello Jimmy
    Kyambadde, Peter
    Title Contextualizing HIV testing experiences within the HIV prevention cascade: qualitative insights from refugee youth in Bidi Bidi refugee settlement, Uganda
    Appearing in BMC Public Health
    Volume 24
    Publication Date 2024-09-27
    Place of Publication Berlin
    Publisher Springer Nature
    Start page 2599, (2024)
    End page n/a
    Language eng
    Abstract Abstract Background There remain key knowledge gaps regarding HIV testing needs and priorities among refugee youth in low and middle-income country (LMIC) humanitarian settings. The HIV prevention cascade framework focuses on three domains (motivation, access, effective use) central to prevention uptake, yet is understudied in relationship to HIV testing, particularly among refugee youth. Uganda is an exemplar context to explore refugee youth HIV testing needs and priorities as it hosts 1.5 million refugees and is Africa’s largest refugee hosting nation. In this study, we explored perceptions and experiences regarding HIV testing among refugee youth living in Bidi Bidi refugee settlement, Uganda. Methods We conducted a community-based research study in Bidi Bidi Refugee Settlement, one of the world’s largest refugee settlements with over 195,000 residents. This qualitative study involved four focus groups (2 with young women, 2 with young men) with refugee youth aged 16–24 living in Bidi Bidi refugee settlement. We applied thematic analysis informed by the HIV prevention cascade to understand domains of motivation, access, and effective use that emerged as salient for HIV testing engagement. Results Participants (n=40; mean age: 20 years, standard deviation: 2.2) included refugee young women (n=20) and young men (n=20), of whom 88% had a lifetime HIV test and 58% had ever heard of HIV self-testing. Participant discussions described HIV testing motivation was influenced by dimensions of: HIV treatment and testing knowledge; risk perception; positive and negative consequences of use; and social norms regarding gender and age. Access to HIV testing was shaped by: limited availability; distance and language barriers; confidentiality concerns; and affordability. Effective use of and engagement with HIV testing was related to HIV serostatus knowledge self-efficacy and in/equitable partner dynamics. Conclusions Complex, multi-level factors shape motivation for, access to, and effective use of HIV testing among refugee youth in Bidi Bidi. Findings align with the HIV prevention cascade framework that helps to identify gaps to inform intervention development with youth in humanitarian settings. HIV testing approaches tailored for refugee youth in contexts such as Bidi Bidi can foster HIV prevention and treatment literacy, gender equity, gender-based violence prevention, and intersectional stigma reduction.
    Keyword Refugee and internally displaced
    HIV testing
    HIV self-testing
    Humanitarian
    Uganda
    Adolescent and youth
    HIV prevention
    Copyright Holder author(s)
    Copyright Year 2024
    Copyright type Creative commons
    DOI https://doi.org/10.1186/s12889-024-20135-2
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    Created: Tue, 22 Oct 2024, 23:24:21 JST by Haideh Beigi on behalf of UNU INWEH