Exploring a syndemic of poverty, cumulative violence, and HIV vulnerability among refugee youth: multi-method insights from a humanitarian setting in Uganda

Logie, Carmen H., Loutet, Miranda G., Okumu, Moses, Coelho, Madelaine, Odong Lukone, Simon, Kisubi, Nelson, Latif, Maya, McAlpine, Alyssa and Kyambadde, Peter, (2023). Exploring a syndemic of poverty, cumulative violence, and HIV vulnerability among refugee youth: multi-method insights from a humanitarian setting in Uganda. AIDS Care, 36 36-43

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  • Sub-type Journal article
    Author Logie, Carmen H.
    Loutet, Miranda G.
    Okumu, Moses
    Coelho, Madelaine
    Odong Lukone, Simon
    Kisubi, Nelson
    Latif, Maya
    McAlpine, Alyssa
    Kyambadde, Peter
    Title Exploring a syndemic of poverty, cumulative violence, and HIV vulnerability among refugee youth: multi-method insights from a humanitarian setting in Uganda
    Appearing in AIDS Care
    Volume 36
    Publication Date 2023-11-03
    Place of Publication London
    Publisher Taylor & Francis
    Start page 36
    End page 43
    Language eng
    Abstract Synergistic associations between social inequities and HIV vulnerabilities - known as a syndemic - are understudied with youth in humanitarian settings. We explored refugee youths' HIV prevention needs in Bidi Bidi Refugee Settlement, Uganda. This multi-methods study involved 6 focus groups and 12 in-depth individual interviews (IDI) with refugee youth (n = 60) aged 16-24, and IDI with refugee elders (n = 8) and healthcare providers (n = 8). We then conducted cross-sectional surveys with refugee youth (16-24 years) (n = 115) to assess: poverty, recent sexual and gender-based violence (SGBV), and condom engagement motivation (CEM) (wanting to learn about condoms for HIV prevention). Multivariable logistic regression was used to estimate adjusted odds ratios for associations between poverty and SGBV with CEM. Qualitative narratives revealed poverty and trauma elevated substance use, and these converged to exacerbate SGBV. SGBV and transactional sex increased HIV vulnerabilities. Among survey participants, poverty and recent SGBV were associated with reduced odds of CEM. The interaction between poverty and recent SGBV was significant: the predicted probability of CEM among youth who experienced both poverty and SGBV was almost half than among youth who experienced poverty alone, SGBV alone, or neither. Findings signal the confluence of poverty, violence, and substance use elevate refugee youth HIV vulnerabilities.
    Keyword HIV risks
    Refugee
    Uganda
    poverty
    syndemics
    violence
    youth
    Copyright Holder Taylor & Francis
    Copyright Year 2024
    Copyright type All rights reserved
    DOI 10.1080/09540121.2023.2277151
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    Created: Sat, 21 Sep 2024, 01:28:27 JST by Haideh Beigi on behalf of UNU INWEH