Top

BMC Public Health

Published in:

Open Access 01-12-2019 | Human Immunodeficiency Virus | Research article

Psychosocial correlates of self-reported HIV among youth in the slums of Kampala

Authors: Monica H. Swahn, Rachel Culbreth, Laura F. Salazar, Nazarius M. Tumwesigye, Rogers Kasirye

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Human immunodeficiency virus (HIV) rates are high in Uganda (6.7%), and rates are especially high among at-risk groups such as youth living in the slums of Kampala, Uganda. The objective of this study was to assess the psychosocial correlates, particularly alcohol use, associated with HIV among youth living in the slums of Kampala, Uganda.

Methods

Analyses are based on cross-sectional survey data collected in Spring of 2014. Participants comprised a convenience sample (N = 1134) of urban service-seeking youth living on the streets or in the slums, 12–18 years of age who were participating in a Uganda Youth Development Link drop-in center (56.1% female and 43.9% male). Chi-Square Tests were used to determine differences in the proportions of alcohol use patterns between self-reported HIV-positive and HIV-negative youth. Bivariate and multivariable logistic regression were conducted to determine the associated risk factors with self-reported HIV. Institutional Review Board approvals were obtained from the Georgia State University and the Uganda National Council for Science and Technology.

Results

Among the total sample of youth (N = 1103), 10.5% (n = 116) reported being HIV-positive. There were statistically significant differences between HIV-positive and HIV-negative youth on ever living on the streets (χ² =10.14, df = 1, p = 0.002), past 12-month alcohol use (χ² =16.38, df = 1, p < .0001), ever having sexual intercourse (χ² =14.52, df = 1, p = 0.0001), ever engaging in sex work (χ² =13.19, df = 1, p = 0.0003), inconsistent condom use in the past 3 months (χ² =5.03, df = 1, p = 0.03), and ever being raped (χ² =15.29, df = 1, p < 0.0001). A higher percentage of HIV-positive youth were classified as problem drinkers, defined by the CAGE scores (21.6% vs. 13.9%, respectively). In the multivariable analysis, previously being raped (OR: 1.70; 95% CI: 1.02, 2.83) and alcohol use without problem drinking (OR: 2.14; 95% CI: 1.24, 3.69) was associated with HIV.

Conclusion

Youth living in the slums of Kampala, Uganda have a high prevalence of HIV. These youth are in dire need of interventions which address both alcohol use behaviors and sexual risk behaviors to reduce further complications of their existing health conditions, including HIV.

UNAIDS. Gap Report; 2014. http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf.

World Health Organization Global Health Observatory Data. Uganda Country Data and Statistics. http://www.who.int/gho/countries/uga/en/. Acccessed 5 Oct 2017.

Swahn MH, Culbreth R, Salazar LF, Kasirye R, Seeley J. Prevalence of HIV and associated risks of sex work among youth in the slums of Kampala. AIDS Res Treat. 2016;2016:5360180. https://doi.org/10.1155/2016/5360180.CrossRefPubMedPubMedCentral

Swahn MH, Palmier JB, Kasirye R, Yao H. Correlates of suicide ideation and attempt among youth living in the slums of Kampala. Int J Environ Res Public Health. 2012;9(2):596–609. https://doi.org/10.3390/ijerph9020596.CrossRefPubMedPubMedCentral

Swahn MH, Gressard L, Palmier JB, Kasirye R, Lynch C, Yao H. Serious violence victimization and perpetration among youth living in the slums of Kampala, Uganda. West J Emerg Med. 2012;13(3) http://escholarship.org/uc/item/9h4660nd. Accessed 10 Sept 2015.CrossRefPubMedPubMedCentral

Swahn MH, Braunstein S, Kasirye R. Demographic and psychosocial characteristics of Mobile phone ownership and usage among youth living in the slums of Kampala, Uganda. West J Emerg Med. 2014;15(5):600–3. https://doi.org/10.5811/westjem.2014.4.20879.CrossRefPubMedPubMedCentral

Swahn MH, Dill LJ, Palmier JB, Kasirye R. Girls and young women living in the slums of Kampala. SAGE Open. 2015;5(2):2158244015580853. https://doi.org/10.1177/2158244015580853.CrossRef

Gilbert L, Raj A, Hien D, Stockman J, Terlikbayeva A, Wyatt G. Targeting the SAVA (substance abuse, violence, and AIDS) Syndemic among women and girls: a global review of epidemiology and integrated interventions. J Acquir Immune Defic Syndr. 2015;69:S118–27. https://doi.org/10.1097/QAI.0000000000000626.CrossRefPubMedPubMedCentral

Capaldi DM, Knoble NB, Shortt JW, Kim HK. A systematic review of risk factors for intimate partner violence. Partn Abus. 2012;3(2):231–80. https://doi.org/10.1891/1946-6560.3.2.231.CrossRef

10.

Campbell JC, Baty ML, Ghandour RM, Stockman JK, Francisco L, Wagman J. The intersection of intimate partner violence against women and HIV/AIDS: a review. Int J Inj Control Saf Promot. 2008;15(4):221–31. https://doi.org/10.1080/17457300802423224.CrossRef

11.

Kouyoumdjian FG, Calzavara LM, Bondy SJ, et al. Intimate partner violence is associated with incident HIV infection in women in Uganda. AIDS Lond Engl. 2013;27(8):1331–8. https://doi.org/10.1097/QAD.0b013e32835fd851.CrossRef

12.

Li Y, Marshall CM, Rees HC, Nunez A, Ezeanolue EE, Ehiri JE. Intimate partner violence and HIV infection among women: a systematic review and meta-analysis. J Int AIDS Soc. 2014;17:18845.CrossRefPubMedPubMedCentral

13.

Chersich MF, Rees HV, Scorgie F, Martin G. Enhancing global control of alcohol to reduce unsafe sex and HIV in sub-Saharan Africa. Glob Health. 2009;5:16. https://doi.org/10.1186/1744-8603-5-16.CrossRef

14.

Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prev Sci Off J Soc Prev Res. 2007;8(2):141–51. https://doi.org/10.1007/s11121-006-0061-2. CrossRef

15.

Mbulaiteye SM, Ruberantwari A, Nakiyingi JS, Carpenter LM, Kamali A, Whitworth JA. Alcohol and HIV: a study among sexually active adults in rural Southwest Uganda. Int J Epidemiol. 2000;29(5):911–5.CrossRefPubMed

16.

Oyefara JL. Food insecurity, HIV/AIDS pandemic and sexual behaviour of female commercial sex workers in Lagos metropolis, Nigeria. SAHARA J J Soc Asp HIV AIDS Res Alliance SAHARA Hum Sci Res Counc. 2007;4(2):626–35.

17.

Bukenya J, Vandepitte J, Kwikiriza M, Weiss HA, Hayes R, Grosskurth H. Condom use among female sex workers in Uganda. AIDS Care. 2013;25(6):767–74. https://doi.org/10.1080/09540121.2012.748863.CrossRefPubMed

18.

Mbonye M, Rutakumwa R, Weiss H, Seeley J. Alcohol consumption and high risk sexual behaviour among female sex workers in Uganda. Afr J AIDS Res AJAR. 2014;13(2):145–51. https://doi.org/10.2989/16085906.2014.927779.CrossRefPubMed

19.

Muldoon KA. A systematic review of the clinical and social epidemiological research among sex workers in Uganda. BMC Public Health. 2015;15:1226. https://doi.org/10.1186/s12889-015-2553-0.CrossRefPubMedPubMedCentral

20.

Coldiron ME, Stephenson R, Chomba E, et al. The relationship between alcohol consumption and unprotected sex among known HIV-discordant couples in Rwanda and Zambia. AIDS Behav. 2008;12(4):594–603. https://doi.org/10.1007/s10461-007-9304-x.CrossRefPubMed

21.

Kim EJ, Hladik W, Barker J, et al. Sexually transmitted infections associated with alcohol use and HIV infection among men who have sex with men in Kampala, Uganda. Sex Transm Infect. 2015. https://doi.org/10.1136/sextrans-2015-052034.CrossRefPubMed

22.

Brody C, Tuot S, Chhea C, Saphonn V, Yi S. Factors associated with sex work among at-risk female youth in Cambodia: a cross-sectional study. AIDS Care. 2015:1–8. https://doi.org/10.1080/09540121.2015.1096893.CrossRefPubMed

23.

Dias S, Gama A, Fuertes R, Mendão L, Barros H. Risk-taking behaviours and HIV infection among sex workers in Portugal: results from a cross-sectional survey. Sex Transm Infect. 2015;91(5):346–52. https://doi.org/10.1136/sextrans-2014-051697.CrossRefPubMed

24.

Le TT, Nguyen QC, Tran HT, Schwandt M, Lim HJ. Correlates of HIV infection among street-based and venue-based sex workers in Vietnam. Int J STD AIDS. 2015. https://doi.org/10.1177/0956462415608556.CrossRef

25.

Lang DL, Salazar LF, DiClemente RJ, Markosyan K. Gender based violence as a risk factor for HIV-associated risk behaviors among female sex workers in Armenia. AIDS Behav. 2013;17(2):551–8. https://doi.org/10.1007/s10461-012-0245-7.CrossRefPubMed

26.

Zachariah R, Spielmann MP, Harries AD, Nkhoma W, Chantulo A, Arendt V. Sexually transmitted infections and sexual behaviour among commercial sex workers in a rural district of Malawi. Int J STD AIDS. 2003;14(3):185–8. https://doi.org/10.1258/095646203762869197.CrossRefPubMed

27.

Uganda Youth Development Link | Official Website. http://www.uydel.org/. Accessed 31 Aug 2015.

28.

World Health Organization. Global school-based student health survey. http://www.who.int/chp/gshs/en/. Acccessed 5 Oct 2017.

29.

Conigrave KM, Hall WD, Saunders JB. The AUDIT questionnaire: choosing a cut-off score. Alcohol use disorder identification test. Addict Abingdon Engl. 1995;90(10):1349–56.CrossRef

30.

National Institute on Alcohol Abuse and Alcoholism, American Psychiatric Association. CAGE Questionnaire; 2002. http://pubs.niaaa.nih.gov/publications/inscage.htm.

31.

Romer D, Sznitman S, DiClemente R, et al. Mass media as an HIV-prevention strategy: using culturally sensitive messages to reduce HIV-associated sexual behavior of at-risk African American youth. Am J Public Health. 2009;99(12):2150–9. https://doi.org/10.2105/AJPH.2008.155036.CrossRefPubMedPubMedCentral

32.

USAid. Uganda AIDS Indicator Survey. https://dhsprogram.com/pubs/pdf/AIS10/AIS10.pdf. Acccessed 5 Oct 2017.

33.

USAID. Demographic Health Survey. https://www.usaid.gov/what-we-do/global-health/cross-cutting-areas/demographic-and-health-surveys-program. Acccessed 5 Oct 2017.

34.

Rotheram-Borus MJ, Tomlinson M, Durkin A, Baird K, DeCelles J, Swendeman D. Feasibility of using soccer and job training to prevent drug abuse and HIV. AIDS Behav. 2016;20(9):1841–50. https://doi.org/10.1007/s10461-015-1262-0.CrossRefPubMedPubMedCentral

35.

Dunbar MS, Kang Dufour M-S, Lambdin B, Mudekunye-Mahaka I, Nhamo D, Padian NS. The SHAZ! Project: results from a pilot randomized trial of a structural intervention to prevent HIV among adolescent women in Zimbabwe. PLoS One. 2014;9(11):e113621. https://doi.org/10.1371/journal.pone.0113621.CrossRefPubMedPubMedCentral

36.

Mufune P. Street youth in southern Africa. Int Soc Sci J. 2000;52(164):233–43. https://doi.org/10.1111/1468-2451.00254.CrossRef

37.

Oppong Asante K, Meyer-Weitz A, Petersen I. Substance use and risky sexual behaviours among street connected children and youth in Accra, Ghana. Subst Abuse Treat Prev Policy. 2014;9:45. https://doi.org/10.1186/1747-597X-9-45.CrossRefPubMedPubMedCentral

Title: Psychosocial correlates of self-reported HIV among youth in the slums of Kampala
Authors: Monica H. Swahn
Rachel Culbreth
Laura F. Salazar
Nazarius M. Tumwesigye
Rogers Kasirye
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Human Immunodeficiency Virus
Acquired Immune Deficiency Syndrome
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7480-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Psychosocial correlates of self-reported HIV among youth in the slums of Kampala

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2019

The Safe Pregnancy study - promoting safety behaviours in antenatal care among Norwegian, Pakistani and Somali pregnant women: a study protocol for a randomized controlled trial

“A good little tool to get to know yourself a bit better”: a qualitative study on users’ experiences of app-supported menstrual tracking in Europe

“If you can, change this system” -Pregnant asylum seekers‘ perceptions on social determinants and material circumstances affecting their health whilst living in state-provided accommodation in Germany - a prospective, qualitative case study

Barriers and facilitators to adoption, implementation and sustainment of obesity prevention interventions in schoolchildren– a DEDIPAC case study

Environmental injustice and childhood lead exposure in peri-urban (ger) areas of Darkhan and Erdenet, Mongolia

Influence of anonymous HIV testing on national HIV surveillance in the Republic of Korea (2000 to 2015): a retrospective analysis