Factor-Iwentash Faculty of Social Work, 7938University of Toronto, Toronto, ON, Canada.
Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
Int J STD AIDS. 2022 Mar;33(4):374-384. doi: 10.1177/09564624211069236. Epub 2022 Feb 5.
BACKGROUND: Urban refugee youth may live in social contexts characterized by structural drivers of HIV such as poverty and violence. Knowledge gaps remain regarding HIV testing practices among urban refugee youth, despite the increasing trend toward refugee settlement in urban contexts. This study examined social contextual factors associated with lifetime HIV testing among urban refugee youth in Kampala, Uganda. METHODS: We conducted a community-based study with a peer-recruited cohort of urban refugee youth aged 16-24 years living in Kampala's informal settlements, and present baseline cross-sectional findings. We conducted descriptive statistics and logistic regression to examine socio-demographic (e.g., gender and age), material (e.g., income insecurity and education), relational (e.g., social support), and symbolic contexts (e.g., HIV-related stigma and intimate partner violence (IPV]) associated with lifetime HIV testing. RESULTS: Participants ( = 450) had a mean age of 20.4 years (standard deviation: 2.4 years), most lived in Uganda for 1-5 years (53.2%), and less than half reported lifetime HIV testing (43.4%). In multivariable analyses, odds of lifetime HIV testing were higher among youth with secondary school education or higher (adjusted odds ratio (aOR]: 2.30, 95% confidence interval (CI]: 1.27-4.17), currently employed (aOR: 1.79, 95% CI: 1.03-3.10), and reporting IPV (aOR: 3.61, 95% CI: 1.43-9.10). Having children was marginally associated with HIV testing (aOR: 2.17, 95% CI: 0.98-4.81, = 0.052). CONCLUSIONS: Findings demonstrate suboptimal HIV testing and the importance of tailored strategies to reach urban refugee youth who are unemployed and have limited formal education. There is a need to meaningfully engage urban refugee youth to create enabling environments for sexual health.
背景:城市难民青年可能生活在以贫困和暴力等艾滋病毒结构性驱动因素为特征的社会环境中。尽管难民在城市环境中的定居趋势不断增加,但城市难民青年的艾滋病毒检测实践仍存在知识差距。本研究调查了乌干达坎帕拉非正规住区的城市难民青年一生中艾滋病毒检测与社会背景因素的关系。
方法:我们对一个由 16-24 岁的城市难民青年组成的同伴招募队列进行了一项基于社区的研究,并介绍了基线横断面研究结果。我们进行了描述性统计和逻辑回归分析,以检查与一生中艾滋病毒检测相关的社会人口统计学(如性别和年龄)、物质(如收入不稳定和教育)、关系(如社会支持)和象征意义(如艾滋病毒相关耻辱和亲密伴侣暴力(IPV])。
结果:参与者(n=450)的平均年龄为 20.4 岁(标准差:2.4 岁),大多数人在乌干达居住 1-5 年(53.2%),不到一半的人报告一生中进行过艾滋病毒检测(43.4%)。在多变量分析中,具有中学或以上学历的青年一生中进行艾滋病毒检测的几率较高(调整后的优势比(aOR):2.30,95%置信区间(CI):1.27-4.17),目前就业(aOR:1.79,95%CI:1.03-3.10),以及报告亲密伴侣暴力(aOR:3.61,95%CI:1.43-9.10)。有子女与艾滋病毒检测略有相关(aOR:2.17,95%CI:0.98-4.81,P=0.052)。
结论:研究结果表明,艾滋病毒检测情况不理想,需要制定有针对性的战略,以覆盖失业和正规教育程度有限的城市难民青年。有必要让城市难民青年积极参与,为性健康创造有利环境。
PLOS Glob Public Health. 2024-2-14