HIV-Related Stigma Among Youth Living With HIV in Western Uganda

Kimera, Emmanuel; Vindevogel, Sofie; Engelen, Anne-Mie; Maeyer, Jessica De; Reynaert, Didier; Kintu, Mugenyi Justice; Rubaihayo, John; Bilsen, Johan

doi:10.1177/10497323211012347

Cited by 10 publications

(11 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, baseline data do suggest our sample is fairly representative of AYAH in Kenyan and Ugandan schools, and similar to school‐age cohorts throughout Anglophone Africa. Our findings agree with previous studies that despite the optimism brought by a sense of agency, school intensifies stigma triggers, with boarding schools especially ideal for such triggers to flourish and interrupt ART adherence [35, 50, 51].…”

Section: Discussionsupporting

confidence: 92%

“I was still very young”: agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda

et al. 2022

View full text Add to dashboard Cite

Introduction Adolescents and young adults living with HIV (AYAH) have the lowest rates of retention in HIV care and antiretroviral therapy (ART) adherence, partly due to the demands of school associated with this life stage, to HIV‐related stigma and to fears of serostatus disclosure. We explore the implications of school‐based stigma and disclosure on the development of agency during a critical life stage in rural Kenya and Uganda. Methods We conducted a qualitative study in the baseline year of the SEARCH Youth study, a combination intervention using a life‐stage approach among youth (15–24 years old) living with HIV in western Kenya and southwestern Uganda to improve viral load suppression and health outcomes. We conducted in‐depth, semi‐structured interviews in 2019 with three cohorts of purposively selected study participants (youth [n = 83], balanced for sex, life stage and HIV care status; recommended family members of youth [n = 33]; and providers [n = 20]). Inductive analysis exploring contextual factors affecting HIV care engagement revealed the high salience of schooling environments. Results Stigma within school settings, elicited by non‐consensual serostatus disclosure, medication schedules and clinic appointments, exerts a constraining factor around which AYAH must navigate to identify and pursue opportunities available to them as young people. HIV status can affect cross‐generational support and cohort formation, as AYAH differ from non‐AYAH peers because of care‐related demands affecting schooling, exams and graduation. However, adolescents demonstrate a capacity to overcome anticipated stigma and protect themselves by selectively disclosing HIV status to trusted peers and caregivers, as they develop a sense of agency concomitant with this life stage. Older adolescents showed greater ability to seek out supportive relationships than younger ones who relied on adult caregivers to facilitate this support. Conclusions School is a potential site of HIV stigma and also a setting for learning how to resist such stigma. School‐going adolescents should be supported to identify helpful peers and selectively disclose serostatus as they master decision making about when and where to take medications, and who should know. Stigma is avoided by fewer visits to the clinic; providers should consider longer refills, discreet packaging and long‐acting, injectable ART for students.

show abstract

Section: Discussionsupporting

confidence: 92%

“I was still very young”: agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda

et al. 2022

View full text Add to dashboard Cite

show abstract

“…For instance, in Thailand and Cambodia, 25.6% of ALWHIV reported experiencing stigma [11]. This trend is also evident in Uganda, where stigma is characterized by demeaning attitudes, gossip, and discrimination, even extending to those whose parents succumbed to HIV [17][18][19][20]. Key drivers of HIV stigma include the status disclosure, societal myths, and misconceptions about HIV.…”

Section: Introductionmentioning

confidence: 99%

Double Stigma Among Pregnant Adolescents Living With HIV in Northern Uganda: A Pilot Cross-Sectional Study

Olum,

Mukasa,

Geng

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Despite a global decline in HIV/AIDS incidence, adolescent girls and young women in sub-Saharan Africa remain disproportionately affected. Pregnant adolescents living with HIV/AIDS (ALWHIV) in Uganda may experience dual stigma from their HIV status and pregnancy. However, this remains unexplored, limiting targeted interventions. This study assessed the burden and factors associated with stigma among pregnant ALWHIV in Northern Uganda. Methods We analyzed baseline data from a pilot quasi-experimental study conducted between June and September 2023 at two tertiary hospitals to evaluate the feasibility of group therapy. All pregnant adolescents aged 10–19 with a confirmed diagnosis of HIV/AIDS were enrolled consecutively after informed consent. Stigma was determined using the HIV-stigma scale for children (HSS-10) and adolescent pregnancy stigma scale, and composite scores were normalized to a scale of 0–100 for comparison. Linear regression models were used to identify factors associated with HIV and pregnancy stigma in STATA 18.0. Results A total of 40 pregnant ALWHIV, 20 from each facility, were enrolled. The mean participant age was 18.2 years (SD: 0.9), 95% were school dropouts, and 60% were married or cohabiting. About 35% acquired HIV/AIDS perinatally, while 37.5% had a prior pregnancy. The median HIV-stigma score was 29/40 (IQR: 26–32), and the mean pregnancy stigma score was 46.5/75.0 (SD: 9.7). HIV stigma score was significantly higher than the adolescent pregnancy stigma score (median difference: 10.0%, p = 0.001), and pregnancy stigma had a strong positive correlation with HIV stigma (ρ = 0.67, p < 0.0001). HIV stigma was significantly associated with not living with a spouse/partner (adjusted β: 8.51, 95% CI: 0.17, 16.85, p = 0.046) and rural residence (β: 11.65, 95% CI: 2.36, 20.94, p = 0.046). Pregnancy stigma was significantly associated with not living with a spouse/partner (β: 15.51, 95% CI: 5.94, 25.08, p = 0.002) and not receiving support with domestic tasks at home (β: 13.84, 95% CI: 3.59, 24.08, p = 0.009). Conclusion Pregnant ALWHIV in our study faced significant stigma to HIV/AIDS and pregnancy, and this is significantly associated with not living with the marital partner. Those in rural settings also experienced higher HIV stigma, while those experiencing pregnancy stigma were more likely not to be receiving support with domestic tasks at home. Further research is needed on comprehensive support programs to alleviate the burden and enhance maternal and child health outcomes.

show abstract

“…Our previous research in Uganda documented that adversities and challenges reported by youths living with HIV (YLWH) are not only due to the impact of HIV on their health, but are typically compounded through interactions with these surrounding systems ( Kimera et al, 2020a , b ). Although social attitudes and public discourses have evolved considerably since the emergence of the pandemic in the 1980s, they are shown to be still predominantly negative, stigmatizing and disempowering in Uganda ( Obare et al, 2011 ; Nabunya et al, 2020 ; Kimera et al, 2020b ; Kimera et al, 2021 ) and elsewhere ( Sangowawa and Owoaje, 2012 ; Mburu et al, 2014 ; Dahlui et al, 2015 ; Asamoah et al, 2017 ; Crowley et al, 2021 ; Adams et al, 2022 ). These social conditions create additional, everyday adversities for these youths, leading to self-devaluation ( Filiatreau et al, 2021 ), occupational deprivation ( Kimera et al, 2020a ) and discrimination ( Sangowawa and Owoaje, 2012 ), among other consequences that jeopardize their well-being.…”

Section: Introductionmentioning

confidence: 99%

Social ecological resources for youths living with HIV in western Uganda

Vindevogel,

Kimera

2023

Front. Psychol.

Self Cite

View full text Add to dashboard Cite

IntroductionThe adversities faced by youths living with HIV (YLWH) are manifold, resulting not only from the health impact but also from society’s response to HIV and the people living with it. This study sought to explore these youths’ perceptions and representations of what promotes resilience.MethodsPhotovoice methodology was chosen to elicit first-person accounts that are grounded in lived experience and experiential knowledge. Eleven young people, boys and girls aged 14–21 living in western Uganda, participated in seven group sessions aimed at imagining, producing and discussing visual stories about what fosters resilience in the face of HIV-related adversity. The visual stories were subjected to inductive content analysis by the participants, and then thematically analyzed and interpreted by the researchers using the theoretical framework of social-ecological resilience.ResultsWe found that participants experience well-being amidst HIV-related adversity through managing tensions in material resources, sense of identity, power and control in their lives, cultural adherence, relationships, sense of cohesion and social justice.DiscussionThe findings add to the body of knowledge on youth resilience in Sub-Saharan Africa by documenting multisystemic resources for YLWH in Ugandan communities. The findings further show that resources are highly incidental and situational, neither widely available nor structurally embedded in society. The study therefore informs the global HIV/AIDS agenda to spur ecologies of resilience around YLWH.

show abstract

HIV-Related Stigma Among Youth Living With HIV in Western Uganda

Cited by 10 publications

References 51 publications

“I was still very young”: agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda

“I was still very young”: agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda

Double Stigma Among Pregnant Adolescents Living With HIV in Northern Uganda: A Pilot Cross-Sectional Study

Social ecological resources for youths living with HIV in western Uganda

Contact Info

Product

Resources

About