Perceptions of health care services and HIV-related health-seeking behavior among Uganda adolescents

Abstract

Youth represent almost half of all new HIV infections globally. Although condom use is an effective method of HIV prevention among sexually active youth in sub-Saharan Africa (SSA), they face substantial barriers in obtaining condoms in environments where adults hold attitudes condemning premarital sex. More research is needed to better understand the multitude of factors that affect SSA youths' behaviors regarding safe sex practices, including factors that may influence their ability to obtain condoms, and decisions to be tested for HIV. In this study of Uganda youth (n = 1503) from five secondary schools, logistic regression models highlight factors that influence perceptions regarding respect and confidentiality at health centers, condom acquisition, and HIV testing. Family support appears to be an especially important factor that affects youth perceptions about how they will be treated when seeking condoms and HIV testing. Condom acquisition and HIV-testing behaviors are also associated with peer influence, self-esteem, and demographic characteristics, such as age.

Increased adolescent HIV testing with a hybrid mobile strategy in Uganda and Kenya

“…[18] Third, self-reported prior testing is subject to bias, but our findings are consistent with prior research. [10, 15] Lastly, in Uganda and Kenya adolescents >12 years can access HIV testing independent of parental consent; our findings may not be generalizable to settings where parental consent is required up to 18 or 21 years.…”

“…[10] This approach provided an opportunity for the majority of adolescent residents to access other prevention services, including sexual education and condoms , and could serve as a platform for introducing pre-exposure prophylaxis (PrEP) to at-risk youth. For HIV-infected adolescents, this approach offered a chance to ensure access to care and antiretroviral therapy (ART).…”

“…For HIV-infected adolescents, this approach offered a chance to ensure access to care and antiretroviral therapy (ART). Given the low rates of school attendance among adolescent women observed (annex), and relatively low use of clinic-based services by adolescents,[10, 11] approaches that are not dependent on accessing schools or clinics may be ideal for reaching a diverse group of adolescents in rural Africa. This approach reached early adolescents before a time of increased HIV risk - a critical window for prevention.…”

Evaluating oral HIV self-testing to increase HIV testing uptake among truck drivers in Kenya

“…We also found that participants' self-esteem score was significantly associated with greater odds of having tested in the previous six months and testing during follow-up in the complete case multivariable model. Another study in Uganda also explored the relationship between self-esteem and having ever tested for HIV and found no significant association (OR 1.0; p = 0.819), although its population was restricted to adolescents (Hampanda et al 2014). Certainly, future research is warranted to better understand if, and how, individual beliefs and attitudes influence HIV testing behavior.…”

Re-focusing HIV Prevention Messages: A Qualitative Study in Rural Uganda

“…We were surprised to find that despite decades of intensive HIV/AIDS education in Rakai condom use among youth continued to be confounded by misconceptions and shame-aspects which might be contributing in part to their limited uptake. Previous research also had demonstrated challenges ranging from limited access, to generational and gendered power dynamics that make it difficult to negotiate condom use, among youth [36,37]. Sustained efforts are needed to increase in-depth knowledge, dispel myths, and enhance access to condoms and HIV-prevention services for youth.…”