Psychosocial health concerns among service-seeking orphans in the slums of Kampala

Swahn, Monica H.; Culbreth, Rachel; Staton, Catherine A.; Kasirye, Rogers

doi:10.1080/17450128.2017.1290306

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…Our study found parental death to be a significant event due to both loss of economic and social support which impacted the drug use trajectories of many WWUDHIV. This is in line with data from other studies that have found orphanhood to be associated with drug use [ 28 ]. A life course perspective complements the life history approach by considering the influence of broader social, cultural, and economic factors that shape adolescent girls and young women’s life trajectories.…”

Section: Discussionsupporting

confidence: 92%

From trauma to transmission: exploring the intersection of adversity, substance use, and HIV risk in women’s life histories

West,

Kussaga,

Rittenhouse

et al. 2023

Int J Equity Health

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Background At increased risk for poor health outcomes, physical and/or sexual violence, and onward transmission of HIV, women who use drugs and are living with HIV (WWUDHIV) are vulnerable and in need of services. Understanding the role of trauma across their life history may offer insights into HIV and drug use prevention and opportunities for intervention. We explored trauma and drug use among WWUDHIV in Dar es Salaam, Tanzania. Methods We conducted in-depth interviews with 30 WWUDHIV from January-March 2019. Interviewers used semi-structured interview guides and asked questions about the life history as related to drug use. Interviews were audio recorded, transcribed, translated, coded, and life histories charted. We utilized content analysis. Results Participants described death of family members as traumatic catalysts for drug use. Sexual partners early in their life history were often the point of introduction to drugs and source of HIV acquisition. Death of partners was present across many life histories and was a traumatic event negatively influencing life trajectories, including start of sex work for survival or to support drug use. Sex work in-turn often led to traumatic events including sexual and/or physical violence. HIV diagnosis for many participants followed the start of drug use, frequently occurred during pregnancy or severe illness and was described by most participants as a trauma. Despite this, particularly during pregnancy, HIV diagnosis was a turning point for some participant’s desire to engage in drug use treatment. Traumatic events were often cumulative and regularly described as catalysts for poor mental health that could lead to new or increased drug use for coping. Conclusions These findings suggest trauma is common in the life history of WWUDHIV and has negative impacts on drug use and HIV vulnerability. Our life history charting highlights the cumulative and cyclical nature of trauma and drug use in this population. This study allows for better understanding of trauma, drug use, and HIV prevention, which offers opportunities for intervention among a group with limited access to services: during adolescence for orphaned youth, following the death of a child or partner, and when vulnerable women engage with the health system (HIV diagnosis, pregnancy, illness).

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Section: Discussionsupporting

confidence: 92%

From trauma to transmission: exploring the intersection of adversity, substance use, and HIV risk in women’s life histories

West,

Kussaga,

Rittenhouse

et al. 2023

Int J Equity Health

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“…Among the youth who reported drinking, problem drinking was associated with orphan status in both the separate gender logistic models and the overall logistic model. Alcohol prevention interventions for orphans should be examined for this population, as orphans are also at a heightened risk of experiencing other adverse health outcomes [38].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Context of Alcohol Use, Problem Drinking and Alcohol-Related Harm among Youth Living in the Slums of Kampala, Uganda

Swahn

Culbreth

Salazar

et al. 2020

IJERPH

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Background. The purpose of this paper is to investigate the prevalence and context of alcohol use, problem drinking and alcohol-related harm among boys and girls in the slums of Kampala, Uganda. Methods. The Kampala Youth Survey is a cross-sectional study conducted in 2014 among youth (ages 12–18 years) living in the slums of Kampala (n = 1133) who were participating in Uganda Youth Development Link (UYDEL) centers. Chi-square tests were used to determine differences in alcohol use behaviors between 1) gender (boys vs. girls), and 2) alcohol use behaviors between problem drinkers and non-problem drinkers, stratified by gender. Results. Among all participants (n = 1133), the prevalence of any alcohol use in the past 12 months was 31% (n = 346). A higher percentage of girl drinkers reported having sex in the past month, without a condom (57.9%) due to alcohol consumption, compared to boy drinkers (41.9%) ( χ 2 = 8.09, df = 1, p = 0.005). For girl and boy drinkers, nearly half (49.5% and 44.1%, respectively) met the criteria for problem drinkers, measured using the Cut-Annoyed-Guilty-Eye-Opener (CAGE) questionnaire. Conclusions. The high prevalence of alcohol use and problem drinking among youth, as well as alcohol-related harm, warrant urgent alcohol prevention and intervention strategies, particularly among these underserved girls.

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“…Additionally, there is a hypothesized bidirectional relationship between depression and the SAVA syndemic components [13][14][15][16][17]. Lastly, orphanhood is strongly associated with alcohol use and substance abuse more broadly [18,19]. Through a lack of parental oversight, orphans may engage in risky sexual behaviors, potentially leading to HIV infection [20,21].…”

Section: Introductionmentioning

confidence: 99%

The Intersection of Alcohol Use, Gender Based Violence and HIV: Empirical Findings among Disadvantaged Service-Seeking Youth in Kampala, Uganda

et al. 2021

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The SAVA syndemic is frequently used to describe the co-occurrence of HIV, gender-based violence (GBV), and substance use. In this study we determine the extent to which the typologies of the SAVA syndemic can be described and utilized for intervention strategies among youth living in the slums of Kampala, Uganda. We analyzed the "Kampala Youth Survey 2014," a cross-sectional survey conducted in the spring of 2014, consisting of a convenience sample (N = 1134) of urban youth (12-18 years of age). Descriptive statistics were computed for hypothesized risk factors and demographic variables among the 8 typologies of GBV, HIV, and alcohol use. Multinomial logistic regression was conducted to determine statistically significant correlates with each typology. The overall prevalence of GBV was 31.7%, whereas the overall prevalence of alcohol use in the past 12 months was 31.2%. HIV-Positive youth comprised 10.5% of the total sample. Females comprised the majority of the typology with no SAVA components compared to males (55% vs. 45%, respectively), as well as the SAVA syndemic typology (GBV + HIV + ALC +) (58% vs. 42%, respectively). Engaging in commercial sex work (36%), witnessing parental abuse (61%), and depression/suicidality (81%) were all highly prevalent among youth in the SAVA syndemic typology (GBV, HIV, and alcohol use). Sex work and observing parental abuse were associated with the SAVA syndemic typology in the multivariable model. In our study, alcohol rarely coexisted without GBV among the typologies. Therefore, prevention efforts including structural interventions may be particularly warranted in vulnerable populations to address alcohol use, which may directly or indirectly impact GBV and HIV.

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Psychosocial health concerns among service-seeking orphans in the slums of Kampala

Cited by 9 publications

References 10 publications

From trauma to transmission: exploring the intersection of adversity, substance use, and HIV risk in women’s life histories

From trauma to transmission: exploring the intersection of adversity, substance use, and HIV risk in women’s life histories

The Prevalence and Context of Alcohol Use, Problem Drinking and Alcohol-Related Harm among Youth Living in the Slums of Kampala, Uganda

The Intersection of Alcohol Use, Gender Based Violence and HIV: Empirical Findings among Disadvantaged Service-Seeking Youth in Kampala, Uganda

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