‘I still desire to have a child’: a qualitative analysis of intersectional HIV- and childlessness-related stigma in rural southwestern Uganda

Background: Key populations have a disproportionate burden of HIV compared with the general population. HIV-related stigma has been recognized as a major barrier to HIV prevention and treatment efforts. It remains unclear whether HIV-related stigma is a significant driver of HIV transmission risk behavior among boda boda (motorcycle taxi) riders, a key population in Uganda. Methods: We conducted a cross-sectional study among boda boda motorcyclists in Mbarara Municipality of southwestern Uganda. Using multistage sampling, we recruited participants aged 18–59 years who had been riding for at least 6 months. The primary explanatory variable of interest was HIV-related stigma, measured using the 7-item STRIVE scale and dichotomized at “no stigma” versus “any stigma.” Self-reported HIV transmission risk behaviors included: condomless sexual intercourse, sexual intercourse under the influence of alcohol, having non-primary sexual partners, and sexual intercourse with a commercial sex worker. We used multivariable logistic regression to estimate the association between HIV-related stigma and HIV transmission risk behavior. Results: We enrolled 401 boda boda motorcyclists. All were men. Most [330 (82%)] were classified as having HIV-related stigma, particularly among younger men aged 18–29 years. One hundred and thirty-two (34%) participants reported their last sexual encounter was with a non-primary partner, 153 (39%) did not know the serostatus of their last sexual partner, and 138 (36%) reported sexual intercourse with a sex worker in the past 6 months. In multivariable logistic regression, HIV-related stigma (adjusted odds ratio [aOR] = 1.88, 95% CI: 1.06–3.34) had a statistically significant association with any HIV transmission risk behavior. Men who reported either minimal alcohol use (aOR = 1.81, 95% CI: 1.07–2.95) or harmful alcohol use (aOR = 3.5, 95% CI: 1.92–6.54), compared with men who reported no alcohol use, also reported greater odds of HIV transmission risk behavior. Conclusions: HIV transmission risk behavior is common among boda boda motorcyclists in the municipality and is associated with both HIV-related stigma and alcohol use. Interventions aimed at reducing HIV-related stigma and alcohol use may potentially reduce the high rates of HIV transmission risk behavior in this key population.

Download Full-text

HIV-Related Stigma among People with HIV and their Families: A Qualitative Analysis

AIDS and Behavior ◽

10.1007/s10461-007-9231-x ◽

2007 ◽

Vol 12 (2) ◽

pp. 244-254 ◽

Cited By ~ 127

Author(s):

Laura M. Bogart ◽

Burton O. Cowgill ◽

David Kennedy ◽

Gery Ryan ◽

Debra A. Murphy ◽

...

Keyword(s):

Qualitative Analysis ◽

Related Stigma

Download Full-text

Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

BMC Public Health ◽

10.1186/s12889-021-11547-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Moses Muwanguzi ◽

Henry Mark Lugobe ◽

Elastus Ssemwanga ◽

Allan Phillip Lule ◽

Elizabeth Atwiine ◽

...

Keyword(s):

Young Adults ◽

Associated Factors ◽

Adolescents And Young Adults ◽

Hiv Care ◽

Multivariable Logistic Regression Analysis ◽

Factors Associated ◽

Retention In Hiv Care ◽

Related Stigma ◽

Perinatally Acquired ◽

Southwestern Uganda

Abstract Background Retention in HIV care contributes to antiretroviral therapy adherence, which is a key factor for improved treatment outcomes and prevention of drug resistance. However, HIV treatment among the youths is characterized by loss to follow up, poor adherence to ART, risk of treatment failure and high mortality rates compared to young children and adults. There is limited information about factors associated with retention of youths in HIV care in rural settings in Uganda. We aimed to determine retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda. Methods A cross-sectional study was conducted among youths aged 15–24 years who were receiving care at the HIV clinic at Kabuyanda HC IV who had been in care for at least 1 year before the study. We used an interviewer-administered questionnaire to collect socio-demographic information. Participant chart abstraction was used to collect information on HIV clinic attendance. We collected information on HIV related stigma using the 40-item Berger Stigma Scale. Chi-square test and multivariable logistic regression analysis were used to determine the factors associated with retention in HIV care with a significance level of < 0.05. Retention in HIV care was, defined as having sought care at least once per quarter in the 12 months prior to the study. Results We enrolled 102 participants with a mean age of 20.95 (SD ± 3.07) years. Two thirds (65.7%) of the youths had been retained in HIV care in the previous 12 months. In adjusted analyses, being male, married and had perinatally acquired HIV were independently associated with retention in HIV care. The association between HIV related stigma and retention in HIV care was not statistically significant. Conclusion Retaining adolescents and young adults in HIV care in rural southwestern Uganda is still much lower than the WHO target of 90%. Being male, having perinatally acquired HIV and married or in a relationship are associated with retention in HIV care. Interventions targeting adolescents and young adults living with HIV are necessary to improve retention in HIV care to the WHO target of 90%.

Download Full-text

Factors Influencing Utilization of HIV Testing Services among Boda-Boda Riders in Kabarole District, Southwestern Uganda: A Cross-Sectional Study

BioMed Research International ◽

10.1155/2021/8877402 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Vicent Ssekankya ◽

Stanley Kamau Githaiga ◽

Timothy Aleko ◽

Esther Faith Munguciada ◽

Vivian Patience Nabakka ◽

...

Keyword(s):

Hiv Testing ◽

Cross Sectional Study ◽

Hiv Care ◽

Sectional Study ◽

Cross Sectional ◽

Factors Influencing ◽

Related Stigma ◽

Hiv Testing Services ◽

Southwestern Uganda ◽

Hiv Aids

Background. HIV testing is an important step for entry and linkage into HIV care. Utilization of HIV testing services among transport workers may be challenging, because of the mobile nature of their jobs. We assessed utilization of HIV testing services and identified factors influencing the utilization of HIV testing services among motorcycle taxi (boda-boda) riders in Fort Portal Municipality, Kabarole District, Southwestern Uganda. Methods. We conducted a cross-sectional study among boda-boda riders, aged 18 years and above, from July 15 to July 29, 2020. We recruited participants through simple random sampling. Data were captured using a self-administered questionnaire. Binary logistic regression was used to identify factors associated with utilization of HIV testing services. Results. Of the 315 participants who received questionnaires, 305 (97%) responded. The mean age of the participants was 32 (±7.1) years and ranged from 18 to 55 years. Of the 305 participants, 238 reported having taken an HIV test and received results in the past 12 months, for an HIV testing utilization rate of 78.0% (95% CI: 73.0–82.6%). In multivariable analysis, participants who were less likely to utilize HIV testing services were those aged ≥30 years ( aOR = 0.33 ; 95% CI: 0.16–0.70, P = 0.004 ) and those who had HIV-related stigma ( aOR = 0.27 ; 95% CI: 0.08–0.88, P = 0.030 ). Participants who were more likely to utilize HIV testing services were those who knew HIV status of their primary partners ( aOR = 4.23 ; 95% CI: 1.24–14.49, P = 0.022 ) and those who had good knowledge on HIV/AIDS ( aOR = 3.94 ; 95% CI: 1.65–9.41, P = 0.002 ). Conclusions. Utilization of HIV testing services among the boda-boda riders in Fort Portal Municipality, Southwestern Uganda, was high. More efforts should focus on targeting older boda-boda riders for HIV testing, reduction of HIV-related stigma, improving knowledge on HIV/AIDS, and encouraging communication and disclosure between partners, in order to consolidate the gains made in HIV testing services in this bridge population.

Download Full-text

Retention in HIV Care and Associated Factors Among Youths Aged 15-24 Years in Rural Southwestern Uganda

10.21203/rs.3.rs-97997/v1 ◽

2020 ◽

Author(s):

Moses Muwanguzi ◽

Henry Mark Lugobe ◽

Elastus Ssemwanga ◽

Allan Phillip Lule ◽

Elizabeth Atwiine ◽

...

Keyword(s):

Young Adults ◽

Associated Factors ◽

Hiv Treatment ◽

Adolescents And Young Adults ◽

Hiv Care ◽

Limited Information ◽

Cross Sectional ◽

Retention In Hiv Care ◽

Related Stigma ◽

Southwestern Uganda

Abstract Background: Retention in HIV care contributes to antiretroviral therapy adherence, which is a key factor for improved treatment outcomes and prevention of drug resistance. However, HIV treatment among the youths is characterized by loss to follow up, poor adherence to ART, risk of treatment failure and high mortality rates compared to young children and adults. There is limited information about factors contributing to poor retention of youths in rural settings in Uganda. We aimed to determine the extent of retention in HIV care, level of and associated factors among youths aged 15-24 years in rural southwestern Uganda.Methods: A cross-sectional study was conducted among youths aged 15-24 years who were receiving care at the HIV clinic at Kabuyanda HC IV who had been in care for at least 1 year before the study. We used a researcher administered questionnaire to collect sociodemographic information and retention. We collected information on HIV related stigma using the 40-item Berger Stigma Scale. We used the SPSS chi-square test and regression analysis assess the association between predictors and retention HIV care, at 95% level of confidence and at a level of significance of 0.05. Retention in HIV care was, defined as having sought care at least once per quarter in the 12 months prior to the study. Results: We enrolled 102 participants with mean age of 20.95 (SD±3.07) years. Two thirds (65.7%) of the youths had been retained in HIV care in the previous 12 months. Retention in HIV care was significantly associated with female gender (AOR: 0.15, 95%CI 0.03-0.69, p=0.015), being a ‘Mukiga’ by tribe (AOR: 5.77, 95%CI 1.76-18.91, p=0.004) and being married or in a relationship (AOR: 0.18, 95%CI 0.06-0.53, p=0.002). The association between HIV related stigma and retention in HIV care was non-statistically significant.Conclusion: Retaining adolescents and young adults in HIV care in rural southwestern Uganda is still much lower than the WHO target of 90%. Being female and married or in a relationship are associated with good retention in HIV care. Interventions targeting adolescents and young adults are necessary to improve retention in HIV care to the WHO target of 90%.

Download Full-text