Abstract
ObjectiveLittle is known about HIV infection and the related vulnerabilities of young people living in resource-scarce, post-emergency transit camps that are now home to thousands of Internally Displaced Persons (IDPs) following two decades of war in northern Uganda. The objective of this analysis was to assess the prevalence and correlates of HIV infection among young people living in post-conflict transition in Gulu District, northern Uganda.MethodsIn 2010, a cross-sectional demographic and behavioural survey was conducted in two of Gulu District’s sub-counties with 384 purposively selected transit camp residents aged 15 to 29 years. Biological specimens were collected for rapid HIV testing in the field and confirmatory laboratory testing. Multivariable logistic regression identified independent determinants of HIV infection.ResultsHIV prevalence was alarmingly high at 12.8% (95% CI: 9.6%, 16.5%). The strongest determinant of HIV infection among young people was a non-consensual sexual debut (adjusted odds ratio [AOR], 9.88; 95% CI: 1.70–18.06). Residing in Awach sub-county (AOR, 2.93; 95% CI: 1.28–6.68), experiencing STI symptoms in the previous 12 months (AOR, 2.36; 95% CI: 1.43–6.17), and practicing dry sex (AOR, 2.31; 95% CI: 1.04–5.13) were other key determinants of HIV infection.ConclusionsStudy findings contribute to filling an important gap in epidemiological evidence and are useful for planning public health interventions in northern Uganda that effectively target young people in post-conflict transition and support them in the resettlement process. Findings serve to recommend reaching beyond traditional prevention programming in a way more effectively beneficial to young people in post-conflict settings by developing population-specific responses sensitive to local contexts and sufficient to address the underlying causes of the complex risk factors influencing the spread of HIV.
Highlights
For over two decades prior to 2006, northern Uganda experienced a brutal conflict between the Government of Uganda and the rebel force, the Lord’s Resistance Army (LRA)
70 percent of the displaced population were under 25 years of age [6] and an estimated 66,000 young people between the ages of 14 to 30 years had been abducted by the rebels and forced to serve as child soldiers, labourers and sex slaves [7]
Estimates based on antenatal clinic (ANC) data collected in 2005 demonstrate HIV prevalence among pregnant women to be higher in Gulu District (10.3%) than the surrounding North Central Districts (9.1% in Kitgum, 4.3% in Pader), indicating a high HIV prevalence in Gulu District [32]
Summary
For over two decades prior to 2006, northern Uganda experienced a brutal conflict between the Government of Uganda and the rebel force, the Lord’s Resistance Army (LRA). 70 percent of the displaced population were under 25 years of age [6] and an estimated 66,000 young people between the ages of 14 to 30 years had been abducted by the rebels and forced to serve as child soldiers, labourers and sex slaves [7]. The members of this traumatized generation are possibly at a heightened risk of contracting HIV. The cases of South Sudan, Sierra Leone, Angola, and eastern DRC demonstrate that conflict can both enable HIV transmission and protect people from it [9,14,15,16,17,18]
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