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Lost in transition : determining HIV prevalence and related vulnerabilities among young people surviving abduction and displacement in post-conflict northern Uganda Patel, Sheetal Harish


Background: Little 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 IDPs following two decades of war in northern Uganda. This population in transition provided a unique opportunity to assess the influence of conflict on HIV infection among young people in post-conflict settings. Methods: In 2010, a cross-sectional demographic and behavioural survey was conducted with a purposively selected sample of 384 transit camp residents aged 15 to 29, in two of Gulu District’s sub-counties. Biological specimens were collected for HIV rapid testing in-field and confirmatory laboratory testing. Multivariable logistic regression identified independent predictors for HIV infection among the sample and stratified by gender. Additionally, a bivariate analysis was conducted comparing HIV risk profiles of former abductees to non-abductees. Results: Of the 384 participants sampled, 192 (50%) were female and 107 (27.9%) were abductees. HIV prevalence was alarmingly high, at 12.8% overall; 15.6% among females; 9.9% among males, and; 12.1% among abductees. Sample sub-groups revealed no significant differences in proportions positive. The strongest predictor of HIV infection among young people was non-consensual sexual debut (Adjusted Odds Ratio [AOR]: 9.88, 95% Confidence Interval [CI]: 1.70, 18.06). Among females, having practiced dry sex was the strongest predictor (AOR: 7.62, 95%CI: 1.56, 16.95), and among males, non-consensual sexual debut was the strongest predictor (AOR: 3.24, 95%CI: 1.37, 7.67). Finally, in bivariate analysis comparing abductees to non-abductees, limited differences in risk profiles were demonstrated. Conclusions: This study sought to fill a lacuna in epidemiological evidence and provide the Ugandan government and NGOs with the data necessary to inform timely and appropriate responses to HIV among young people in post-conflict transition. Study findings serve to recommend a gradual cessation of post-emergency aid and the design of interventions based on well-identified needs rather than circumstantial categorization. Additionally, development of population-specific responses sensitive to local contexts and sufficient to address the underlying causes of complex risk factors influencing the spread of HIV will reach beyond traditional prevention programming in a manner more effectively beneficial to young people in post-conflict settings.

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