Understanding the socio-structural context of high HIV transmission in kasensero fishing community, South Western Uganda

BMC Public Health

Research Article

Caitlin Kennedy¹  Neema Nakyaanjo²  Edgar Hiire²  Tom Lutalo²  Godfrey Kigozi²  Gertrude Nakigozi²  David Serwadda²  Fred Nalugoda²  Muhamadi Lubega³  Steven James Reynolds⁴  Ronald Gray⁵  Maria Wawer⁵  Sumaya Nansubuga⁶ 

[1] Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA;Rakai Health Sciences Program, PO Box 279, Old Bukoba road, Kalisizo, Uganda;Rakai Health Sciences Program, PO Box 279, Old Bukoba road, Kalisizo, Uganda;Division of Global Health, IHCAR, Department of Public Health Sciences, Karolinsika Institutet, PO Box 1717007, Stockholm, Sweden;School of Graduate Studies and Research Busoga University, PO Box 154, Iganga, Uganda;Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA;Rakai Health Sciences Program, PO Box 279, Old Bukoba road, Kalisizo, Uganda;Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA;Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA;Rakai Health Sciences Program, PO Box 279, Old Bukoba road, Kalisizo, Uganda;Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA;School of Graduate Studies and Research Busoga University, PO Box 154, Iganga, Uganda;

关键词: Fishing Community;    Social Ecological Model;    Lake Victoria Basin;    Rakai District;    Circumcision Service;   

DOI  :  10.1186/s12889-015-2371-4

 received in 2015-03-16, accepted in 2015-09-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission remains high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44 %, reaching up to 74 % among female sex workers. We explored the social contextual factors for the high HIV transmission at Kasensero to inform future policy and preventive interventions.MethodsWe conducted 20 in-depth interviews, including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community from April-September 2014. Content analysis was performed to identify recurrent themes.ResultsOur findings suggest that the high HIV transmission in Kasensero is a complex function of eight themes including; positive/negative attitudes about HIV and combination HIV prevention such as the demand for services versus ART/circumcision disinhibition; HIV depository; Multiple partners; Frequent unprotected sex; Clothing; Parental behaviors; Pressure within the sex industry; and Cross generational sex.ConclusionsThe current combination HIV prevention services by the RHSP need to be enhanced with more government involvement including ensuring sustainable supply of ART and circumcision services since they are reportedly highly demanded. Community involvement through the engagement of popular peers could also help in the campaign to change the HIV predisposing culture, misconceptions and risky social norms of the population.Social Context HIV Transmission Fishing Community.

【 授权许可】

CC BY   
© Lubega et al. 2015