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Sheetal H. Patel Martin T. Schechter, Herbert Muyinda, Noah Kiwanuka,

Lost in Transition: Prevalence and Correlates of HIV Infection Among Young Men and Women Surviving Abduction and Displacement in Post-Conflict Northern Uganda. Sheetal H. Patel Martin T. Schechter, Herbert Muyinda, Noah Kiwanuka, Nelson K. Sewankambo, Patricia M. Spittal

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Sheetal H. Patel Martin T. Schechter, Herbert Muyinda, Noah Kiwanuka,

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  1. Lost in Transition: Prevalence and Correlates of HIV Infection Among Young Men and Women Surviving Abduction and Displacement in Post-Conflict Northern Uganda Sheetal H. Patel Martin T. Schechter, Herbert Muyinda, Noah Kiwanuka, Nelson K. Sewankambo, Patricia M. Spittal International AIDS Conference July 25, 2012

  2. Context: Post-conflict Transition Cessation of Hostilities Agreement, August 2006 Population in post-conflict transition: moving back home or to transit camps Three phases of post-conflict transition

  3. Context: Post-conflict Transition • As of Dec 2010 ~ 200,000 people in transit camps

  4. Conflict and HIV/AIDS • Influence of war on HIV transmission remains unclear in northern Uganda • Complex relationship between HIV/AIDS and conflict • Enabling or protective effect on HIV transmission?

  5. Conflict and HIV/AIDS ENABLING effect on HIV transmission Decreased Risk • Reduction in mobility • Reduction in accessibility • Increase in resources and services in displacement camps Increased Risk • Behavioural change resulting from the breakdown of social structures • Lack of income and basic needs • Gender-based violence and transactional sex • Lack of health infrastructure and education PROTECTIVE effect on HIV transmission

  6. Study Rationale • Far less is known about HIV transmission in post-conflict settings • Government of Uganda reinstating plans for resettlement and redevelopment • Development of HIV frameworks essential • Paucity of HIV epidemiology: limited evidence to plan post-conflict HIV programming

  7. Objectives • To determine prevalence and correlates of HIV infection among young people aged 15-29 years in Gulu District, northern Uganda • To analyze the risk of HIV infection in relation to gender and risk behavior among young people

  8. Methods • Target population: young people aged 15-29 years residing in a transit camp; 2 sub-counties • Sampling method:(purposive) proportional and non-proportional quota sampling • Sample size: 384 young men and women - 216 from Ongako - 192 females - 168 from Awach - 192 males

  9. Methods • Data collection: • demographic and behavioral questionnaire • INSTI rapid HIV test; ELISA & Western Blot • Return of testing results • Referrals for care

  10. Statistical Analyses • Prevalence of HIV infection • Point estimates and 95% confidence intervals • Bivariate analysis • Pearson’s chi-square, Fischer’s exact, & Wilcoxon rank sum tests • Stratified by gender • Logistic regression analysis • Odds ratios and 95% confidence intervals • Separate models for male and female participants

  11. Results

  12. Table 1: Prevalence of HIV infection among study participants

  13. Table 1: Prevalence of HIV infection among study participants

  14. Summary of Findings Bivariate analyses…. • Gender marginally associated with HIV infection • Having been abducted by the LRA was NOT associated with HIV positivity

  15. Table 2: Determinants of HIV Infection

  16. Table 3: Determinants of HIV infection by gender

  17. Table 2: Determinants of HIV infection

  18. Table 3: Determinants of HIV infection by gender

  19. Traditional prevention programming will not be enough Need for HIV/AIDS programmes to be contextualized Example: non-consensual 1st sex and HIV infection Example: dry sex practice and HIV infection Scope of traditional prevention programmes must be broadened Recommendation

  20. Acknowledgements • Study participants • Study team

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