Risk Denial and Socio-Economic Factors Related to High HIV Transmission in a Fishing Community in Rakai, Uganda: A Qualitative Study
Identifieur interne : 001429 ( Main/Exploration ); précédent : 001428; suivant : 001430Risk Denial and Socio-Economic Factors Related to High HIV Transmission in a Fishing Community in Rakai, Uganda: A Qualitative Study
Auteurs : Muhamadi Lubega [Ouganda, Suède, États-Unis] ; Neema Nakyaanjo [Ouganda] ; Sumaya Nansubuga [Ouganda] ; Edgar Hiire [Ouganda] ; Godfrey Kigozi [Ouganda] ; Gertrude Nakigozi [Ouganda] ; Tom Lutalo [Ouganda] ; Fred Nalugoda [Ouganda] ; David Serwadda [Ouganda] ; Ronald Gray [Ouganda, États-Unis] ; Maria Wawer [Ouganda, États-Unis] ; Caitylin Kennedy [États-Unis] ; Steven James Reynolds [Ouganda, États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission is still very 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 drivers for the high HIV transmission at Kasensero from the perspective of fishermen and other community members to inform future policy and preventive interventions.
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 were conducted during April-September 2014. Content analysis was performed to identify recurrent themes.
The socio-economic risk factors for high HIV transmission in Kasensero fishing community cited were multiple and cross-cutting and categorized into the following themes: power of money, risk denial, environmental triggers and a predisposing lifestyle and alcoholism and drug abuse. Others were: peer pressure, poor housing and the search for financial support for both the men and women which made them vulnerable to HIV exposure and or risk behavior.
There is a need for context specific combination prevention interventions in Kasensero that includes the fisher folk and other influential community leaders. Such groups could be empowered with the knowledge and social mobilization skills to fight the negative and risky behaviors, perceptions, beliefs, misconceptions and submission attitudes to fate that exposes the community to high HIV transmission. There is also need for government/partners to ensure effective policy implementation, life jackets for all fishermen, improve the poor housing at the community so as to reduce overcrowding and other housing related predispositions to high HIV rates at the community. Work place AIDS-competence teams have been successfully used to address high HIV transmission in similar settings.
Url:
DOI: 10.1371/journal.pone.0132740
PubMed: 26309179
PubMed Central: 4550390
Affiliations:
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<author><name sortKey="Kigozi, Godfrey" sort="Kigozi, Godfrey" uniqKey="Kigozi G" first="Godfrey" last="Kigozi">Godfrey Kigozi</name>
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<author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name>
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<author><name sortKey="Nalugoda, Fred" sort="Nalugoda, Fred" uniqKey="Nalugoda F" first="Fred" last="Nalugoda">Fred Nalugoda</name>
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<author><name sortKey="Serwadda, David" sort="Serwadda, David" uniqKey="Serwadda D" first="David" last="Serwadda">David Serwadda</name>
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<author><name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name>
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<author><name sortKey="Kennedy, Caitylin" sort="Kennedy, Caitylin" uniqKey="Kennedy C" first="Caitylin" last="Kennedy">Caitylin Kennedy</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea>
<placeName><region type="state">Maryland</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Reynolds, Steven James" sort="Reynolds, Steven James" uniqKey="Reynolds S" first="Steven James" last="Reynolds">Steven James Reynolds</name>
<affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Rakai Health Sciences Program, Old Bukoba road, P.O Box 279, Kalisizo, Uganda</addr-line>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea>Rakai Health Sciences Program, Old Bukoba road, P.O Box 279, Kalisizo</wicri:regionArea>
<wicri:noRegion>Kalisizo</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff004"><addr-line>Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland</wicri:regionArea>
<placeName><region type="state">Maryland</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff005"><addr-line>Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea>
<placeName><region type="state">Maryland</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">PLoS ONE</title>
<idno type="eISSN">1932-6203</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title>
<p>In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission is still very 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 drivers for the high HIV transmission at Kasensero from the perspective of fishermen and other community members to inform future policy and preventive interventions.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>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 were conducted during April-September 2014. Content analysis was performed to identify recurrent themes.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>The socio-economic risk factors for high HIV transmission in Kasensero fishing community cited were multiple and cross-cutting and categorized into the following themes: power of money, risk denial, environmental triggers and a predisposing lifestyle and alcoholism and drug abuse. Others were: peer pressure, poor housing and the search for financial support for both the men and women which made them vulnerable to HIV exposure and or risk behavior.</p>
</sec>
<sec id="sec004"><title>Conclusions</title>
<p>There is a need for context specific combination prevention interventions in Kasensero that includes the fisher folk and other influential community leaders. Such groups could be empowered with the knowledge and social mobilization skills to fight the negative and risky behaviors, perceptions, beliefs, misconceptions and submission attitudes to fate that exposes the community to high HIV transmission. There is also need for government/partners to ensure effective policy implementation, life jackets for all fishermen, improve the poor housing at the community so as to reduce overcrowding and other housing related predispositions to high HIV rates at the community. Work place AIDS-competence teams have been successfully used to address high HIV transmission in similar settings.</p>
</sec>
</div>
</front>
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</div1>
</back>
</TEI>
<affiliations><list><country><li>Ouganda</li>
<li>Suède</li>
<li>États-Unis</li>
</country>
<region><li>Maryland</li>
<li>Svealand</li>
</region>
<settlement><li>Stockholm</li>
</settlement>
</list>
<tree><country name="Ouganda"><noRegion><name sortKey="Lubega, Muhamadi" sort="Lubega, Muhamadi" uniqKey="Lubega M" first="Muhamadi" last="Lubega">Muhamadi Lubega</name>
</noRegion>
<name sortKey="Gray, Ronald" sort="Gray, Ronald" uniqKey="Gray R" first="Ronald" last="Gray">Ronald Gray</name>
<name sortKey="Hiire, Edgar" sort="Hiire, Edgar" uniqKey="Hiire E" first="Edgar" last="Hiire">Edgar Hiire</name>
<name sortKey="Kigozi, Godfrey" sort="Kigozi, Godfrey" uniqKey="Kigozi G" first="Godfrey" last="Kigozi">Godfrey Kigozi</name>
<name sortKey="Lubega, Muhamadi" sort="Lubega, Muhamadi" uniqKey="Lubega M" first="Muhamadi" last="Lubega">Muhamadi Lubega</name>
<name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name>
<name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name>
<name sortKey="Nakyaanjo, Neema" sort="Nakyaanjo, Neema" uniqKey="Nakyaanjo N" first="Neema" last="Nakyaanjo">Neema Nakyaanjo</name>
<name sortKey="Nalugoda, Fred" sort="Nalugoda, Fred" uniqKey="Nalugoda F" first="Fred" last="Nalugoda">Fred Nalugoda</name>
<name sortKey="Nansubuga, Sumaya" sort="Nansubuga, Sumaya" uniqKey="Nansubuga S" first="Sumaya" last="Nansubuga">Sumaya Nansubuga</name>
<name sortKey="Reynolds, Steven James" sort="Reynolds, Steven James" uniqKey="Reynolds S" first="Steven James" last="Reynolds">Steven James Reynolds</name>
<name sortKey="Serwadda, David" sort="Serwadda, David" uniqKey="Serwadda D" first="David" last="Serwadda">David Serwadda</name>
<name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name>
</country>
<country name="Suède"><region name="Svealand"><name sortKey="Lubega, Muhamadi" sort="Lubega, Muhamadi" uniqKey="Lubega M" first="Muhamadi" last="Lubega">Muhamadi Lubega</name>
</region>
</country>
<country name="États-Unis"><region name="Maryland"><name sortKey="Lubega, Muhamadi" sort="Lubega, Muhamadi" uniqKey="Lubega M" first="Muhamadi" last="Lubega">Muhamadi Lubega</name>
</region>
<name sortKey="Gray, Ronald" sort="Gray, Ronald" uniqKey="Gray R" first="Ronald" last="Gray">Ronald Gray</name>
<name sortKey="Kennedy, Caitylin" sort="Kennedy, Caitylin" uniqKey="Kennedy C" first="Caitylin" last="Kennedy">Caitylin Kennedy</name>
<name sortKey="Reynolds, Steven James" sort="Reynolds, Steven James" uniqKey="Reynolds S" first="Steven James" last="Reynolds">Steven James Reynolds</name>
<name sortKey="Reynolds, Steven James" sort="Reynolds, Steven James" uniqKey="Reynolds S" first="Steven James" last="Reynolds">Steven James Reynolds</name>
<name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name>
</country>
</tree>
</affiliations>
</record>
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