Abstract: (see Poster Gallery) Social Influences on HIV Services Engagement Among Adolescents Experiencing HIV Stigma and Discrimination in Uganda (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

All in-person and virtual presentations are in Mountain Standard Time Zone (MST).

SSWR 2023 Poster Gallery: as a registered in-person and virtual attendee, you have access to the virtual Poster Gallery which includes only the posters that elected to present virtually. The rest of the posters are presented in-person in the Poster/Exhibit Hall located in Phoenix A/B, 3rd floor. The access to the Poster Gallery will be available via the virtual conference platform the week of January 9. You will receive an email with instructions how to access the virtual conference platform.

307P (see Poster Gallery) Social Influences on HIV Services Engagement Among Adolescents Experiencing HIV Stigma and Discrimination in Uganda

Friday, January 13, 2023
Phoenix C, 3rd Level (Sheraton Phoenix Downtown)
* noted as presenting author
Simon Mwima, MA, MPH, Public Health, University of Illinois at Urbana-Champaign, Urbana, IL
Eusebius Small, PhD, Associate Professor, University of Texas at Arlington, Arlington, TX
Bonita Sharma, PhD, Assistant Professor, University of Texas at San Antonio, San Antonio, TX
Moses Okumu, PhD, Assistant Professor, University of Illinois, Urbana-Champaign, Urbana, IL
Jennifer Evans, Doctoral student, University of Illinois at Urbana-Champaign, Urbana, IL
Agnes Nzomene, MSW, Education & Employment Trainer, Catholic Charities, New York City, NY
Ramirez Xavy, Predoc Fellow, University of Illinois at Urbana-Champaign, Urbana, IL
Background: HIV/AIDS-related stigma, catalyzed by restrictive laws, policies and attitudes are invoked as a persistent and pernicious problem resulting in limited access to HIV testing services, condom use, PrEP, and low adherence to treatment, stand in the way of health service utilization among Adolescents and young people living with HIV. Critically affected are sexual minorities, sex workers and injecting drug users. In 2019, more than 33% of key populations living with HIV in Uganda did not have adequate access to care. Using Andersen's model of health utilization, the study aimed to identify HIV utilization structural barriers, focusing on specific role of social influences and disengagement due to restrictive and less inclusive laws in Uganda.

Methods: The study was conducted using grounded theory involving in-depth semi-structured interviews with 31 focus group YPLHIV participants ages 18 and 25, recruited through urban HIV clinics and counseling facilities in Kampala between December 2020 and May 2021. The interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose, a cross-platform App for analyzing qualitative and mixed methods research data.

Results: Consistent with the Andersen model of service utilization, five barriers to HIV services utilization were mapped: Theme 1: Governmental restrictive HIV laws and policies, Theme 2: Stigma practices that include discrimination and prejudice, intersectional stigma, including internalized, perceived, and interpersonal. Theme 3: Inadequate healthcare providers trained to address the needs of adolescents living with HIV, Theme 4: Influence of informal social networks (i.e., sexual partners, peers, families); interactions with healthcare workers; and 5: Health service delivery mechanisms.

Conclusions: Future interventions should advocate for less discriminatory policies that marginalize vulnerable populations. Strengthening social support improving care-seeking, behaviors and increasing privacy assurances while engaging in HIV care will break down the barriers in Uganda. Building solutions to future HIV prevention, testing, treatment, and care responses could address inequities by drawing on peer support network to partner with already understaffed health workforce and help fellows navigate the heavily criminalized and stigmatized settings to utilize healthcare services.