The Role of Self-Concept and Gender in Shaping HIV Prevention Attitudes Among Adolescents Orphaned By HIV/AIDS in Uganda

Background and Purpose: Adolescents orphaned by HIV/AIDS face unique challenges, including heightened vulnerability to HIV infection. This study investigates the relationship between self-concept and HIV prevention attitudes among adolescents orphaned by HIV/AIDS in Uganda, while exploring the moderating role of gender. Guided by resilience theory, the study hypothesizes that higher self-concept predicts more positive HIV prevention attitudes and that gender influences this relationship.

Methods: We analyzed baseline data from the Suubi-Maka study, a cluster randomized controlled trial involving 346 adolescents aged 12–16 from ten rural public primary schools in Masaka and Rakai political districts of Uganda, areas severely impacted by HIV/AIDS and poverty. Ordinary least squares (OLS) regression with cluster-robust standard errors was used to examine the relationship between self-concept and HIV prevention attitudes. A gender × self-concept interaction term was included to test for moderation.

Results: Self-concept significantly predicted HIV prevention attitudes (b = 0.08, p < 0.01), with higher self-concept associated with more positive attitudes. Age also emerged as a significant predictor (b = 0.26, p = 0.01), with older adolescents reporting more favorable HIV prevention attitudes. Gender differences were observed, with males reporting significantly higher HIV prevention attitudes than females (15.8 vs. 14.3, p < 0.001).

Conclusions and Implications: The findings highlight the importance of self-concept in shaping HIV prevention attitudes among adolescents orphaned by HIV/AIDS, with gender playing a significant moderating role. Interventions that foster positive self-concept, particularly among females, could significantly enhance HIV prevention efforts in Uganda and similar low-resource settings. Gender-sensitive and age-appropriate strategies are essential to address disparities and promote equitable health outcomes. Integrating psychosocial support into HIV prevention programs may improve health behaviors and outcomes for this vulnerable population. Policymakers should prioritize funding for holistic, gender-responsive health initiatives tailored to the unique needs of adolescents orphaned by HIV/AIDS. Additionally, future research should explore the long-term impact of self-concept interventions and investigate cultural and contextual factors to inform more effective, tailored strategies.