Abstract: Baseline Findings of a Multilevel HIV Prevention Trial Among Displaced Youth in Uganda: Key Factors Influencing Prevention Outcomes (Society for Social Work and Research 30th Annual Conference Anniversary)

Schedule:

Sunday, January 18, 2026

Independence BR A, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

Moses Okumu, PhD, Assistant Professor, University of Illinois at Urbana-Champaign, Urbana, IL

Carmen Logie, MSW, PhD, Professor, University of Toronto, Toronto, ON, Canada

Zerihun Admassu, PhD, Post-doctoral fellow, University of Toronto, ON, Canada

Frannie MacKenzie, BA, Research Coordinator, Factor Inwetash Faculty of Social Work, University of Toronto,, Toronto, ON, Canada

Lauren Tailor, PharmD, PhD Candidate, University of Toronto, Toronto, ON, Canada

Robert Hakiza, Executive Director, Young African Refugees for Integral Development, Kampala, Uganda

Brenda Katisi, MBA, Research Manager, Young African Refugees for Integral Development, Kampala, Uganda

Daniel Kibuuka Musoke, MD, Executive Director, International Research Consortium, Kampala, Uganda

Aidah Nakitende, Research Coordinator, International Research Consortium, Kampala, Uganda, Kampala, Uganda

Catherine Nafula, MPH, District Coordinator Arua , Madi-Okollo and Terego, AVSI Foundation Uganda, Arua, Uganda

Morris Komakech, PhD, Assistant Professor, Nipissing University, North Bay, ON, Canada

David Okimait, PhD, Assistant Professor, Kyambogo University, Kampala, Uganda

Paul Bukuluki, PhD, Professor, Makerere University, Kampala, Uganda

Peter Kyambadde, MD, Executive Director, Most At Risk Populations Initiative, Mulago Hospital, Kampala, Uganda

Lawrence Mbuagbaw, PhD, Professor, McMaster University, Hamilton, ON, Canada

Liliane Windsor, PhD, Associate Professor and Director of Faculty Research, University of Illinois at Urbana-Champaign, Urbana, IL

Background: While displaced youth (16–24 years) face HIV vulnerabilities spanning social-ecological levels, knowledge gaps persist regarding HIV prevention cascades—even despite the increased trend of refugees, urbanization, and HIV exposures. Multilevel factors that influence HIV prevention service utilization—including effective condom use and HIV testing practices such as HIV self-testing (HIVST)—among refugees remain underexplored.

Methods: We conducted a baseline analysis of the Tushirikiane-4-Uthabiti clustered randomized controlled trial to evaluate the effectiveness of: (1) HIVST alone (standard of care); (2) a mobile health (mHealth) and graphic medicine (comic) program for mental health alongside HIVST; and (3) the combination of HIVST, a livelihoods program, and mHealth mental health program, in advancing HIV testing uptake among urban refugee youth across five informal settlements in Kampala, Uganda. No participant had received an intervention at the time they completed our self-reported behavioral survey. We conducted descriptive statistics to summarize the data. To understand factors associated with HIV outcomes at structural (e.g., food insecurity and education), community (e.g., stigma), and interpersonal (e.g., relationship dynamics) levels, we conducted (1) multiple regression for condom self-efficacy and (2) multivariable logistic regression for consistent condom use, access to HIVST kits, and HIV testing practices.

Results: A total of 330 participants completed the baseline survey, comprising cisgender women (53.3%) and cisgender men (46.7%). A majority of participants (62.1%) had a post-secondary education, were unemployed (69.8%), and were from the Democratic Republic of the Congo (77.9%). Participants’ mean condom self-efficacy score was 28.34 (SD = 6.48). Overall, participants exhibited suboptimal consistent condom use (19.1%), access to HIVST kits (56.4%), and HIV testing uptake (50.6%). Food insecurity (β = -2.78, 95% CI = [-5.41, -0.15]), education (β = 2.48, 95% CI = [1.02, 3.95]), and financial resilience (β = 0.14, 95% CI = [0.06, 0.22]) were associated with condom self-efficacy. Consistent condom use was associated with condom self-efficacy (aOR = 1.12, 95% CI = [1.02, 1.22]) and sex with multiple partners (aOR = 3.33, 95% CI = [1.12, 9.90]). HIVST kit access was associated with education (aOR = 2.45, 95% CI = [1.44, 4.17]), adolescent sexual and reproductive health stigma (aOR = 1.16, 95% CI = [1.03, 1.29]), and perceived HIV stigma (aOR = 1.05, 95% CI = [1.01, 1.10]). HIV testing uptake was associated with financial resilience (aOR = 1.05; 95% CI = [1.02, 1.08]) and having children (aOR = 2.32; 95% CI = [1.17, 4.62]).

Conclusion: Findings demonstrate participants’ suboptimal HIV prevention outcomes and highlight the need for multicomponent interventions designed with and for urban refugee youth who are younger, are women, have limited formal education, and are economically vulnerable. Such interventions have the potential to improve the sexual health of displaced youth in Uganda and globally.