HIV-positive youth's engagement in treatment, care and prevention: Stories from HIV-positive young adults in Uganda

Objective: The study sought to describe and document the challenges of young adults living with HIV and /AIDS, and to explore recommendations from them for management of HIV infection and prevention of further transmission of the disease. Methods: Key informant interviews were conducted with youth aged 18 to 24 from three districts (urban and rural). Inquiry was organized around experiences of HIV infection, disclosure, social support, self care, sexuality and HIV preventive practices. Informants were male and female, in school and out of school, single and married with children, with heterosexual and vertically acquired HIV. Results: participant concerns included: (a) lack of privacy at free antiretroviral treatment facilities as a major barrier to utilization of health services, (b) lack of formalized social support for rural youth leading to increased isolation, hopelessness, vulnerability and risk sexual behaviors, (c) food and fluid shortages complicating antiretroviral drug adherence, and (e) lack of self-efficacy to consistently using condoms. Conclusions: Interventions need to improve access to food and privacy at HIV testing and medication support facilities. Lack of privacy and basic needs like food and shelter counter attitudes and behaviors that youth need to adhere to medication, safer sex and self-care. Contribution and implications for practice and further research: (a) mode of viral transmission shapes a young person's experiences; (b) social support improves self-care and reduces further HIV transmission; (c) prevention knowledge is not enough to stop HIV spread. Unmet basic needs significantly influence survival choices that increase the risk of contracting and spreading HIV.