Online Program

Psychosocial challenges and strategies for coping with HIV-infection among in-school perinatally-infected adolescents in Uganda: A qualitative study

Tuesday, November 5, 2013 : 3:00 p.m. - 3:15 p.m.

Massy Mutumba, BSN, MPH, PhD Candidate, Health Behavior and Health Education, University of Michigan, Ann Arbor, Ann Arbor, MI
Francis Kiweewa, MBcHB, MMED, MPH, Makerere University-Walter Reed Project, Kampala, Uganda
Rachel Snow, DSc, Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Victor Musiime, MBcHB, MMED, Joint Clinical Research Center, Kampala, Kampala, Uganda
Expanding access to antiretroviral therapy (ART) in Uganda has increased the longevity of children perinatally infected with HIV but data on the socio-emotional coping among HIV-infected adolescents remain scarce. The purpose of this study was to investigate the psychosocial challenges and coping strategies among HIV-infected adolescents, with the aim of identifying issues amenable to intervention. In-depth interviews were conducted with a purposive sample of 38 perinatally-infected adolescents, 12 - 19 years at a large HIV treatment center in Kampala, Uganda. Data were analyzed thematically to identify themes and domains related to stressors and specific coping strategies. Psychosocial challenges included difficulties in disclosing HIV status to peers and siblings, perceived and enacted stigma/discrimination, financial worries, adherence difficulties, and HIV transmission concerns. Treatment optimism, rationalizing techniques e.g. “I am not the first and last person to have HIV”, social comparison, religiosity, avoidance and distraction were the most frequently reported emotional coping strategies. Disclosure and stigma/discrimination concerns were largely managed by non-disclosure or limited disclosure to close family members and peers. HIV transmission worries were managed by avoiding sexual partners and delay of sexual initiation. Lastly, adherence was managed using alarms, keeping medications with nurses at the school clinics, special arrangements with school authorities e.g. resting permits, use of decoys and self-monitoring of health status. Age and gender differences also emerged: younger participants generally lacked specific coping strategies; compared to females, male adolescents reported greater use of avoidance/distraction techniques. Results highlight several opportunities for program interventions to improve the wellbeing of HIV-infected adolescents.

Learning Areas:

Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
Identify the psychosocial challenges of adolescents living with HIV/AIDS in a resource-limited setting Describe the strategies for coping with HIV among HIV-infected adolescents in a resource-limited setting

Keyword(s): Adolescents, International, Coping

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For the past 7 years, I have worked as a nurse and researcher with adolescents living with HIV/AIDS in Uganda. Additionally, I have been a co-investigator on several studies exploring HIV related challenges among women infected and affected by HIV/AIDS. My scientific interests include addressing psychosocial and sexual reproductive health challenges among adolescents living with HIV/AIDS. I am interested in developing interventions to address their diverse psychosocial needs of young people.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.