142nd APHA Annual Meeting and Exposition

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“Cango Lyec Project – Healing the Elephant”: The HIV related vulnerabilities of the formerly abducted in post-conflict Northern Uganda

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 11:06 AM - 11:18 AM

Alden Blair, PhD. Candidate , School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Patricia M Spittal, PhD. , School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Martin T Schechter , School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Noah Kiwanuka, PhD , School of Public Health, Makerere University, Kampala, Uganda
Achilles Katamba, PhD. , School of Medicine, Makerere University, Kampala, Uganda
Eugene Kinyanda, PhD. , Uganda Virus Research Institute, Entebbe, Uganda
James Mughisha, PhD. , Makerere University, Kampala, Uganda
Martin Ogwang, M.D. , Lacor Hospital, Gulu, Uganda
Patrick Odong, M.D. , District Health Officer, Amuru, Uganda
Nelson Sewankambo, PhD, MD , College of Health Sciences, Makerere University, Kampala, Uganda
Paul Kato , IAVI, Entebbe, Uganda
Lillian Tebere , Northern Uganda Youth Development Centre, Gulu, Uganda
Sheetal Patel, PhD. , Ottawa Hospital Research Institute, Ottawa, ON, Canada
Herbert Muyinda, PhD , Child Health and Development Center, University of Makerere College of Health Sciences, Kampala, Uganda
Sam Malambas, PhD , Center for Disease Control (CDC), Entebbe, Uganda
Background: Abduction by the Lords Resistance Army profoundly impacts the physical and psychosocial wellbeing of those surviving the conflict in Northern Uganda. It is estimated that more than 66,000 were abducted between 1986-2006. It is important to understand the HIV related vulnerabilities of this ‘at risk’ population.

 

Methods: The Cango Lyec Project is a prospective cohort of 2448 participants aged 13-49 in Northern Uganda. Participants consented to HIV testing and completed surveys on socio-demographics, PTSD (HTQ), and depression (HSCL-25). Multivariable logistic regression models were used to assess HIV vulnerability.

 

Results: Of formerly-abducted participants 319 (54.1%) were women and 271 (45.9%) were men. HIV prevalence was 20.4% and 11.8% respectively (p=0.005). Males were abducted more times (2.1 vs. 1.6 times; p=0.006). 34.2% of women and 3.3% of men experienced war related sexual violence. 26.3% of abducted women were given as a wife to LRA commanders. Of those with HIV, 9.4% of men and 24.6% of women screened positively for PTSD, while 21.8% and 43.1% screened positively for depression. There is difference in levels of PTSD or depression between those with and without HIV. In the multi-variable logistic regression, being female (AOR: 1.68; 95%CI: 1.03-2.80), one-year increase in age (1.04; 1.01-1.07), genital ulcers in the past year (3.77; 2.15-6.58), and living in the Gulu (2.34; 1.25-4.20) or Nwoya (2.25; 1.10-4.67) compared to Amuru district were associated with HIV positivity.

 

Discussion: Culturally safe HIV programming addressing these specific HIV related vulnerabilities of people surviving abduction and war in Northern Uganda are urgently required.

Learning Areas:

Advocacy for health and health education
Epidemiology
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Assess the specific HIV-related vulnerabilities faced by formerly abducted child-soldiers in Northern Uganda.

Keyword(s): HIV/AIDS, War

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator on the Cango Lyec Project along with all other authors of this abstract. I have been working on health delivery and research programs across sub-Saharan Africa for the last seven years with a special focus on post-conflict settings. I hold a masters in Epidemiology from LSHTM and am a PhD. Candidate in Epidemiology and Bio-Statistics at UBC's SPPH.
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.

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