Online Program

“The Cango Lyec Project – Healing the Elephant”: Comparisons of HIV, PTSD, and depression between former abductees compared to their non-abducted counterparts in post-conflict Northern Uganda

Wednesday, November 4, 2015 : 10:44 a.m. - 10:58 a.m.

Alden Blair, PhD. Candidate, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Sheetal Patel, PhD., Ottawa Hospital Research Institute, Ottawa, ON, Canada
Achilles Katamba, PhD., School of Medicine, Makerere University, Kampala, Uganda
Alex Oneka, Northern Uganda Program on Health Sciences, Uganda
Martin Ogwang, M.D., Lacor Hospital, Gulu, Uganda
Lillian Tebere, Northern Uganda Youth Development Centre, Gulu, Uganda
Patrick Odong, M.D., District Health Officer, Amuru, Uganda
Sam Malambas, PhD, Uganda Virus Research Institute, Entebbe, Uganda
Martin T Schechter, OBC MD PhD FRSC FCAHS, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Herbert Muyinda, PhD, Child Health and Development Center, University of Makerere College of Health Sciences, Kampala, Uganda
Margo Pearce, PhD; MSc; MPP; BA, 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
Nelson Sewankambo, PhD, MD, College of Health Sciences, Makerere University, Kampala, Uganda
Background:Experiences of abduction continue to have a profound impact on the mental and physical well-being of of survivors of the conflict in Northern Uganda. Despite the pervasiveness of the conflict into every level of society, relief and recovery efforts lack a sound evidence base in program design and implementation, often mistakenly targeting perceived ‘at-risk’ groups.

Methods: This prospective cohort study examines 2500 participants age 13-49 in three districts of Northern Uganda who consented to complete trauma (HTQ), depression (HSCL-25) sociodemographic surveys, and provide blood samples for HIV testing. Three separate multivariable logistic regressions examine a history of abduction and the likelihood of HIV positivity, PTSD, and depression.

Results: Of included participants, 27.4% of men (n=271) and 22.9% of women (n=319) experienced abduction. Among women, abductees faced more HIV risk factors including sexual abuse (34.2% vs. 7.15%), participation in sex work (2.2% vs. 0.5%), syphilis (7.2% vs. 4.4%), and experienced more traumatic events (32.9% vs. 1.8%). Among men, abductees were more likely to report inconsistent condom use (6.3% vs. 15.6%), to have experienced more traumatic events (33.1% vs. 1.84%), and to have abused their current sexual partner (19.6% vs. 8.9%). After adjustment for potential confounders, history of abduction was significantly associated with depression (AOR: 1.89; 95%CI 1.43-2.49) and PTSD (AOR: 2.10; 95%CI 1.56-2.83), but was notsignificantly associated with HIV infection (AOR: 1.08, 95%CI 0.80-1.47).

Discussion:HIV is not confined to easily defined groups in Northern Uganda, requiring a crucial rethinking of treatment and prevention programs. Trauma informed HIV prevention and culturally safe mental health care initiatives are urgently required.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research

Learning Objectives:
Compare the experiences of young people abducted vs never-abducted in post-conflict Northern Uganda to understand how the event shapes current vulnerabilities.

Keyword(s): War, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator on the Cango Lyec Project study, part of which makes up my PhD dissertation at the School of Population and Public Health at UBC. I lived in Uganda for a year during the collection and cleaning of this data overseeing much of the work of our team there.
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.

Back to: 5110.0: HIV/AIDS II