Narrating the Transition to Adulthood for Youth in Uganda: Leaving School, Mobility, Risky Occupations, and HIV

Overview

Journal Health Educ Behav

Publisher Sage Publications

Specialties Medical Education
Public Health
Social Sciences

Date 2019 Feb 23

PMID 30791714

Citations 9

Authors

Philip Kreniske

Stephanie Grilo

Neema Nakyanjo

Fred Nalugoda

Jason Wolfe

John S Santelli

Affiliations

Soon will be listed here.

Abstract

School enrollment, mobility, and occupation are each important factors to consider when examining HIV (human immunodeficiency virus) infection risk among youth in sub-Saharan Africa. Through an analysis of narrative life histories from 30 HIV-positive and 30 HIV-negative youth (aged 15-24 years), matched on gender, age, and village and purposively selected and interviewed from the Rakai Community Cohort Study, this article shows the complex connection between leaving school, mobility, and occupation with implications for HIV risk. We identified a pattern of risk factors that was present in many more HIV-positive than HIV-negative youth life stories. These HIV-positive youth shared a similar pathway during their transition to adulthood: After leaving school, they moved in search of occupations; they then engaged in risky occupations before eventually returning to their home village. Linking the lines of inquiry on school enrollment, mobility, and risky occupations, our findings have important implications for adolescent health research, practice, and policy in Uganda and across sub-Saharan Africa and the developing world.

Citing Articles

How migration shapes modern contraceptive use among urban young women: Evidence from six African countries.

Pinchoff J, Pike I, Austrian K, Grace K, Kabiru C PLoS One. 2024; 19(7):e0307141.

PMID: 39042650 PMC: 11265688. DOI: 10.1371/journal.pone.0307141.

Interest in I-PrEP and Willingness to Participate in Clinical Trials Among Men and Transfeminine Persons Who have Sex with Men in Sub-Saharan Africa: Quantitative and Qualitative Findings from HPTN 075.

Sandfort T, Kreniske P, Mbeda C, Reynolds D, Tshabalala G, Madiwati B AIDS Behav. 2024; 28(7):2361-2377.

PMID: 38761334 PMC: 11199096. DOI: 10.1007/s10461-024-04334-x.

Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS): Protocol for a Pilot Randomized Controlled Trial.

Kreniske P, Namuyaba O, Kasumba R, Namatovu P, Ssewamala F, Wingood G JMIR Res Protoc. 2023; 12:e49352.

PMID: 38113102 PMC: 10762611. DOI: 10.2196/49352.

Implications of rapid population growth on survey design and HIV estimates in the Rakai Community Cohort Study (RCCS), Uganda.

Khalifa A, Ssekubugu R, Lessler J, Wawer M, Santelli J, Hoffman S BMJ Open. 2023; 13(7):e071108.

PMID: 37495389 PMC: 10373715. DOI: 10.1136/bmjopen-2022-071108.

The negative health spillover effects of universal primary education policy: Ethnographic evidence from Uganda.

Moore E, Hirsch J, Nakyanjo N, Nakubulwa R, Morse-Karzen B, Daniel L Glob Public Health. 2023; 18(1):2221973.

PMID: 37305987 PMC: 10357409. DOI: 10.1080/17441692.2023.2221973.

References

Nyanzi B, Nyanzi S, Wolff B, Whitworth J . Money, men and markets: economic and sexual empowerment of market women in southwestern Uganda. Cult Health Sex. 2006; 7(1):13-26. DOI: 10.1080/13691050410001731099. View

Arnett J . Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol. 2000; 55(5):469-80. View

Daher J, Vijh R, Linthwaite B, Dave S, Kim J, Dheda K . Do digital innovations for HIV and sexually transmitted infections work? Results from a systematic review (1996-2017). BMJ Open. 2017; 7(11):e017604. PMC: 5695353. DOI: 10.1136/bmjopen-2017-017604. View

Ssewamala F, Wang J, Neilands T, Bermudez L, Garfinkel I, Waldfogel J . Cost-Effectiveness of a Savings-Led Economic Empowerment Intervention for AIDS-Affected Adolescents in Uganda: Implications for Scale-up in Low-Resource Communities. J Adolesc Health. 2017; 62(1S):S29-S36. PMC: 5744872. DOI: 10.1016/j.jadohealth.2017.09.026. View

Sprague C, Scanlon M, Pantalone D . Qualitative Research Methods to Advance Research on Health Inequities Among Previously Incarcerated Women Living With HIV in Alabama. Health Educ Behav. 2017; 44(5):716-727. DOI: 10.1177/1090198117726573. View

Higgins J, Mathur S, Eckel E, Kelley L, Kelly L, Nakyanjo N . Importance of relationship context in HIV transmission: results from a qualitative case-control study in Rakai, Uganda. Am J Public Health. 2014; 104(4):612-20. PMC: 4025686. DOI: 10.2105/AJPH.2013.301670. View

Dworkin S, Ehrhardt A . Going beyond "ABC" to include "GEM": critical reflections on progress in the HIV/AIDS epidemic. Am J Public Health. 2006; 97(1):13-8. PMC: 1716252. DOI: 10.2105/AJPH.2005.074591. View

Mojola S . Multiple transitions and HIV risk among orphaned Kenyan schoolgirls. Stud Fam Plann. 2011; 42(1):29-40. PMC: 3518408. DOI: 10.1111/j.1728-4465.2011.00262.x. View

Barongo L, Borgdorff M, Mosha F, Nicoll A, Grosskurth H, Senkoro K . The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania. AIDS. 1992; 6(12):1521-8. DOI: 10.1097/00002030-199212000-00016. View

10.

Griffith D, Shelton R, Kegler M . Advancing the Science of Qualitative Research to Promote Health Equity. Health Educ Behav. 2017; 44(5):673-676. DOI: 10.1177/1090198117728549. View

11.

Underwood C, Skinner J, Osman N, Schwandt H . Structural determinants of adolescent girls' vulnerability to HIV: views from community members in Botswana, Malawi, and Mozambique. Soc Sci Med. 2011; 73(2):343-50. DOI: 10.1016/j.socscimed.2011.05.044. View

12.

Blankenship K, Friedman S, Dworkin S, Mantell J . Structural interventions: concepts, challenges and opportunities for research. J Urban Health. 2006; 83(1):59-72. PMC: 1473169. DOI: 10.1007/s11524-005-9007-4. View

13.

Dellar R, Dlamini S, Abdool Karim Q . Adolescent girls and young women: key populations for HIV epidemic control. J Int AIDS Soc. 2015; 18(2 Suppl 1):19408. PMC: 4344544. DOI: 10.7448/IAS.18.2.19408. View

14.

Chang L, Grabowski M, Ssekubugu R, Nalugoda F, Kigozi G, Nantume B . Heterogeneity of the HIV epidemic in agrarian, trading, and fishing communities in Rakai, Uganda: an observational epidemiological study. Lancet HIV. 2016; 3(8):e388-e396. PMC: 4973864. DOI: 10.1016/S2352-3018(16)30034-0. View

15.

Cassels S, Manhart L, Jenness S, Morris M . Short-term Mobility and Increased Partnership Concurrency among Men in Zimbabwe. PLoS One. 2013; 8(6):e66342. PMC: 3688871. DOI: 10.1371/journal.pone.0066342. View

16.

Santelli J, Edelstein Z, Wei Y, Mathur S, Song X, Schuyler A . Trends in HIV acquisition, risk factors and prevention policies among youth in Uganda, 1999-2011. AIDS. 2014; 29(2):211-9. PMC: 6668715. DOI: 10.1097/QAD.0000000000000533. View

17.

Patton G, Sawyer S, Santelli J, Ross D, Afifi R, Allen N . Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016; 387(10036):2423-78. PMC: 5832967. DOI: 10.1016/S0140-6736(16)00579-1. View

18.

Serwadda D, Wawer M, Musgrave S, Sewankambo N, Kaplan J, Gray R . HIV risk factors in three geographic strata of rural Rakai District, Uganda. AIDS. 1992; 6(9):983-9. DOI: 10.1097/00002030-199209000-00012. View

19.

Boerma J, Urassa M, Nnko S, Ngweshemi J, Isingo R, Zaba B . Sociodemographic context of the AIDS epidemic in a rural area in Tanzania with a focus on people's mobility and marriage. Sex Transm Infect. 2002; 78 Suppl 1:i97-105. PMC: 1765836. DOI: 10.1136/sti.78.suppl_1.i97. View

20.

Camlin C, Kwena Z, Dworkin S, Cohen C, Bukusi E . "She mixes her business": HIV transmission and acquisition risks among female migrants in western Kenya. Soc Sci Med. 2014; 102:146-56. PMC: 3935174. DOI: 10.1016/j.socscimed.2013.11.004. View