The role of social support on HIV testing and treatment adherence: A qualitative study of HIV-infected refugees in southwestern Uganda

ABSTRACT

Little is known about the factors that encourage or discourage refugees to test for HIV, or to access and adhere to HIV care. In non-refugee populations, social support has been shown to influence HIV testing and utilisation of services. The present study enrolled HIV-infected refugees on anti-retroviral therapy (ART) in Uganda, who participated in qualitative interviews on HIV testing, treatment, and adherence. Interviews were analysed for themes about four types of social support: emotional, informational, instrumental, and appraisal support. A total of 61 interviews were analysed. Four roles for these types of social support were identified: (1) informational support encouraged refugees to test for HIV; (2) emotional support helped refugees cope with a diagnosis of HIV; (3) instrumental support facilitated adherence to ART and (4) after diagnosis, HIV-infected refugees provided informational and emotional support to encourage other refugees to test for HIV. These results suggest that social support influences HIV testing and treatment among refugees. Future interventions should capitalise on social support within a refugee settlement to facilitate testing and treatment.

KEYWORDS:

• HIV
• AIDS
• social support
• refugee
• Uganda

Acknowledgements

We would like to thank the study participants, who volunteered their time to share their experiences and participate in the research. This work was made possible by the Gesellschaft für Technische Zusammenarbeit (GIZ) Health Clinic Staff in the Nakivale Refugee Settlement as well as GIZ leadership in Uganda. We are grateful to the United Nations High Commissioner for Refugees in Uganda and to the Office of the Prime Minister in Mbarara for their assistance and support.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Harvard Medical School Eleanor and Miles Shore Fellowship. Dr Tsai acknowledges salary support from US National Institutes of Health [grant number K23MH096620].