“I Tried to Resist and Avoid Bad Friends”

Abstract

Urban informal settlements are sites of high HIV incidence and intimate partner violence (IPV). Young men in these contexts often draw on a youthful hypermasculinity that prioritize sexual dominance and displays of violence, although many aspire to a traditional masculinity, which is less violent and uses economic provision and social dominance to control women. Working with young men, we undertook a gender transformative and livelihood strengthening intervention to reduce HIV risk and IPV perpetration. We sought to understand how the wider social context shaped the project's outcomes. We undertook thirty-eight in-depth interviews and three focus groups postintervention. We conducted thematic analysis using

Contextual factors associated with depression among urban refugee and displaced youth in Kampala, Uganda: findings from a cross-sectional study

“…Such supportive and health-enabling social contexts include equitable social relationships. Three elements of social context emerge as important in understanding health promotion [27,29]. Material contexts include access to resources, such as money, food, housing, and other economic opportunities.…”

Social contextual factors associated with lifetime HIV testing among the Tushirikiane urban refugee youth cohort in Kampala, Uganda: Cross-sectional findings

“…8 There is a paucity of research on HIV testing practices among refugee youth in urban settings such as Kampala, and advancing this understanding can inform targeted HIV testing initiatives. 9 Socio-contextual theoretical approaches that consider health enabling environments for HIV prevention engagement 10,11 may be particularly relevant for understanding HIV testing barriers and facilitators with refugee youth. This approach considers three dimensions of context: material context, such as economic opportunities and resource access; relational context, including relationships with families, peers, and communities; and symbolic contexts, such as social norms and worldviews that shape access to power and recognize or elide worth, respect, and dignity.…”

“…21 Relational contexts, comprised of social relationships between persons, intimate partners, families, and external actors (e.g., service providers), shape access to power, agency, and resources. 10,11 Parenting and social support are relational contexts that may be linked with youths' HIV testing practices. Sub-Saharan Africa has the highest global adolescent pregnancy and birth rates.…”

“…12 A study with settlementbased refugee adults in Uganda identified informational dimensions of social support as important in facilitating HIV testing engagement. 32 Symbolic contexts, shaped by social norms and values, 10,11 can influence access to resources; stigma and gender-based violence are examples of symbolic contexts that devalue persons and reduce opportunities for accessing equitable healthcare. For instance, qualitative work with urban refugee youth in Kampala has identified stigma in health systems and communities toward refugees, HIV, and sex workers as barriers to HIV testing.…”

“…This approach considers three dimensions of context: material context , such as economic opportunities and resource access; relational context , including relationships with families, peers, and communities; and symbolic contexts, such as social norms and worldviews that shape access to power and recognize or elide worth, respect, and dignity. 10 , 11 For instance, material contexts of economic insecurity may pose barriers to HIV testing among urban refugee youth. 12 , 13 A qualitative study with urban refugee youth in Kampala documented that due to widespread poverty and unemployment, transportation costs were a barrier to accessing free HIV testing offered at public clinics.…”