Associations between extreme weather, resource insecurities and mobility with HIV risks among Ugandan refugee youth.

BACKGROUND

Humanitarian settings face elevated extreme weather events (EWEs), yet few studies with refugees have examined EWE-related risks and associations with human immunodeficiency virus (HIV) vulnerabilities.

METHODS

Among refugee youth ages 16-24 y in a Ugandan refugee settlement, we conducted latent class analysis to examine EWE-related risk classes (resource insecurities [water, food, sanitation], EWE exposure, mobility) and multivariable regression to assess associations between class membership and HIV vulnerabilities (sexual relationship power [SRP], intimate partner violence [IPV], condom use self-efficacy [CUSE], reproductive autonomy).

RESULTS

Participants' (n=400, 50% women; mean age 19.49 y [standard deviation 2.3]) class profiles included Class-1 (moderate resource insecurity, high mobility, high EWE), Class-2 (water insecurity, low mobility, low EWE) and Class-3 (severe resource insecurity, moderate mobility, high EWE). Compared with Class-2, Class-1 and Class-3 reported lower SRP (Class-1: adjusted beta coefficient (aβ)=-3.63 [95% confidence interval {CI} -6.27 to -0.98]; Class-3: aβ=-4.24 [95% CI -6.80 to -1.68]) and CUSE (Class-1: aβ=-2.55 [95% CI -4.21 to -0.90]; Class-3: aβ=-3.09 [95% CI -4.69 to -1.48]) and higher IPV (Class-1: odds ratio [OR] 4.81 [95% CI 1.00 to 23.03]; Class-3: OR 5.59 [95% CI 1.19 to 26.36]), and Class-1 reported lower reproductive autonomy (aβ=-0.27 [95% CI -0.54 to -0.01]).

CONCLUSION

Converging EWE, mobility and resource insecurities increase refugee youths' HIV vulnerabilities, requiring urgent attention.