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HIV stigma is a critical barrier to HIV prevention and care. This study evaluates the psychometric properties of the HIV Stigma Mechanisms Scale (HIV-SMS) among people living with HIV (PLHIV) in central Uganda and tests the underlying framework. Using data from the PATH/Ekkubo study, (n = 804 PLHIV), we assessed the HIV-SMS' reliability and validity (face, content, construct, and convergent). We used multiple regression analyses to test the HIV-SMS' association with health and well-being outcomes. Findings revealed a more specific (5-factor) stigma structure than the original model, splitting anticipated and enacted stigmas into two subconstructs: family and healthcare workers (HW). The 5-factor model had high reliability (α = 0.92–0.98) and supported the convergent validity (r = 0.12–0.42, p < 0.01). The expected relationship between HIV stigma mechanisms and health outcomes was particularly strong for internalized stigma. Anticipated-family and enacted-family stigma mechanisms showed partial agreement with the hypothesized health outcomes. Anticipated-HW and enacted-HW mechanisms showed no significant association with health outcomes. The 5-factor HIV-SMS yielded a proper and nuanced measurement of HIV stigma in central Uganda, reflecting the importance of family-related stigma mechanisms and showing associations with health outcomes similar to and beyond the seminal study. [ABSTRACT FROM AUTHOR]

Expectant or parenting youth (EPY) with foster care histories are often in need of a range of services yet experience barriers to accessing and utilizing those services. This exploratory qualitative study was informed by ecological systems theory and utilized interviews and focus groups with EPY (n = 11) and service providers (n = 28) to identify factors that facilitate service utilization for EPY. We found characteristics at the service provider, agency, and system levels that act as facilitators. Service provider characteristics that facilitate service use include empathy and trustworthiness, supportive navigation, and youth-centeredness. Agency facilitators included representative diversity and inclusivity, trauma-informed training and practice, and availability of tangible supports. System facilitators included having a variety of service providers, systems integration, and co-location. Findings provide a more nuanced understanding of the facilitators that contribute to EPY's service utilization. Future research is warranted to examine how these youth- and provider-identified drivers of service use influence health, mental health, parenting, education, relationships, employment, and housing outcomes for EPY. [ABSTRACT FROM AUTHOR]

In sub-Saharan Africa, research regarding young people's intimate partner violence (IPV) experiences is scarce. We provide national estimates of the prevalence, characteristics, and correlates of IPV among adolescents (aged 13–19; n = 1,182) and young adults (aged 20–24; n = 1,648) living in Uganda. We analyzed the Uganda Violence Against Children Survey data. Descriptive statistics were conducted using age-and-gender stratified samples. We also examined logistic regression models using age-stratified samples and testing gender as a potential moderator. Descriptive results indicated higher lifetime physical IPV rates among young adults (24.7%) compared to adolescents (12.3%). We found no significant difference comparing adolescents' (16.9%) and young adults' (14.6%) lifetime sexual IPV rates. There were notable age group and gender differences when examining specific sexual IPV types and first physical and sexual IPV episode characteristics. Significant IPV correlates across both age groups included being widowed, divorced, or separated (adolescents: aOR = 4.6, 95% CI: 1.6–13.5; young adults: aOR = 5.2, 95% CI: 2.5–10.8), being female (adolescents: aOR = 3.9, 95% CI: 2.2–6.8; young adults: aOR = 3.0, 95% CI: 2.1–4.4), witnessing parental IPV (adolescents: aOR = 1.8, 95% CI: 1.1–3.0; young adults: aOR = 1.7, 95% CI: 1.2–2.6), and poorer mental health levels (adolescents: aOR = 1.1, 95% CI: 1.04–1.1; young adults: aOR = 1.1, 95% CI: 1.1–1.1). Gender moderated the relationship between age and IPV, but only among adolescents (aOR = 1.4, 95% CI:1.1–1.9). IPV programs that are developmentally tailored for Ugandan young people are needed. These programs should promote gender equality and consider gender intersectionality. Policy changes around child maltreatment and early marriage must simultaneously occur for program success. [ABSTRACT FROM AUTHOR]