Qualitative insights on sexual health counselling from refugee youth in Bidi Bidi Refugee Settlement, Uganda: Advancing contextual considerations for brief sexuality-related communication in a humanitarian setting

Characteristics of enabling healthcare environments to support brief sexuality-related communication (BSC) are understudied in humanitarian settings. We implemented a qualitative study with refugee youth aged 16–24 living in Bidi Bidi Refugee Settlement to understand the feasibility of implementing...

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Vydáno v:	PloS one Ročník 19; číslo 11; s. e0310682
Hlavní autoři:	Loutet, Miranda G., Logie, Carmen H., Okumu, Moses, Coelho, Madelaine, Blondeel, Karel, McAlpine, Alyssa, Mackenzie, Frannie, Lukone, Simon Odong, Kisubi, Nelson, Lukone, Jimmy Okello, Isaac, Atama Malon, Kyambadde, Peter, Toskin, Igor
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 21.11.2024 Public Library of Science (PLoS)
Témata:	Adolescent Adult Altruism Biology and Life Sciences Collaboration Communication Communication in medicine Confidentiality Context Counseling Displaced persons Empowerment Feasibility studies Female Focus Groups Gender Health aspects Health care Health care access Health care policy Health promotion Health services Human settlements Humanitarianism Humans Male Management Medical tests Medicine and Health Sciences People and Places Primary care Qualitative analysis Qualitative Research Refugee camps Refugees Refugees - psychology Reproductive health Sexual Behavior - psychology Sexual Health Sexuality Sexuality - psychology Sexually transmitted diseases Social aspects Social Sciences STD Stigma (Social psychology) Teenagers Uganda Verbal communication Young Adult Young adults Youth Uganda
ISSN:	1932-6203, 1932-6203
On-line přístup:	Získat plný text
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Shrnutí:	Characteristics of enabling healthcare environments to support brief sexuality-related communication (BSC) are understudied in humanitarian settings. We implemented a qualitative study with refugee youth aged 16–24 living in Bidi Bidi Refugee Settlement to understand the feasibility of implementing BSC in a humanitarian context. We examined feelings toward doctor’s visits in general, including types of conversations youth engage in with healthcare providers, as well as comfort, safety, and willingness to talk with healthcare providers about sexual health. We implemented four focus groups with refugee youth in Bidi Bidi, two with young women and two with young men, and applied thematic analysis informed by a social contextual theoretical framework that explores enabling environments for sexual health promotion. Participants (n = 40; mean age: 20 years, standard deviation: 2.2; women: n = 20; men: n = 20) reported relational, symbolic, and material dimensions of context considered important when discussing sexual health. Relational contexts included a) trusting relationship with local healthcare practitioners, including practices that foster comfort and confidentiality, and b) family, friends, and mentors as additional sources of health information. Symbolic contexts refer to values, norms, and beliefs that reflect what is perceived as valuable and worthy, and in turn, what is devalued and stigmatized. Specific to sexual health, participants discussed stigma toward STIs and HIV, devaluation of women in healthcare settings, and generalized fear of doctors and disease as barriers to engaging in dialogue about sexual health with healthcare providers. Material contexts include agency linked with resource access and experiences. Youth narratives revealed that positive experiences accessing medication to manage pain and infections increased their willingness to engage in healthcare discussions, whereby clinic layouts and dynamics that compromised confidentiality and privacy reduced the likelihood of sexual health dialogue. Language barriers and healthcare provider time constraints were additional factors that reduced healthcare engagement. Taken together, findings can inform BSC implementation strategies that consider the inner and outer settings that shape sexual health dialogue and sexual health and wellbeing among refugee youth living in humanitarian settings.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Some authors are current or former staff members of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of the World Health Organization.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0310682