Straight Talk Foundation (STF), Uganda WEAD0202 Richard Imakit Straight Talk Foundation (STF), Uganda “The Sexual and Reproductive Health (SRH) needs and experiences of Youth Living With HIV In Uganda"

Background The 1994 ICPD marked: Rights-based approach to SRH, Focus: individual needs, aspirations and rights SRH needs of YLHIV are often overlooked

Addressing SRH for YLHIV is fundamental SRH of YLHIV is a neglected area Research and programming Represents a priority on 2015 post-MDG agenda. STF investigated the dynamics underpinning SRH for YLHIV in Uganda.

Methods A cross sectional study design Among YLHIV who lived: an urban setting (Kampala) or a rural or post war (Gulu) Systematic sampling within peer networks A sequential exploratory approach

Methods… Semi-Structured interviews Key informants- Counselors & Medical staffs Voice recorders were used Data was transcribed and exported to Nvivo v10. Consent was sought from the young people.

Results YLHIV were sexually active Sex was there before we were born, its part of us, we can’t abstain forever YLHIV were sexually active Relationships with Sero-discordant partners Unplanned sexual encounters Challenging & inconsistent Negotiation4safe sex Disclosure Use of contraceptives ART-Health facilities No SRH services

Results… Public HIV-related stigma & discrimination Social isolation, Reduces social support networks Poor self-esteem Risky Sexual Behaviors In adequate SRH information Fuelling myths and misconceptions

Results… YLHIV faced cultural taboos Sexual immorality Inhibiting discussion of safer sex, Contraception use

Social vulnerability of YLHIV to SRH threats Complex information needs -Community myths & misconceptions -Cultural taboos -Individual information needs Psychosocial needs during sexual development -Stigma -Discrimination -Challenges of sexual development -Poor social support -Peer pressure Inability to negotiate safer sex and relationships -Non disclosure -Poor negotiation skills -Un planned sexual encounters -Gender inequality -Poverty

Conclusion Social vulnerability of YLHIV to SRH threats Complex and Multifaceted To address: -Need a holistic approach that addresses the broader social environment -Evolving capacity of YLHIV needs to be recognized and they require guidance and not instructions -Age appropriate information -YLHIV need to be treated as individuals rather than a homogenous group

Recommendations Interventions need to address the social determinants of SRH Programmes need to be flexible and responsive to the diverse and dynamic needs of YLHIV Counseling services need to help YLHIV to develop communication and negotiation skills for: Safer sex Disclosure & Condom use Contraceptive use SRH services need to be open, confidential, fun and integrated

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