Engaging migrants and displaced persons through family support group meetings for behavioral change and Access to Psychosocial support services: A case of AIDS Information centrr – Uganda. Authors: Dr. Hilda Kizito, Racheal Mirembe, Hannah Nakazibwe Tadeo Tumusiime and Nassali Teddy
Uganda hosts the largest number of refugees in East Africa particularly those escaping conflicts in their home states. Their vulnerability as displaced persons places them at risk of contracting HIV because of various socio-economic factors such as unemployment and rape of refugee girls and women. Refugees who are already PLHIV require linkage to HIV care, treatment and support services which may not be readily accessible particularly to urban refugees.
METHODS: The AIDS information centre (AIC) provides comprehensive HIV services to urban refugees in Kampala city referred from InterAid Uganda (an NGO working with UNHCR). Between January – December 2018, 99 refugees (including 15 children and adolescents) accessed these services. Among the services provided was Antiretroviral Therapy for 92 refugees. Psychosocial support is a key pillar in HIV care and as such we sought to prioritize these clients’ psychosocial needs and define the challenges in counselling support they encounter at the centre. Therefore, between July to September 2018 all refugee clients on ART were required to have at least one individual counselling session and were invited to group counselling through inclusion in family support group meeting.
RESULTS: From these sessions, the following were highlighted:
- Language barriers prevent comprehensive counselling – the refugees express themselves more fluently in Swahili and/or French than in English or other local languages.
- Suffer post-traumatic stress disorders particularly those who experienced rape and war.
- Distrust fellow refugees affecting uptake of group sessions or community ART distribution.
- Unwilling to participate in support groups which lack tangible benefits like food and money.
- Suffer stigma and discrimination amongst fellow refugees and typically don’t disclose their HIV status. This prevents the identification of treatment supporters.
- Prone to sexual exploitation and gender based violence.
- Non-adherence to ART in hope of repatriation to the West on medical grounds.
- Prefer to suffer homelessness and nutritional lack rather than to live in designated refugee camps.
- Refugees require comprehensive counselling to include issues not related to HIV/AIDS.
- Healthcare workers need to become multilingual to support the counselling needs of this community.
- There is need to support income generating activities and urban gardening for this community.