Experiences and perceptions of youth living with HIV in Western Uganda on school attendance: barriers and facilitators

摘要

Background: The globally recognized socio-economic benefits of education have stirred many countries in SubSaharanAfrica like Uganda to promote universal access to schooling by removing fiscal barricades for those inprimary and secondary schools. However, the proportion of Youth Living With HIV/AIDS (YLWHA) missing school,studying with difficulties and dropping out of school in Uganda has been observed to be higher than that of otheryouth. This study aimed at understanding the barriers and facilitators for YLWHA in Uganda to attend school.Methods: We conducted a qualitative inquiry with 35 purposively selected YLWHA aged 12 to 19 years, including16 females at three accredited Antiretroviral Therapy (ART) treatment centres in Kabarole district in WesternUganda. Individual semi-structured interviews were tape-recorded, transcribed verbatim and subjected to thematicinductive analysis.Results: We identified five main themes in which barriers to attend school were reported and four main themes inwhich facilitators were reported by participants. The main themes for barriers were: 1) management of ART andillnesses, 2) fear, negative thoughts and self-devaluation, 3) lack of meaningful and supportive relationships, 4)reactionary attitudes and behaviours from others at school, 5) financial challenges. The main themes for facilitatorswere: 1) practical support at school, home and community, 2) counselling, encouragement and spirituality, 3)individual coping strategies, 4) hopes, dreams and opportunities for the future.Conclusion: Most of the barriers reported arose from HIV-related stigma and financial challenges whose genesistranscends school boundaries. While YLWHA reported measures to cope, and support from other people, thesewere non-sustainable and on a limited scale due to disclosure apprehension at school and the indiscretion of thosewho learnt about their status. To promote supportive school environments for YLWHA, integrated curricular andextracurricular interventions are necessary to increase HIV knowledge, dispel misconceptions about HIV andconsequently transform the school community from a stigmatizing one to a supportive one.