ArticleBMJ global health2022
Examining the substance use, violence, and HIV and AIDS (SAVA) syndemic among urban refugee youth in Kampala, Uganda: cross-sectional survey findings.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Gender-based violence syndemics in global health: A systematic review.Social science & medicine (1982) · 2025Pooled it
- Prevalence and epidemiological distribution of substance use among people living with HIV in the East African region: a meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Prevalence and associated factors of depression among refugees in East Africa: a systematic review and meta-analysis.BMC psychiatry · 2024Pooled it
- Prevalence of physical violence against people in insecure migration status: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Economic precarity shapes engagement in sex work and HIV-related behaviors among African refugee male sex workers in Italy: A mixed-methods study.Research square · 2026Article
- Trauma led us to substance use: an interpretative phenomenological analysis of refugee youth experiences with substance use during the COVID-19 pandemic in Uganda.BMJ public health · 2026Article
- Substance Use and HIV Risk in a Syndemic Context: Vulnerabilities Among African Refugee Sex Workers in Italy.Research square · 2025Article
- Developing and testing tele-support psychotherapy using mobile phones for depression among youth in Kampala district, Uganda: study protocol for a pilot randomized controlled trial.Frontiers in digital health · 2025Article
- Prevalence of depression and associated factors among HIV/AIDS Patients on HAART in Okugu Refugee Camp, Gambella, Ethiopia.Frontiers in psychiatry · 2025Article
- Sexual health of Syrian women in protracted forced displacement: the syndemic interplay of violence, war trauma, poor mental health and food insecurity.BMJ public health · 2025Article
- Article
- Vulnerable conditions syndemic, depression, and suicidal ideation among school children in China: cross-sectional census findings.Child and adolescent psychiatry and mental health · 2024Article
- Sexual and reproductive health among forcibly displaced persons in urban environments in low and middle-income countries: scoping review findings.Reproductive health · 2024Article
- Combining a guided self-help and brief alcohol intervention to improve mental health and reduce substance use among refugee men in Uganda: a cluster-randomized feasibility trial.Global mental health (Cambridge, England) · 2024Article
- Exploring ecosocial contexts of alcohol use and misuse during the COVID-19 pandemic among urban refugee youth in Kampala, Uganda: Multi-method findings.Journal of migration and health · 2024Article
- War, forced displacement, and alcohol abuse: experiences and perceptions of war-affected south Sudanese refugee youth living in Bidibidi refugee settlement in northern Uganda.Frontiers in public health · 2024Article
- A syndemic of inequitable gender norms and intersecting stigmas on condom self-efficacy and practices among displaced youth living in urban slums in Uganda: a community-based cross-sectional study.Conflict and health · 2023Article
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInteractions between substance use, violence, HIV and AIDS, known as the 'SAVA' syndemic, are understudied among refugee youth. We assessed the synergistic effects of frequent alcohol use, depression and violence on HIV vulnerability among urban refugee youth aged 16-24 years in Kampala, Uganda.
methodsWe conducted a cross-sectional survey between January and April 2018 with a convenience sample of refugee youth aged 16-24 years living in informal settlements in Kampala (Kabalagala, Rubaga, Kansanga, Katwe, Nsambya). We assessed non-communicable health conditions (frequent [≥3 times per week] alcohol use [FAU]; depression); violence (young adulthood violence [YAV] at age ≥16 years, intimate partner violence [IPV]), and HIV vulnerability (past 12-month transactional sex; recent [past 3-month] multiple [≥2] sex partners). We calculated the prevalence and co-occurrence of non-communicable health conditions, violence and HIV vulnerability variables. We then conducted multivariable logistic regression analyses to first create unique profiles of FAU, depression, YAV and IPV exposures, and second to assess for interactions between exposures on HIV vulnerability outcomes.
resultsMost participants (n=445; mean age: 19.59, SD: 2.6; women: n=333, 74.8%, men: n=112, 25.2%) reported at least one non-communicable health condition or violence exposure (n=364, 81.8%), and over half (n=278, 62.4%) reported co-occurring exposures. One-fifth reported FAU (n=90; 20.2%) and one-tenth (n=49; 11%) major depression. In logistic regression models including all two-way product terms, adjusted for sociodemographics, we found (a) multiplicative interaction for joint effects of FAU and IPV (adjusted OR (aOR)=4.81, 95% CI: 1.32 to 17.52) on multiple sex partners, and (b) multiplicative interaction for joint effects of FAU and IPV (aOR=3.72, 95% CI: 1.42 to 9.74), and YAV and depression (aOR=7.13, 95% CI: 1.34 to 37.50), on transactional sex.
conclusionFindings signal the importance of addressing the SAVA syndemic among urban refugee youth in Uganda. Synergistic interactions indicate that addressing FAU, depression or violence may concomitantly reduce HIV vulnerability with urban refugee youth.
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