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Positive Influences and Challenges for the Deaf Community Navigating Access to HIV Information, Testing, and Treatment in Kampala, Uganda: A Qualitative Study

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Abstract

Although sub-Saharan Africa has the highest HIV burden globally, few studies have investigated disabilities and HIV in this region. We conducted a secondary analysis of text data from in-depth interviews (2014–2015) to describe HIV perceptions among a subsample of 73 deaf individuals participating in the Crane survey, Kampala, Uganda. Being deaf was defined as being profoundly or functionally deaf, having deafness onset 5 + years ago, and preferring sign language to communicate. Among participants ever tested for HIV (47%), most (88%) had a negative test. Thematic analysis revealed overcoming challenges/barriers followed by socioeconomic status, support systems, HIV, stigma, abuse, and health conditions as major themes. An unanticipated finding was the role of sex work to support basic living needs. The data showed related themes among participants, suggesting a complex context in which deaf participants experience HIV prevention and treatment. It is important to tailor HIV interventions for deaf and disabled persons.

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Acknowledgements

We are thankful to the  Crane survey staff and the deaf participants who participated in the survey and Larissa Cruz and Forrest Brady for editing this manuscript.

Funding

This project has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention under the terms of cooperative agreement 5U2GPS000971.

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Authors and Affiliations

  1. Division of Global HIV & Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, 1 Corporate Boulevard, MS E-30, Atlanta, GA, 30329, USA

    Italia V. Rolle, Naeemah Logan & Wolfgang Hladik

  2. Internal Medicine Residency Program, The George Washington University, Washington, DC, USA

    Amanda Moyer

  3. School of Public Health, Makerere University, Kampala, Uganda

    Moses Ogwal, Ronald Kibalama, Justine Nyende, Patrick Awoii, Dorcus Julliet & David Serwada

  4. Morehouse School of Medicine, Atlanta, GA, USA

    Jonela Rogers

  5. Division of Global HIV & Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Kampala, Uganda

    Enos Sande & George Aluzimbi

Authors
  1. Italia V. Rolle
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  2. Amanda Moyer
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  3. Moses Ogwal
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  4. Naeemah Logan
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  5. Jonela Rogers
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  6. Enos Sande
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  7. Ronald Kibalama
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  8. George Aluzimbi
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  9. Justine Nyende
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  10. Patrick Awoii
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  11. Dorcus Julliet
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  12. David Serwada
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  13. Wolfgang Hladik
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Contributions

IR: developed and wrote the manuscript, coded the qualitative interviews. AM: developed codebook and coded the qualitative interviews. NL, JR: developed codebook and contributed to manuscript development. DS, ES, GA, MO, WH: designed the study and contributed to manuscript development. JN, RK, PA, DJ: conducted interviews and interpreted.

Corresponding author

Correspondence to Italia V. Rolle.

Ethics declarations

Conflict of interests

The authors declare that they have no conflict of interests.

Ethical Approval

The Crane survey was approved by Makerere University’s Institutional Review Board and the Center for Global Health in the United States Centers for Disease Control and Prevention. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to Participate

Informed consent was obtained from all individual participants included in the study. All deaf participants reviewed a video-based informed consent, and provided non-written consent through sign language.

Data Availability

The questionnaire is provided as an additional file. The data are not publicly available.

Code Availability

The qualitative codebook is provided in the manuscript.

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Supplementary Information

Below is the link to the electronic supplementary material.

Additional file 1: Deaf qualitative interview questions. Supplementary file1 (PDF 78 KB)

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Rolle, I.V., Moyer, A., Ogwal, M. et al. Positive Influences and Challenges for the Deaf Community Navigating Access to HIV Information, Testing, and Treatment in Kampala, Uganda: A Qualitative Study. AIDS Behav 26, 1222–1228 (2022). https://doi.org/10.1007/s10461-021-03477-5

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