article · PLOS Global Public Health
Refugee children and adolescents living with HIV in Uganda experience compounded mental health and psychosocial difficulties due to both their humanitarian circumstances and their HIV status. While multiple health and social welfare partners provide support in refugee settlements across West Nile, existing mental health and psychosocial support services have lacked clear documentation to guide service design and care-seeking. Qualitative investigations involving young people living with HIV, caretakers, and care providers identified three core thematic areas: perceptions and indicators of mental unwellness, the intersecting challenges stemming from displacement and HIV serostatus, and the contributions of various actors to psychosocial wellbeing. The findings show that mental health challenges and interventions in these settings are multifaceted, relying on specialised personnel, non-specialised providers, and the children themselves to navigate and address contextual needs.
Displaced children with HIV experience severe disruptions to healthcare and heightened psychosocial distress. Understanding how mental health is perceived and treated within humanitarian settlements enables public health agencies and humanitarian organisations to design targeted, culturally sensitive mental health support programmes that integrate both professional clinical services and community resources to improve outcomes for vulnerable young populations.
The abstract does not indicate a direct commercial application pathway. The findings instead offer early-stage qualitative evidence to assist humanitarian agencies, social welfare bodies, and healthcare non-governmental organisations in designing and structuring mental health and psychosocial support programmes within refugee settlements.
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Refugee populations face disruptions in social services, particularly HIV- related care such as access to Highly Active Antiretroviral Therapy. Uganda hosts the highest number of refugees in Africa. These children and adolescents (CAs) are faced with several mental health and psychosocial challenges that are amplified by their humanitarian context. Multiple health and social welfare partners support Children and Adolescents with HIV (CA-HIV) in overcoming these challenges. However, no clear documentation exists on the mental health and psychosocial support (MHPSS) services available to aid the care-seeking process and design. We therefore set out to explore MHPSS services for CA-HIV in the refugee settlements of West Nile, Uganda. This study utilized an exploratory-descriptive qualitative approach. Participants included CA-HIV, their caretakers and people involved in offering MHPSS services to them. Altogether, we conducted 4 in-depth interviews and 9 focus group discussions. Study participants were recruited from refugee settlements in West Nile, Uganda and were invited to participate in focus group discussions, key informant interviews and in-depth interviews. The proceedings from these discussions and interviews were audio recorded, transcribed, and translated to English when necessary. Analysis by inductive thematic analysis was done using NVivo software. Three key themes emerged: Perceptions and markers of mental unwellness (including etiology, signs and symptoms), MHPSS and its related challenges among refugee CA-HIV (arising due to both the HIV serostatus and refugee status of the CA) and the role of the self, specialized and non-specialized service providers towards the MHPSS wellbeing of this population. MHPSS markers, challenges and interventions are multifaceted. The interventions involve specialized personnel, non-specialized personnel and the children themselves. All these ought to be carefully considered as we seek to address the contextual MHPSS challenges faced by refugee CA-HIV.
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DOI: 10.1371/journal.pgph.0007000
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