Next Article in Journal
Metal Water-Sediment Interactions and Impacts on an Urban Ecosystem
Previous Article in Journal
Health Risks Associated with Exposure to Filamentous Fungi
Article Menu
Issue 7 (July) cover image

Export Article

Open AccessArticle
Int. J. Environ. Res. Public Health 2017, 14(7), 721;

Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

Equity and Health Policy Research Group, Department of Public Health Sciences, Karolinska Institute, Tomtebodavägen 18a, Widerströmska Huset, 171 77 Stockholm, Sweden
Centre for Global Health (CGH), Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland
Ministry of Health, Mogadishu, Somalia
Banadir Hospital, Women and Child Care Section, Mogadishu, Somalia
Author to whom correspondence should be addressed.
Received: 10 June 2017 / Revised: 27 June 2017 / Accepted: 29 June 2017 / Published: 5 July 2017
(This article belongs to the Section Global Health)
Full-Text   |   PDF [276 KB, uploaded 5 July 2017]


Background: Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Methods: Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to families and communities, which creates a risk of self-isolation and ill health. Still, affected individuals have developed resilient mechanisms for managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups, and maintain the utmost optimism about their prognosis. View Full-Text
Keywords: Somali; conflict; health system; resilience; fragile; access; government; NGO Somali; conflict; health system; resilience; fragile; access; government; NGO
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Kulane, A.; Owuor, J.O.A.; Sematimba, D.; Abdulahi, S.A.; Yusuf, H.M.; Mohamed, L.M. Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali. Int. J. Environ. Res. Public Health 2017, 14, 721.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top