A Social Ecological Approach: Understanding the Factors Associated with HIV Risk in Fishing Communities in Lake Victoria, Uganda.

Uganda has an estimated 1.4 million Human Immunodeficiency Virus (HIV) -positive adults (United Nations Program on HIV/AIDS [UNAIDS], 2011). The initial cases of acquired immune deficiency syndrome (AIDS) in Uganda were identified in fishing villages on the shores of Lake Victoria in 1985 (Serwadda et al., 1985). Fishing villages continue to remain at high risk of HIV transmission (United Nations Program on HIV/AIDS [UNAIDS], 2012). Evidence suggests that the HIV- prevalence rates among fishermen and commercial sex workers (CSWs) in the Wakiso District are more than 20 percent (Alex, Michael, & Nordin, 2011). The purpose of this study was to understand the factors associated with HIV risk in fishing communities in the Wakiso District of Lake Victoria in Uganda using the social ecological model (Stokols, 1995). Eight focus groups (n=50) were conducted to understand the dynamics of these communities in Lake Victoria, Uganda. The focus groups were composed of six or seven individuals. Two focus groups were conducted with fishermen, fishmongers and alcohol sellers. One focus group was conducted with commercial sex workers and one other focus group was with restaurant ors. The data showed that negative health behavior factors were present at all levels of the social ecological model (intrapersonal, interpersonal, community, & policy) in the fishing communities and are a driving force in the increased HIV risk of individuals. Understanding these social ecological factors can guide targeted multi-level interventions to achieve a decrease in new HIV infections in fishing communities