COVID-19 related stressors and alcohol use among urban refugee youth in Kampala, Uganda

Background: It is critical to understand COVID-19 impacts on stress and related substance use among refugee youth in Uganda—Sub-Saharan Africa’s largest refugee hosting nation. This is particularly salient in Kampala, where refugees disproportionately experience poverty. To understand stressors and coping strategies, including alcohol use, during COVID-19, we conducted a qualitative study with urban refugee youth living in informal settlements in Kampala, Uganda.

Methods: We conducted in-depth individual interviews (IDI) with refugee youth aged 16-24 (n=24) and key informants (n=6) (social/health providers), living in five informal settlements in Kampala. We applied thematic analyses across qualitative data to explore linkages between COVID-19 related stress and coping strategies.

Results: Key themes across qualitative narratives (youth: n=24; n=12 women, n=12 men; mean age: 21 years old) included a) pandemic-related economic insecurity contributed to food and water insecurity and stress, which in turn contributed to alcohol related coping; b) hazardous alcohol use often resulted in physical harm, including harm to oneself and at time harm to others; and c) 'idleness' caused by elevated unemployment and school closures during the lockdown magnified chronic stress.

Conclusion: Findings suggest that chronic stress and poverty contribute to coping strategies including hazardous alcohol use. Understanding interactions between alcohol use and larger socio-structural risk environments can advance localized supportive strategies and hazardous alcohol use prevention with urban refugee youth in Uganda.