Table 1.

Material contexts associated with HIV and STI prevention and testing engagement with urban refugee adolescents and youth in Kampala, Uganda

Material context	Sub‐theme	Illustrative quotation
Transportation and location	Close proximity helpful to access HIV/STI testing	‘Some people get interested since they want to know their status, so if that service comes nearby in a community which you are living in, it becomes an advantage. It is for free’. (focus group [FG], young women, aged 20–24, ID#6) ‘There can be still some challenges so far, for example transport, to find transport is very difficult because most of them they don’t work and they are jobless. They don’t have money. So, the distance also can be a challenge and the means of reaching there’. (KI, young refugee agency) ‘Let them know if there will be transport, once you explain to them, maybe we shall need one day a campaign where you mobilise all youths’. (FG, young men, aged 20–24, ID #3) ‘Sometimes you find that someone stopped going for testing because the place is very far’. (FG, young women, aged 16–19, ID #8) ‘Up to now we still find sex workers that are shy, yet are in Kampala town; you can't tell them to go to a street in Kampala..most times if we mobilize them to come here we get them transportation’. (KI, sex work agency)
	Need far distance from home for privacy	‘We need privacy and it’s an assurance that no one will know whether you’re positive or negative, no one will see you going to hospital for test. After that you may go on for treatment but at least you are doing it alone because you may choose any hospital which is farther from your house’. (FG, young men, aged 20–24, ID #6)
Private spaces	For self‐testing implementation and disposal	‘Have (testing) at these centres, tents in schools, and in the community because it allows some people to go and do their test not in the centres that are near them, but attend centres that are farther because they don’t trust health workers there, and they need privacy’. (FG, young men, aged 20–24, ID #8)
	To access self‐testing kits	‘It’s better to have them [HIV self‐test kits] in all centres like clinics, pharmacies, its more accessible’ (FG, young men, aged 20–24, ID #7) ‘We can put them [HIV self‐testing kits] in churches and universities’ (FG, young women, aged 16–19, ID #2)
Literacy	Literacy and a lack of access to formal education is a barrier	‘There are people who know how to read and those who don’t know how to read, so I think during the period of distribution, you first teach them so that they can also use without reading those instructions. I think you can first explain to them, and even if they don’t read the instructions they can still use that test kit’. (FG, young women, aged 20–24, ID #3) ‘We as community members have to create a lot of awareness first, because there are people who have never been to school and they know nothing about this self‐test’. (FG, young women, aged 16–19, ID #2)
	Illustrations may not be sufficient so there is a need for alternative ways of educating	‘I think we can use the community radio and make an announcement that these young people can come and test for free, so most of the time if you have tested recently or know your status they don’t tend to go there but those ones who have never tested or those ones who tested a long time ago are the ones who come. So when you call out like that, the people who come are the exact people that you want’. (FG, young women, aged 16–19, ID #9) ‘When it comes to sex workers, you still have to physically show them how these instructions are practically done. Even beyond the pictures. At some point, stand there and show them exactly the whole process as they are looking. Because some of the sex workers are not educated’. KI, sex work agency) ‘It is not a matter of just reading the instructions, it is better if someone comes to buy it and you explain to them how it is used and how long it takes to wait for the results, that it is twenty minutes. Because you might just give it out and on reaching at home they wonder where to insert it, whether in the armpit, so it is good you first teach them how to use it’. (FG, young women, aged 20–24, ID #2)
Language	For HIV self‐testing instructions	‘You can add as many languages as you can, because here we have refugees from different locations’. (FG, young women, aged 16–19, ID #3) ‘If (HIV/STI) leaflets are distributed, they should also be translated into French and Swahili’. (KI, humanitarian agency) ‘You should also have persons that speak different languages, say Lingala, French, since these refugees may not feel comfortable speaking Luganda or English. When they realize that you have someone who speaks their language, they open up’. (KI, HIV service provider) ‘There are those who are educated but don't know English, yet most of these instructions are in English. Now if I take it to an old person and I tell them it is here, and I go away, they cannot know what is there because the instructions are in English. For example, if the instructions say open the box, they should also put it in Swahili, French’. (FG, young women, aged 20–24, ID #1)
	For HIV services and healthcare	‘Most times we can't go for an outreach without a counsellor who we attach to an interpreter, because sometimes they trust that person who speaks their language who explains very well in their own language’. (KI, sex work agency) ‘At a facility, refugees mainly have a language barrier because most of them speak French and Lingala like the Congolese, the Burundians French and Kirundi, then Rwandese French and Kinyarwanda… majority like eighty percent are affected by language barrier. We tried to help them access health services by placing volunteers… to support their fellow refugees access health services because they understand the local languages for refugees and also English so that they can interpret for refugees when they go to health centers during sessions with doctors and nurses’. (KI, humanitarian agency)