Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-05-2019 | Sexually Transmitted Infection | Research

The knowledge-risk-behaviour continuum among young Ugandans: what it tells us about SRH/HIV integration

Authors: Raquel Palomino González, Damazo Twebaze Kadengye, Roy William Mayega

Published in: BMC Public Health | Special Issue 1/2019

Login to get access

Abstract

Background

With a human immunodeficiency virus (HIV) prevalence of 2.1% among 15–24 year olds, opportunities for further integration of sexual and reproductive health (SRH) and HIV prevention services for young people in Uganda exist. We examine a range of factors that contribute to variance in risky sexual behaviour among young Ugandans.

Methods

A cross-sectional, nationally representative household survey was conducted between February and March 2016. The questionnaire used assessed knowledge, attitudes and practices related to SRH among young people aged 10–24 years. A composite indicator was constructed to assess risky sexual behaviour, defined as being involved in sexual relations under the influence of alcohol or drugs, engaging in sexual activities without a condom, and having multiple sexual partners in the 6 months preceding the survey. Exploratory analysis was conducted to provide descriptive statistics. Logistic regression was conducted to determine the factors associated with risky sexual behaviour. This analysis focuses on the sub-category aged 15–24 years, comprised of 2725 respondents.

Results

Knowledge levels of family planning (FP), sexually transmitted infections (STIs) and HIV across all respondents were high (above 82%). Self-reported perceived risk of STIs and pregnancy was consistently higher among 20–24 year old respondents, with 61.5% feeling at risk of STIs compared to 46.2% of 15–19 year olds. A total of 22.7% of respondents reported having been involved in risky sexual behaviour. Factors associated with risky sexual behaviour among the 15–19 years group included gender, single orphanhood, casual work, schooling status, FP knowledge and self-perceived risk of STIs/HIV. For the 20–24 year old respondents, significantly associated factors included gender, educational level, relationship to head of household, place of residence, and self-perceived risk of pregnancy.

Conclusions

Despite high general SRH/HIV knowledge and perceived risk of pregnancy and HIV, risky sexual behaviour among young Ugandans remains high. Effectiveness gaps in the integrated SRH/HIV response for young people should be addressed and targeted interventions focused on holistic prevention at individual level through information, risk awareness, and skill development should be combined with interventions targeting social structures affecting individual behaviour.
Appendix
Available only for authorised users
Literature
1.
WHO, UNFPA, IPPF, UNAIDS. Sexual and reproductive health and HIV/AIDS: A framework for priority linkages. London, New York and Geneva: World Health Organization/United Nations Population Fund/International Planned Parenthood Federation/Joint United Nations Programme on HIV/AIDS; 2005.
2.
WHO, UNFPA, IPPF, UNAIDS, USCF. Sexual and reproductive health and HIV linkages: Evidence review and recommendations. Geneva, New York, London, San Francisco: World Health Organization, United Nations Population Fund, international Planned Parenthood Federation, joint United Nations Programme on HIV/AIDS, University of California san Francisco; 2009.
3.
4.
5.
Druce N, Dickinson C, Attawell K, White AC, Standing H. Strengthening linkages for sexual and reproductive health, HIV and AIDS: Progress, barriers and opportunities for scaling up. London: DFID Health Resource Centre; 2006.
6.
7.
IPPF, UNFPA, WHO, UNAIDS, GNP+, ICW, Young Positives. Rapid assessment tool for sexual & reproductive health and HIV linkages: a generic guide. London: IPPF, UNFPA, WHO, UNAIDS, GNP+, ICW and Young Positives; 2009.
8.
UNAIDS. 90-90-90. An ambitious treatment target to help end the AIDS epidemic. Geneva: Joint United Nations Programme on HIV/AIDS; 2014.
9.
UNAIDS. The sustainable development goals and the HIV response. Stories of putting people at the Centre. Geneva: Joint United Nations Programme on HIV/AIDS; 2017.
10.
Askew I, Berer M. The contribution of sexual and reproductive health services to the fight against HIV/AIDS: a review. Reprod Health Matters. 2003;11(22):51–73.CrossRef
11.
Government of Uganda, UNFPA. National dialogue on SRHR/HIV and SGBV integration report, 1st - 2nd November 2017. Entebbe: Unpublished; 2017.
12.
Republic of Uganda. National strategic plan for HIV&AIDS 2011/12 -2014/15. Revised. Kampala; 2012.
13.
Republic of Uganda National strategy for integration of sexual and reproductive health and rights and HIV/AIDS. Kampala: Ministry of Health; 2012.
14.
Government of Uganda. Presidential fast-track initiative on ending HIV & AIDS in Uganda. A presidential handbook. Kampala; 2017.
15.
Inter-agency Working Group on SRH and HIV Linkages. SRH and HIV linkages compendium. Indicators & related assessment tools. London: IPPF, UNFPA, WHO; 2014.
16.
17.
UBOS. Young people: The untapped resource for development. Thematic series based on the National Population and Housing Census 2014. Kampala: Uganda Bureau of Statistics; 2017.
18.
IPPF, UNFPA, WHO, UNAIDS. Uganda. Rapid assessment of SRH and HIV linkages. Kampala; 2012.
19.
UNDESA. Designing household survey samples: practical guidelines. Series F no.98. New York: United Nations Department of Economic and Social Affairs; 2005.
20.
Ministry of Education and Sports. National sexuality education framework. Kampala; 2018.
21.
UBOS. The national population and housing census 2014 – Main report. Kampala: Uganda Bureau of Statistics; 2016.
22.
Bazargan M, Kelly EM, Stein JA, Husaini BA, Bazargan SH. Correlates of HIV risk-taking behaviors among African-American college students: the effect of HIV knowledge, motivation, and behavioral skills. J Natl Med Assoc. 2000;92:391–404.PubMedPubMedCentral
23.
24.
Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV risk behavior. In: Peterson JL, DiClemente RJ, editors. Handbook of HIV prevention. Boston: Springer; 2000. p. 3–55.CrossRef
25.
26.
27.
28.
29.
30.
31.
32.
Lindegren ML, Kennedy CE, Bain-Brickley D, Azman H, Creanga AA, Butler LM, Spaulding AB, Horvath T, Kennedy GE. Integration of HIV/AIDS services with maternal, neonatal and child health, nutrition, and family planning services. Cochrane Database Syst Rev. 2012. https://​doi.​org/​10.​1002/​14651858.​CD010119.​
33.
Millstein SG, Halpern-Felsher BL. Perceptions of risk and vulnerability. In: Fischhoff B, Nightingale EO, Iannotta JG, editors. Adolescent risk and vulnerability: Concepts and measurement. Washington D.C.: National Academies Press; 2001.
34.
Fisher AW, Fisher JD, Harman J. The information–motivation–behavioral skills model: a general social psychological approach to understanding and promoting health behavior. In: Suls J, Wallston KA, editors. Social psychological foundations of health and illness. Malden: Blackwell Publishing Ltd; 2003.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
Perrino T, Gonzalez-Soldevilla A, Pantin H, Szapocznik J. The role of families in adolescent HIV prevention: a review. Clin Child Fam Psychol Rev. 2000;3(2):81–96.CrossRef
45.
DiClemente RJ, Wingood GM, Crosby R, Sionean C, Cobb BK, Harrington K, Davies S, Hook EW 3rd, Oh MK. Parental monitoring: association with adolescents' risk behaviors. Pediatrics. 2001;107(6):1363–8.CrossRef
46.
47.
48.
Fisher JD, Fisher WA, Williams SS, Malloy TF. Empirical tests of an information-motivation-behavioral skills model of AIDS preventive behavior. Health Psychol. 1994;13:238–50.CrossRef
Metadata
Title
The knowledge-risk-behaviour continuum among young Ugandans: what it tells us about SRH/HIV integration
Authors
Raquel Palomino González
Damazo Twebaze Kadengye
Roy William Mayega
Publication date
01-05-2019

Other articles of this Special Issue 1/2019

BMC Public Health 1/2019 Go to the issue

Research

Community-based self-collected human papillomavirus screening in rural Zimbabwe

Research

Evaluating the vertical HIV transmission risks among South African female sex workers; have we forgotten PMTCT in their HIV programming?

Research

Using partner notification to address curable sexually transmitted infections in a high HIV prevalence context: a qualitative study about partner notification in Botswana

Research

Predictors of early childhood HIV testing among children of sex workers living with HIV in Cameroon