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BMC Women's Health
Published in: BMC Women's Health 1/2015

Open Access 01-12-2015 | Research article

Prevalence of sexual coercion and its association with unwanted pregnancies among young pregnant females in Kampala, Uganda: a facility based cross-sectional study

Authors: Suzan Tusiime, Geofrey Musinguzi, Benjamin Tinkitina, Norah Mwebaza, Rose Kisa, Ronald Anguzu, Noah Kiwanuka

Published in: BMC Women's Health | Issue 1/2015

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Abstract

Background

Sexual coercion is associated with sexually transmitted infections and unwanted pregnancies with consequential unsafe abortions and increased maternal morbidity and mortality. Current literature focuses mainly on its risk factors but less on its resultant deleterious health effects. We conducted a study to determine the prevalence of sexual coercion and its association with unwanted pregnancies among young pregnant women.

Methods

In a cross-sectional study, four hundred and sixteen (416) consenting pregnant females aged 15–24 years attending antenatal clinics in Lubaga division Kampala district in Uganda were enrolled using systematic sampling. Quantitative and qualitative data on sexual coercion were collected by female interviewers.
Adjusted Prevalence Proportion Ratios (Adj. PPRs) of unwanted pregnancy and associated 95 % confidence intervals were estimated by generalized linear models with log link function and Poisson family distribution using robust variance estimator. Quantitative data were analyzed using Stata version 10.0, while qualitative data were analyzed using manifest content analysis.

Results

Prevalence of sexual coercion was 24 % and was higher among those who had non consensual sexual debut (29.0 %) compared with those who had consensual sexual debut (22.6 %). The prevalence of unwanted pregnancy was 18.3 % and was higher among participants who had been sexually coerced relative to their counterparts (p < 0.001). History of sexual coercion in the past 12 months and non consensual sexual debut were associated with unwanted pregnancy [adj.PPR = 2.23, 95 % CI: (1.49-3.32)] and 1.72, 95 % CI: (1.16- 2.54)] respectively. Qualitative results indicated that different forms/contexts of sexual coercion, such as deception, transactional sex and physical force influenced unwanted pregnancies.

Discussion

This study highlights that a quarter of our participants in our quantitative study had experienced sexual coercion in the past twelve months and nearly a third of these, had history of non consensual sexual debut. Unwanted pregnancy was higher among the sexually coerced and those who had non consensual sexual debut.

Conclusion

Sexual coercion among pregnant women aged 15–24 years in Kampala, Uganda is high and is significantly associated with unwanted pregnancy. Comprehensive sex education targeting young people (<25 years), along with availability and access to youth friendly centers may be useful in addressing sexual coercion and its negative outcomes.
Literature
1.
WHO. Preventing intimate partner and sexual violence against women Taking action and generating evidence. Geneva: WHO; 2010.
2.
Bott S, ed. Sexual violence and coercion: implications for sexual and reproductive health. Social determinants of sexual and reproductive health, ed. S. Malarcher. World Health Organisation (WHO). 2010. 133
3.
UNHCR, Sexual and Gender-Based Violence against Refugees, Returnees and Internally Displaced Persons. 2003, United Nations High Commissioner for Refuges.
4.
UN, UNiTE to End Violence Against Women. UN: Published by the UN Department of Public Information, DPI/2546A. 2009.
5.
Cuccinelli KT. Domestic and Sexual Violence in Virginia. Virginia: Law; 2010.
6.
Erulkar AS. The experience of sexual coercion among young people in Kenya. International family planning perspectives, 2004;30(4):182–189.CrossRefPubMed
7.
Ajuwon A, Olaleye A, Faromoju B, Ladipo O. Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria. BMC Public Health. 2006;6(1):310.CrossRefPubMedPubMedCentral
8.
Moore AM, Awusabo-Asare K, Madise N, John-Langba J, Kumi-Kyereme A. Coerced first sex among adolescent girls in Sub-Saharan Africa: prevalence and context. Afr J Reprod Health. 2007;11(3):62.CrossRefPubMedPubMedCentral
9.
Zablotska IB, Gray RH, Koenig MA, Serwadda D, Nalugoda F, Kigozi G, et al. Alcohol use, intimate partner violence, sexual coercion and HIV among women aged 15–24 in Rakai, Uganda. AIDS Behav. 2009;13(2):225–33.CrossRefPubMed
10.
Van Decraen E, Michielsen K, Herbots S, Van Rossem R, Temmerman M. Sexual coercion among in-school adolescents in Rwanda: prevalence and correlates of victimization and normative acceptance. Afr J Reprod Health. 2012;16(3):140–54.PubMed
11.
Wagman J, Baumgartner JN, Geary CW, Nakyanjo N, Ddaaki WG, Serwadda D, et al. Experiences of sexual coercion among adolescent women qualitative findings from Rakai District, Uganda. J Interpers Violence. 2009;24(12):2073–95.CrossRefPubMed
12.
Choudhry V, Ambresin A-E, Nyakato VN, Agardh A. Transactional sex and HIV risks-evidence from a cross-sectional national survey among young people in Uganda. Global Health Action. 2015;8.
13.
Ybarra ML, Bull SS, Kiwanuka J, Bangsberg DR, Korchmaros J. Prevalence rates of sexual coercion victimization and perpetration among Uganda adolescents. AIDS Care, 2012.
14.
Manopaiboon C, Kilmarx PH, Limpakarnjanarat K, Jenkins RA, Chaikummao S,Supawitkul S, et al. Sexual coercion among adolescents in northern Thailand: prevalence and associated factors. 2003.
15.
Varga CA. How gender roles influence sexual and reproductive health among South African adolescents. Stud Fam Plann. 2003;34(3):160–72.CrossRefPubMed
16.
Jewkes R, Morrell R. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention. J Int AIDS Soc. 2010;13(1):6.PubMedPubMedCentral
17.
Heise L, Ellsberg M, and Gottemoeller M. Ending violence against women. 1999.
18.
Koenig MA, Lutalo T, Zhao F, Nalugoda F, Kiwanuka N, Wabwire-Mangen F, et al. Coerced first intercourse and reproductive health among adolescent women in Rakai, Uganda. International family planning perspectives, 2004;30(4):156–163.CrossRefPubMed
19.
Maharaj P, Munthree C. Coerced first sexual intercourse and selected reproductive health outcomes among young women in KwaZulu-Natal, South Africa. J Biosoc Sci. 2007;39(2):231.CrossRefPubMed
20.
Hubacher D, Mavranezouli I, McGinn E. Unintended pregnancy in sub-Saharan Africa: magnitude of the problem and potential role of contraceptive implants to alleviate it. Contraception. 2008;78(1):73–78.CrossRefPubMed
21.
UBOS. Uganda Demographic and Health Survey. Kampala: Uganda Bureau of statistics; 2011.
22.
Kaye DK, Mirembe FM, Bantebya G, Johansson A, Ekstrom AM. Domestic violence as risk factor for unwanted pregnancy and induced abortion in Mulago Hospital, Kampala, Uganda. Trop Med Int Health. 2006;11(1):90–101.CrossRefPubMed
23.
Levandowski BA, Kalilani-Phiri L, Kachale F, Awah P, Kangaude G, Mhango C. Investigating social consequences of unwanted pregnancy and unsafe abortion in Malawi: the role of stigma. Int J Gynaecol Obstet. 2012;118:S167–71.CrossRefPubMed
24.
Logan C, Holcombe E, Manlove J, Ryan S. The consequences of unintended childbearing. Washington, DC: Child Trends and National Campaign to Prevent Teen Pregnancy. 2007;28:142–51.
25.
Stella Neema FHARK, Akinrinola Bankole, Adolescent Sexual and Reproductive Health in Uganda: Results from the 2004 National Survey of Adolescents. 2006, Guttmacher Institute.
26.
UNICEF. Adolescence: A time that matters. 2002: UNICEF.
27.
PRB. Unsafe Arbortion Facts and Figures. Washington DC: Population Reference Bureau; 2006.
28.
Oye-Adeniran BA, Adewole IF, Umoh AV, Ekanem EE, Gbadegesin A, Iwere N. Community-Based Survey of Unwanted Pregnancy in Southwestern Nigeria. Afr J Reprod Health. 2004;8(3):103–15.CrossRefPubMed
29.
McFarlane J. Pregnancy following partner rape what we know and what we need to know. Trauma, Violence, Abuse. 2007;8(2):127–34.CrossRefPubMed
30.
Singh S, Wulf D, Hussain R, Bankole A, Sedgh G, Abortion Worldwide: A Decade of Uneven Progress. Guttmacher: Guttmacher Institute. 2013.
31.
Magadi M. Poor pregnancy outcomes among adolecents in South Nyanza Region of Kenya. Afr J Reprod Health. 2007;10(1):26–38.CrossRef
32.
Guttmacher, Unintended Pregnancy and Abortion in Uganda. Guttmacher: Guttmacher Institute. 2009.
33.
Organization WH. WHO guidelines on preventing early pregnancy and poor reproductive health outcomes among adolescents in developing countries. Geneva: WHO; 2011.
34.
Agardh A, Odberg-Pettersson K, Ostergren PO. Experience of sexual coercion and risky sexual behavior among Ugandan university students. BMC Public Health. 2011;11(1):527.CrossRefPubMedPubMedCentral
35.
Birungi R, Nabembezi D, Kiwanuka J, Ybarra M, Bull S. Adolescents’ perceptions of sexual coercion in Uganda. Afr J AIDS Res. 2011;10(4):487–94.CrossRefPubMed
36.
Kish L. ed. Survey Sampling. Newyork, USA: Wiley. 1965.
37.
Gaikwad V, Madhukumar S, Sudeepa D. A Study of Unwanted Pregnancy and Knowledge of Emergency Contraception in Currently Pregnant Women in Bangalore Rural. Indian Journal of Public Health Research & Development. 2014;5(1):42.CrossRef
38.
UBOS. Uganda Demographic Health Survey. Kampala: Uganda Bureau of Statistics (UBOS) and Macro International Inc; 2006.
39.
Heise L, Moore K, Toubia N. Sexual Coercion and Reproductive Health, A focus on Research. New York: The Population council. 1995.
40.
Kongnyuy EJ, Ngassa P, Fomulu N, Wiysonge CS, Kouam L, Doh AS. A survey of knowledge, attitudes and practice of emergency contraception among university students in Cameroon. BMC Emerg Med. 2007;7(1):7.CrossRefPubMedPubMedCentral
41.
WHO. Ethical and Safety Recommendations for Research on Domestic Violence Against Women. Geneva: WHO; 2001.
42.
UNCST. National Guidelines for Research Involving Humans as Research Participants. Kampala: UNCST; 2007.
43.
Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3(1):21.CrossRefPubMedPubMedCentral
44.
Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6.CrossRefPubMed
45.
Deddens J, Petersen MR, Endahl L. Prevalence proportion ratios: estimation and hypothesis testing. Int J Epidemiol. 1998;27(1):91–5.CrossRefPubMed
46.
Gessessew A. Abortion and Unwanted Pregnancy in Adigrat Zonal Hospital, Tigray, North Ethiopia. Afr J Reprod Health. 2010;14(3):183–8.PubMed
47.
Agardh A, Tumwine G, Asamoah BO, Cantor-Graae E. The invisible suffering: sexual coercion, interpersonal violence, and mental health-a cross-sectional study among university students in south-western Uganda. PLoS One. 2012;7(12):e51424.
48.
Hamdela B, Tilahun T. Unwanted Pregnancy and Associated Factors among Pregnant Married Women in Hosanna Town, Southern Ethiopia. PLoS One. 2012;7(6):e39074.
49.
Sedgh G, Bankole A, Oye-Adeniran B, Adewole IF, Singh S, Hussain R. Unwanted pregnancy and associated factors among Nigerian women. International family planning perspectives, 2006: p. 175–184.
50.
Kassa N, Berhane Y, Worku A. Predictors of unintended pregnancy in Kersa, Eastern Ethiopia, 2010. Reprod Health. 2012;9(1):1.
51.
Garoma S, Belachew T, Wondafrash M, Duke N, Sieving R, Pettingell S, et al. Sexual coercion and reproductive health outcomes among young females of Nekemte Town South West Ethiopia. Ethiop Med J. 2008;46(1):19–28.PubMed
52.
Neema S, Ahmed FH, Kibombo R, Bankole A. Adolescent sexual and reproductive health in Uganda: results from the 2004 National Survey of Adolescents. Occasional Report, 2006;25(25):28.
53.
Kuortti M, Kosunen E. Risk-taking behaviour is more frequent in teenage girls with multiple sexual partners. Scand J Prim Health Care. 2009;27(1):47–52.CrossRefPubMedPubMedCentral
54.
WHO. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO; 2013.
Metadata
Title
Prevalence of sexual coercion and its association with unwanted pregnancies among young pregnant females in Kampala, Uganda: a facility based cross-sectional study
Authors
Suzan Tusiime
Geofrey Musinguzi
Benjamin Tinkitina
Norah Mwebaza
Rose Kisa
Ronald Anguzu
Noah Kiwanuka
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2015
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-015-0235-9

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