Open AccessSexual-risk behaviours and HIV and syphilis prevalence among in- and out-of-school adolescent girls and young women in Uganda: A cross-sectional study
Author(s) -
Joseph K. B. Matovu,
Justine Bukenya,
Dickson Kasozi,
Stephens Kisaka,
Rose Kisa,
Agnes Nyabigambo,
Abdulaziz Tugume,
John Baptist Bwanika,
Levicatus Mugenyi,
Irene Murungi,
David Serwadda,
Rhoda K. Wanyenze
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0257321
Subject(s) - syphilis , condom , medicine , demography , psychological intervention , cross sectional study , human immunodeficiency virus (hiv) , gynecology , immunology , psychiatry , pathology , sociology
Background Adolescent girls and young women (AGYW) are at increased risk of sexually transmitted infections (STIs). We assessed sexual-risk behaviours and HIV and syphilis prevalence among AGYW in Uganda to inform the design of target-specific risk-reduction interventions. Methods This analysis utilizes data from 8,236 AGYW aged 10–24 years, collected in 20 districts, between July and August 2018. AGYW engaged in sexual-risk behaviour if they: a) reported a history of STIs; or b) had their sexual debut before age 15; or c) engaged in sex with 2+ partners in the past 12 months; or c) did not use or used condoms inconsistently with their most recent partners. We diagnosed HIV using Determine TM HIV-1/2 , Stat-Pak TM HIV-1/2 and SD Bioline . We used SD Bioline Syphilis test kits to diagnose syphilis and Treponema Pallidum Hemagglutination Assay for confirmatory syphilis testing. Comparison of proportions was done using Chi-square (χ 2 ) tests. Data were analysed using STATA (version 14.1). Results Of 4,488 AGYW (54.5%) that had ever had sex, 12.9% ( n = 581) had their sexual debut before age 15; 19.1% ( n = 858) reported a history of STIs. Of those that had ever had sex, 79.6% (n = 3,573) had sex in the 12 months preceding the survey; 75.6% ( n = 2,707) with one (1) and 24.2% ( n = 866) with 2+ partners. Condom use with the most recent sexual partner was low, with only 20.4% ( n = 728) reporting consistent condom use while 79.6% ( n = 2,842) reported inconsistent or no condom use. In-school AGYW were significantly less likely to have ever had sex (35.6% vs. 73.6%, P <0.001), to have had sexual debut before age 15 (7.7% vs. 15.5%, P <0.001) or to engage in sex with 2+ partners (5.3% vs. 15.8%, P <0.001). Consistent condom use was significantly higher among in-school than out-of-school AGYW (40.1% vs. 12.7%, P <0.001). Overall, 1.7% ( n = 143) had HIV while 1.3% ( n = 104) had syphilis. HIV and syphilis prevalence was higher among out-of-school than in-school AGYW (HIV: 2.6% vs. 0.9%; syphilis: 2.1% vs. 0.5%, respectively). Conclusion In-school AGYW engaged in more protective sexual behaviors and had less HIV and syphilis than their out-of-school counterparts. These findings suggest a need for target-specific risk-reduction interventions stratified by schooling status.