Socio-Demographic Factors and HIV-Risk Sexual Behaviors among adolescents and young adults in Iganga district.

Abstract

This study explored HIV-risk sexual behaviors (early coital debut, coital contact with genital ulcers, coital contact with STD, coital contact with persons suspected to have HIV/AIDS or engage in prostitution, coital contact for monetary rewards, multiple partnerships, condom use, and premarital pregnancies/abortions) and their probable predictors among a sexually active population cohort in Iganga district. A sample of 1024 subjects was selected through multi-staged, systematic and purposive sampling processes. A pre-tested sexual behavior questionnaire for measuring HIV-risk sexual behaviors was administered to a sample of 622 adolescents (321 females and 301 males) and 402 young adults (194 females and 208 males). The questionnaire yielded content validity index of .85 at pre-testing. In order to complement data collected using the questionnaire, interview and focused group discussions were also done with teachers, service providers, parent/elders, religious leaders, cultural/clan leaders, community development officers, adolescent females and males, and young adult males and females. Altogether, eight group discussions and 11 in-depth interview sessions were conducted. Analysis was done using linear regression models, Pearson correlation test and t-test for independent groups together with analytical arrangement of qualitative subject matter. HIV-risk sexual behaviors are common and tend to vary with the sex, age, place of residence, level of education and marital status of respondents. In particular females, adolescents, rural, least educated and married respondents stand a significantly higher chance of experiencing many of these sexual behaviors. This is attributed to the fact that females grow fast and perceive males in the same age bracket immature while adolescents are often curious to know how it feels to venture sex. The large urethra and mucosal surface area of females also complicates early detection of sexually transmitted diseases, which reduces prospects of suspending coitus following infection. Additionally adolescents, rural residents as well as uneducated and married individuals rarely have access to HIV/AIDS preventive information, education and care. This constraint undermines ability to appreciate and avoid HIV-risk sexual behaviors. Other culture and gender-related factors such as early marriage of females and society ostracism of persons who delay or desist sex and those who use condoms also promote early coital debut, unprotected sex and remarriage after death of a spouse, which creates opportunities for coital contact with persons suspected to have HIV/AIDS. In conclusion sex, age, residence, level of education and marital status significantly predict HIV-risk sexual behaviours, and the females, adolescents, rural, least educated and married respondents are especially susceptible to these behaviours. Community and schoolbased HIV preventive education and counselling programs should be planned and implemented. These programs should tackle the specific HIV-risk behaviours identified among these vulnerable groups. New and ongoing AIDS programs should also include strategies, which cover males, young adults, urban residents, and educated and unmarried persons as it enhances their AIDS awareness and prevention ability. More research is still needed focusing on other factors not modelled for this study.