Factors associated with age at first forced sexual act among women aged 15-49 years in Uganda

Abstract

The main objective of this study was to identify the factors associated with Age at First Forced Sexual Act (FFSA) among women aged 15-49 years in Uganda. Data from 1665 girls and women from the 2016 Uganda Demographic and Health Survey (UDHS) was considered for this study. This sample was obtained from the UDHS data based on the list-wise deletion method to deal with missing data. The assumption that age at first forced sexual act initially increases and then decreases was made for this study and thus a parametric approach was employed. A lognormal distribution was thus assumed for this data and in turn, a log-normal regression model was fitted to examine the factors associated with age at first forced sexual act. The median age at first forced sexual act was 20 years. The highest prevalence (28.5%) of a first forced sexual act was found among girls and women in the region of South Buganda. At bivariable analysis, the log-rank test to check for equality of the survival curves showed that the significant factors associated with FFSA were; education level (χ2(3) = 15.16, p =0.002), wealth index (χ2(4) = 22.67, p < 0.001), region (χ2(14) = 47.53, p < 0.001), employment status (χ2(1) = 4.52, p = 0.034), and age group (χ2(3) = 427.78, p < 0.001). The year of birth was significantly associated with age at first forced sexual act among women in Uganda (p < 0.05). The time to the first forced sexual act among women aged 25-34, 35- 44, and above 44 years in Uganda was 15.6% (TR = 1.156; p<0.001), 26.2% (TR = 1.262; p<0.001) and 40.0% (TR = 1.400; p<0.001) respectively longer than that among those aged 15-24 years to show that older women were least likely to be forced into sex early. Other significant factors associated with age at FFSA were education level, region, religion, and the number of sexual partners including spouse, in the past 12 months. This study highlights that the time of the first experience of forced sex is driven by both socioeconomic and demographic and behavioral factors and therefore efforts directed towards fighting this human rights violation by the Ugandan government and other key stakeholders should consider this aspect.