Sexual behaviour among Ugandan university students: A gender perspective
Feminisation of the HIV/AIDS epidemic in sub-Saharan Africa is an important public health concern. Therefore, it is crucial that we understand the various risk factors that shape unsafe sexual behaviours among young people in Uganda. The overall aim of this thesis was to gain a deeper understanding of the various factors that have an association with risky sexual behaviours among Ugandan university students, focusing on a gender perspective. This knowledge can contribute to effective policy formulation and implementation of programs. In 2010, 1,954 students participated in a cross-sectional study and the data was collected using a self-administered questionnaire. Logistic regression was used as the main analytical tool for the analysis and effect modification analysis was conducted for some of the associations. Study I found that there was an association between non-use of contraception and socio-demographic factors, relationship status, and alcohol consumption. The socio-demographic determinants that affected this association were different for males and females. Early sexual debut was found to modify the effect of this association. Study II concluded that there was an association between alcohol consumption and the experience of sexual coercion among Ugandan university students. Frequent consumption of alcohol on the occasion of sexual intercourse and poor mental health were found to have a synergistic effect with recent experience of sexual coercion. Study III demonstrated an association between self-reported poor academic performance and inconsistent condom use with a new sex partner. Females who were poor academic performers were found to be at a higher risk of inconsistent condom use compared to their male counterparts. Study IV showed that there is an association between low condom efficacy and inconsistent condom use with a new sex partner. Gender differences were observed: females with low condom efficacy were at a higher risk of inconsistent condom use, in comparison to males. Our studies concluded that the key factors that contribute towards risky sexual behaviours among Ugandan university students were socio-demographic factors, relationship status, alcohol consumption, academic performance, and condom efficacy. Unequal gender power relations in this region further aggravates the sexual risk behaviours. Therefore, we need to create a policy action environment (not merely policies) in which sexual and reproductive health rights is addressed by raising awareness among males and females. In universities this could be achieved through skill building programs such as sex education, peer counseling, and partner communication, with a special focus on women by providing them skills for negotiating condom and contraceptive use. These programs need to address the socio-cultural and gender perspectives in addition to focusing on safe sex and sexual rights.
Clinical Medicine, Sexual behaviour, alcohol, university students, condom, contraception, sexual coercion, academic performance, Uganda
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Department of Clinical Sciences, Lund University