Sexual-risk behaviours and HIV and syphilis prevalence among in- and out-of-school adolescent girls and young women in Uganda: A cross-sectional study
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. This analysis utilizes data from 8,23...
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| Veröffentlicht in: | PloS one 2021-09, Vol.16 (9), p.e0257321-e0257321 |
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| creator | Matovu, Joseph K B Bukenya, Justine N Kasozi, Dickson Kisaka, Stephens Kisa, Rose Nyabigambo, Agnes Tugume, Abdulaziz Bwanika, John Baptist Mugenyi, Levicatus Murungi, Irene Serwadda, David Wanyenze, Rhoda K |
| description | 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.
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 DetermineTM HIV-1/2, Stat-PakTM 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 (χ2) tests. Data were analysed using STATA (version 14.1).
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 |
| doi_str_mv | 10.1371/journal.pone.0257321 |
| format | Article |
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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 DetermineTM HIV-1/2, Stat-PakTM 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 (χ2) tests. Data were analysed using STATA (version 14.1).
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).
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0257321</identifier><identifier>PMID: 34506577</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adolescents ; Adult ; Age ; AIDS ; Behavior ; Biology and Life Sciences ; Chi-square test ; Child ; Condoms ; Cross-Sectional Studies ; Data analysis ; Demographic aspects ; Diagnosis ; Distribution ; Female ; Girls ; Health aspects ; Health risks ; Hemagglutination ; HIV ; HIV infection ; HIV Infections - complications ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Medicine and Health Sciences ; Models, Statistical ; People and Places ; Prevalence ; Reduction ; Risk ; Risk Factors ; Risk reduction ; Risk taking ; Safe Sex ; Sex ; Sexual Behavior ; Sexual Partners ; Sexually transmitted diseases ; Social Sciences ; STD ; Syphilis ; Syphilis - complications ; Syphilis - epidemiology ; Teenage girls ; Teenagers ; Uganda - epidemiology ; Women ; Womens health ; Young Adult</subject><ispartof>PloS one, 2021-09, Vol.16 (9), p.e0257321-e0257321</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Matovu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Matovu et al 2021 Matovu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-f0cd9356902b661c959f21d6e4bdbb878a55daa3acf8415aa2a13f87d1b3d8743</citedby><cites>FETCH-LOGICAL-c692t-f0cd9356902b661c959f21d6e4bdbb878a55daa3acf8415aa2a13f87d1b3d8743</cites><orcidid>0000-0001-6480-2940</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432796/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432796/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34506577$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Graham, Susan Marie</contributor><creatorcontrib>Matovu, Joseph K B</creatorcontrib><creatorcontrib>Bukenya, Justine N</creatorcontrib><creatorcontrib>Kasozi, Dickson</creatorcontrib><creatorcontrib>Kisaka, Stephens</creatorcontrib><creatorcontrib>Kisa, Rose</creatorcontrib><creatorcontrib>Nyabigambo, Agnes</creatorcontrib><creatorcontrib>Tugume, Abdulaziz</creatorcontrib><creatorcontrib>Bwanika, John Baptist</creatorcontrib><creatorcontrib>Mugenyi, Levicatus</creatorcontrib><creatorcontrib>Murungi, Irene</creatorcontrib><creatorcontrib>Serwadda, David</creatorcontrib><creatorcontrib>Wanyenze, Rhoda K</creatorcontrib><title>Sexual-risk behaviours and HIV and syphilis prevalence among in- and out-of-school adolescent girls and young women in Uganda: A cross-sectional study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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 DetermineTM HIV-1/2, Stat-PakTM 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 (χ2) tests. Data were analysed using STATA (version 14.1).
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).
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.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>Adult</subject><subject>Age</subject><subject>AIDS</subject><subject>Behavior</subject><subject>Biology and Life Sciences</subject><subject>Chi-square test</subject><subject>Child</subject><subject>Condoms</subject><subject>Cross-Sectional Studies</subject><subject>Data analysis</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Distribution</subject><subject>Female</subject><subject>Girls</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Hemagglutination</subject><subject>HIV</subject><subject>HIV infection</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Medicine and Health Sciences</subject><subject>Models, Statistical</subject><subject>People and Places</subject><subject>Prevalence</subject><subject>Reduction</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Risk reduction</subject><subject>Risk taking</subject><subject>Safe Sex</subject><subject>Sex</subject><subject>Sexual Behavior</subject><subject>Sexual Partners</subject><subject>Sexually transmitted diseases</subject><subject>Social Sciences</subject><subject>STD</subject><subject>Syphilis</subject><subject>Syphilis - complications</subject><subject>Syphilis - epidemiology</subject><subject>Teenage girls</subject><subject>Teenagers</subject><subject>Uganda - epidemiology</subject><subject>Women</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk8Fu1DAQhiMEoqXwBggiISE4ZInj2LE5IK0qoCtVqkRpr9bEcRIXJ97GydJ9EZ4XZzetNqgHlIOj8Tf_2P94guA1ihcIZ-jTjR26FsxibVu1iBOS4QQ9CY4Rx0lEkxg_Pfg_Cl44dxPHBDNKnwdHOCUxJVl2HPy5VHcDmKjT7leYqxo22uu6ENoiPFtd71a3XdfaaBeuO7UBo1qpQmhsW4W6jXaEHfrIlpGTtbUmhMIa5aRq-7DSndmLbe3gE37bRrU-LbyqfBA-h8tQdta5yCnZa-vvE7p-KLYvg2clGKdeTetJcPXt68_Ts-j84vvqdHkeScqTPipjWXBMKI-TnFIkOeFlggqq0rzIc5YxIKQAwCBLliICkADCJcsKlOOCZSk-Cd7uddfGOjFZ6oR3E6Xp6JAnVnuisHAj1p1uoNsKC1rsArarBHS9lkYJlJaEZ5Jm3FcDxRjJVUJZKXGekJgwr_VlqjbkjSpGhzowM9H5TqtrUdmNYClOMk69wIdJoLO3g3K9aLQ32hholR325-a-62Q897t_0MdvN1GV76vQbWl9XTmKiiXNUk4ZT0aXFo9Q_itUo6V_f6X28VnCx1mCZ3p111cwOCdWlz_-n724nrPvD9hagelrZ80wPh03B9M9uHtdnSofTEaxGMfn3g0xjo-YxsenvTls0EPS_bzgvxNiFto</recordid><startdate>20210910</startdate><enddate>20210910</enddate><creator>Matovu, Joseph K B</creator><creator>Bukenya, Justine N</creator><creator>Kasozi, Dickson</creator><creator>Kisaka, Stephens</creator><creator>Kisa, Rose</creator><creator>Nyabigambo, Agnes</creator><creator>Tugume, Abdulaziz</creator><creator>Bwanika, John Baptist</creator><creator>Mugenyi, Levicatus</creator><creator>Murungi, Irene</creator><creator>Serwadda, David</creator><creator>Wanyenze, Rhoda K</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6480-2940</orcidid></search><sort><creationdate>20210910</creationdate><title>Sexual-risk behaviours and HIV and syphilis prevalence among in- and out-of-school adolescent girls and young women in Uganda: A cross-sectional study</title><author>Matovu, Joseph K B ; Bukenya, Justine N ; Kasozi, Dickson ; Kisaka, Stephens ; Kisa, Rose ; Nyabigambo, Agnes ; Tugume, Abdulaziz ; Bwanika, John Baptist ; Mugenyi, Levicatus ; Murungi, Irene ; Serwadda, David ; Wanyenze, Rhoda K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-f0cd9356902b661c959f21d6e4bdbb878a55daa3acf8415aa2a13f87d1b3d8743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adolescent</topic><topic>Adolescents</topic><topic>Adult</topic><topic>Age</topic><topic>AIDS</topic><topic>Behavior</topic><topic>Biology and Life Sciences</topic><topic>Chi-square test</topic><topic>Child</topic><topic>Condoms</topic><topic>Cross-Sectional Studies</topic><topic>Data analysis</topic><topic>Demographic aspects</topic><topic>Diagnosis</topic><topic>Distribution</topic><topic>Female</topic><topic>Girls</topic><topic>Health aspects</topic><topic>Health risks</topic><topic>Hemagglutination</topic><topic>HIV</topic><topic>HIV infection</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - epidemiology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Medicine and Health Sciences</topic><topic>Models, Statistical</topic><topic>People and Places</topic><topic>Prevalence</topic><topic>Reduction</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Risk reduction</topic><topic>Risk taking</topic><topic>Safe Sex</topic><topic>Sex</topic><topic>Sexual Behavior</topic><topic>Sexual Partners</topic><topic>Sexually transmitted diseases</topic><topic>Social Sciences</topic><topic>STD</topic><topic>Syphilis</topic><topic>Syphilis - complications</topic><topic>Syphilis - epidemiology</topic><topic>Teenage girls</topic><topic>Teenagers</topic><topic>Uganda - epidemiology</topic><topic>Women</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matovu, Joseph K B</creatorcontrib><creatorcontrib>Bukenya, Justine N</creatorcontrib><creatorcontrib>Kasozi, Dickson</creatorcontrib><creatorcontrib>Kisaka, Stephens</creatorcontrib><creatorcontrib>Kisa, Rose</creatorcontrib><creatorcontrib>Nyabigambo, Agnes</creatorcontrib><creatorcontrib>Tugume, Abdulaziz</creatorcontrib><creatorcontrib>Bwanika, John Baptist</creatorcontrib><creatorcontrib>Mugenyi, Levicatus</creatorcontrib><creatorcontrib>Murungi, Irene</creatorcontrib><creatorcontrib>Serwadda, David</creatorcontrib><creatorcontrib>Wanyenze, Rhoda K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matovu, Joseph K B</au><au>Bukenya, Justine N</au><au>Kasozi, Dickson</au><au>Kisaka, Stephens</au><au>Kisa, Rose</au><au>Nyabigambo, Agnes</au><au>Tugume, Abdulaziz</au><au>Bwanika, John Baptist</au><au>Mugenyi, Levicatus</au><au>Murungi, Irene</au><au>Serwadda, David</au><au>Wanyenze, Rhoda K</au><au>Graham, Susan Marie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sexual-risk behaviours and HIV and syphilis prevalence among in- and out-of-school adolescent girls and young women in Uganda: A cross-sectional study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-09-10</date><risdate>2021</risdate><volume>16</volume><issue>9</issue><spage>e0257321</spage><epage>e0257321</epage><pages>e0257321-e0257321</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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 DetermineTM HIV-1/2, Stat-PakTM 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 (χ2) tests. Data were analysed using STATA (version 14.1).
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).
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34506577</pmid><doi>10.1371/journal.pone.0257321</doi><tpages>e0257321</tpages><orcidid>https://orcid.org/0000-0001-6480-2940</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-09, Vol.16 (9), p.e0257321-e0257321 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2571446577 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adolescent Adolescents Adult Age AIDS Behavior Biology and Life Sciences Chi-square test Child Condoms Cross-Sectional Studies Data analysis Demographic aspects Diagnosis Distribution Female Girls Health aspects Health risks Hemagglutination HIV HIV infection HIV Infections - complications HIV Infections - epidemiology Human immunodeficiency virus Humans Medicine and Health Sciences Models, Statistical People and Places Prevalence Reduction Risk Risk Factors Risk reduction Risk taking Safe Sex Sex Sexual Behavior Sexual Partners Sexually transmitted diseases Social Sciences STD Syphilis Syphilis - complications Syphilis - epidemiology Teenage girls Teenagers Uganda - epidemiology Women Womens health Young Adult |
| title | Sexual-risk behaviours and HIV and syphilis prevalence among in- and out-of-school adolescent girls and young women in Uganda: A cross-sectional study |
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