Abstract #296  -  Coercive Sex among Adolescents in Uganda: Prevalence, Risk and Protective Factors
Authors:   Presenting Author:   Dr. Michele Ybarra - Internet Solutions for Kids, Inc.
Additional Authors:  Dr. Kimberly Mitchell, Dr. Julius Kiwanuka,
Aim: Coercive sex is associated with reduced condom use and HIV preventive behavior. Previous research by Neema and colleagues suggests that sexual coercion is relatively common in Uganda. One in four women and one in eleven boys 15-19 report being a victim of sexual coercion. Little is known about how common sexual coercion is among younger adolescents, specifically those that are less than 15 years of age. Given that 33% of boys and 23% of girls have had sex by the age of 15, examining sexual coercion among younger adolescents is important. The current presentation reports the prevalence of coercive sex victimization and perpetration among 12-18 year-old secondary school students in Mbarara, Uganda.
Method / Issue: Survey data were collected as part of Cybersenga - an ongoing study to develop and test an Internet-based HIV prevention program for adolescents in Uganda. 1,496 adolescents 12 to 18 years of age attending five secondary schools in Mbarara, Uganda were randomly recruited to complete a sexual health survey which informed the larger intervention design. Questions queried the information, motivation, and behavioral skills they had to engage in HIV preventive behavior. Potential co-variates affecting sexual behavior, including sexual coercion perpetration and victimization, also were asked. Data were collected between September and October, 2008 and March and April, 2009. The estimated response rate is 76.7%.
Results / Comments: Data entry is ongoing. Preliminary data based on 680 surveys entered [71% male and 29% female; 12-13 years-old (8%), 14-15 years-old (44%), 16-17 years-olds (35%), and 18 or older (11%)] indicates that 33% percent of respondents have ever had sex (n = 222). Fifty-four percent of sexually active adolescents reported a history of sexual coercion victimization (e.g., 24% were too afraid to say ‘no’ to having sex; 15% had been physically hurt or threatened in order to have sex). Girls were three times more likely to report coercive sex victimization than boys (75% vs. 49% of boys, OR = 3.1, p < .01). Forty-five percent of sexually active adolescents reported coercive sex perpetration (e.g., 14% had physically hurt or threatened someone in order to have sex; 33% had lied or deceived someone in order to have sex). No differences were identified for coercive sex perpetration by sex (38% of girls and 47% of boys, OR = 0.7, p = .32). Logistic regression analyses will be conducted upon completion of data entry. Analyses will focus on characteristics related to coercive sex victimization and perpetration, particularly indications of HIV-risk (e.g., sex without condoms, number of sexual partners) and HIV prevention (e.g., HIV preventive behaviors and motivations). Self-reported self-esteem, orientation to the future, social support, and physical health will be examined for influence on the observed relationships between sexual coercion and HIV behavior.
Discussion: Preliminary data of secondary school students in Mbarara, Uganda suggest that sexual coercion is common: half of sexually active youth report victimization (54%) and almost half (45%) report perpetration. Findings are discussed in terms of implications for HIV prevention programs – particularly those that are tailored for children and adolescents.
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