Disparities in Sexual Activity Indicators among Youth Living in the Slums of Kampala: Comparisons with Representative National and Urban School-Attending Youth
Monica H. Swahn *
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, USA
Sarah Braunstein
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, USA
Jane B. Palmier
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, USA
Rogers Kasirye
Uganda Youth Development Link, Kampala, Uganda
Huang Yao
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, USA
*Author to whom correspondence should be addressed.
Abstract
Aims: This study examined the extent to which youth who live on the streets and in the slums of Kampala experience more HIV risky behaviors than representative national and urban school-attending youth.
Place and Duration of Study: Analyses were based on three cross-sectional surveys: 1. the Kampala Youth Survey (service-seeking youth living in the slums; conducted in 2011; N=457); 2. The Global School-based Student Health Survey (GSHS; nationally representative sample of school-attending youth, conducted in 2003; N=3,215); 3. The Global School-based Student Health Survey (GSHS; urban representative sample of school-attending youth, conducted in 2003; N=1,709).
Methodology: Analyses restricted to youth between ages 14-17 years assessed the differences in prevalence of sexual intercourse, age of sexual initiation, number of partners, and condom use among youth in the three surveys examined. A z-test was used to test the significance of difference in proportions. The prevalence reported in the Kampala Youth Survey was compared to the other two surveys of school-attending youth.
Results: The lifetime prevalence of reporting sexual intercourse was statistically significantly higher (49%) among participants in the Kampala survey compared to the youth in the GSHS National (31%) and GSHS Urban (29%) surveys. Moreover, girls in the Kampala survey reported significantly higher prevalence of sexual intercourse (49%) compared to girls in the GSHS National (23%) and GSHS Urban (22%) surveys. In terms of condom use, the youth in the Kampala survey reported using condoms less in the past year (34%) compared to the youth in the GSHS National (64%) and the GSHS Urban (60%) who reported on condom use at the time of last sexual intercourse.
Conclusion: The youth in the Kampala survey reported higher prevalence of sexual intercourse, having fewer sexual partners, and lower condom use compared to their nationally representative school-attending peers. Prevention strategies that seek to increase condom use specifically appear warranted.
Keywords: Health disparities, vulnerable youth, adolescents, slums, sexual risk behaviors, condom use, HIV/AIDS