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Sexual Health Behaviors and Knowledge Among Ugandan Adolescent Girls: Implications for Advancing Comprehensive Sexual Health Education Technology



Adolescent girls in Uganda have four-fold HIV infections than adolescent boys. Several barriers to accessing comprehensive sexual health education exist for adolescent girls in Uganda, including unequal, social, and economic statuses, limited access to education and health care services, discrimination, and violence.


This study qualitatively examines sexual health behaviors and literacy among Ugandan adolescent girls and explores how technology may be leveraged to improve sexual and reproductive health outcomes in this population.


Four focus group discussions (FGDs) were conducted among 32 adolescent girls aged 14–17 years enrolled in Suubi mHealth. Participants were randomly selected from four secondary schools participating in a randomized clinical trial known as Suubi4Her (N = 1260). FGDs were conducted in the local language, audio-recorded, transcribed verbatim, and translated. Translated transcripts were imported into Dedoose for data management and coding. Emerging themes included Influences for Sex/Relationships, HIV Knowledge, and Sources of Sexual Health Information.


Participants reported common influences for sexual engagement included seeking resource security, limited parental communication, and peer influences. Participants also demonstrated knowledge gaps, requesting information such as how to prevent unplanned pregnancies and HIV, endorsing sexual health myths, and describing limitations to accessing sexual health information.


Noticeable inconsistencies and limited access to information and resources regarding basic sexual health knowledge were reported, which inevitably increases adolescent girls’ risks for adverse sexual and reproductive health outcomes. Developing culturally appropriate interventions may help advance the sexual and reproductive health needs of Ugandan adolescent girls.

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Data Availability

Data used in this study is available from the corresponding author upon reasonable request.


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We are grateful to colleagues at the International Center for Child Health and Development (ICHAD) for their respective contributions to the study design and implementation. We thank the study participants for their insight.


The study was funded by National Institutes of Health (NIH) Grant K02 DA043657 (PI: Dr. Patricia Cavazos-Rehg), the National Institute of Mental Health (NIMH) under Grant 1R01MH113486-01 (PI: Dr. Fred M. Ssewamala), National Institute of Mental Health under Grant R25MH118935 (PI: Dr. Ssewamala, Dr. Mary McKay and Dr. Sean Joe), and the National Institute on Minority Health and Health Disparities grant T37MD014218 (PI: Dr. Cavazos-Rehg, Dr. Ssewamala) The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH, NIMH, or NIMHD.

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Correspondence to William Byansi.

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Institutional Review Board approval for both the parent grant and the supplement were obtained from Washington University in St. Louis (IRB- #201703102) and the Uganda Virus Research Institute (GC/127/17/07/619). Per approved protocols, written informed consent was obtained from caregivers and written informed assent was obtained separately from the adolescents.

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Appendix 1

Appendix 1

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Table 5 Codebook and theme aggregation


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Byansi, W., Howell, T.H., Filiatreau, L.M. et al. Sexual Health Behaviors and Knowledge Among Ugandan Adolescent Girls: Implications for Advancing Comprehensive Sexual Health Education Technology. Child Youth Care Forum 52, 1227–1247 (2023).

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