Adolescent girls and young women are at a higher risk for HIV infection stemming from barriers to accessing comprehensive sexual health education, unequal cultural, social, and economic statuses, limited access to education and health care services, and gender-based violence. This makes adolescent girls susceptible to high-risk sexual behaviors. This study examines the protective role of family, social support factors and gender norms against sexual risk-taking behaviors among secondary school adolescent girls in Uganda. Baseline data from the National Institute of Mental Health-funded Suubi4Her study were analyzed. A total of 1260 girls aged 14–17 years and enrolled in the first or second year of secondary school were recruited across 47 secondary schools. Hierarchical linear regression models were conducted to determine the role of family, social support factors and gender norms on sexual risk-taking behaviors. Results indicate that traditional gender norms, family care and relationships, and social support were all associated with lower levels of sexual risk-taking intentions—a proxy for engaging in sexual risk behaviors. Findings point to the need to develop family level support interventions to equip adolescent girls with adequate sexual health-related knowledge and skills to facilitate safer sexual practices and reduce high-risk sexual-taking behaviors, as they develop and transition into young adulthood.
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The authors are grateful to the staff and the volunteer team at the International Center for Child Health and Development (ICHAD) field offices in Masaka, Uganda, for monitoring the study implementation process. We are grateful to our implementing partners, Reach the Youth (RTY) Uganda, and Rakai Heath Sciences Program (RHSP), and Masaka Diocese—our collaborating partners in the region. Our special thanks go to all children and their caregiving families who agreed to participate in the study.
The Suubi4Her study was funded by the National Institute of Mental Health (NIMH grant # R01MH113486; PI: Fred M. Ssewamala).
Ethics Approval and Consent to Participate
The study received approval from Washington University Institutional Review Board (IRB #201703102), the Uganda Virus Research Institute (GC/127/17/07/619), and the Uganda National Council of Science and Technology (SS4406). It is also registered in the Clinical Trials database NCT03307226. Voluntary written consent from caregivers and assent from adolescents were obtained prior to study participation. Adolescents’ assent was obtained separately from their caregivers to avoid coercion. During the consenting/assenting process and data collection, all participants received monetary compensation for their time, transport refund to and from the research venue, and a drink and a snack. Each interviewer received Good Clinical Practice training and obtained the Collaborative Institutional Training Initiative (CITI) Certificate before interacting with study participants.
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Nabunya, P., Byansi, W., Muwanga, J. et al. Family Factors and Gender Norms as Protective Factors Against Sexual Risk-Taking Behaviors Among Adolescent Girls in Southern Uganda. Glob Soc Welf (2022). https://doi.org/10.1007/s40609-022-00237-8