Attitudes, Norms and Self-Efficacy: Examining Socio-Cognitive Correlates and Sexual Abstinence Among Ugandan Youth Ages 16–18 years, in the Slums of Kampala, Uganda

Abstract

Sex-related beliefs, attitudes, and perceptions have been shown to be associated with HIV-related behaviors. However, little is known about the factors associated with delayed sexual activity among older adolescents in sub-Saharan Africa. This study examined potentially protective beliefs, attitudes, and perceptions associated with delayed sexual initiation among Ugandan youth. Secondary analyses were based on data from the 2014 Kampala Youth Survey, in which 1137 youth aged 12–18, living in 6 slum communities throughout Kampala, Uganda, were surveyed about sociodemographic factors and various health outcomes including drinking patterns, sexual behavior, HIV status, and violence exposure. Participants were recruited, consented, and interviewed by trained by Uganda Youth Development Link staff. After controlling for significant sociodemographic factors, older adolescent (aged 15–18 years old, n = 757, males = 44%, female 56%) sexual abstainers (never had sexual intercourse) were more likely than sexually active youth to (1) perceive HIV as a serious health issue; (2) have positive perceptions of condom use; (3) believe that their friends planned to delay sex and; (4) be confident in their ability to avoid or refuse sex. Sexual abstinence was also associated with lower odds of reporting drunkenness. Study findings revealed that abstainers held more protective beliefs and attitudes for HIV-related risk, compared to sexually active youth. Identifying predictors for early sexual activity provides opportunities for the development of HIV prevention strategies that encourage the delay of sexual debut.