Abstract
BackgroundIn most Sub-Saharan African countries, little is known about young adolescents’ sexual and reproductive health (SRH). Though some efforts have been made to understand and improve SRH of older adolescents, very young adolescents (VYAs) are often overlooked, and little is known about their sexual knowledge and behaviors. The goal of this study was to describe SRH knowledge, information-seeking, and sexual behavior of VYAs in Uganda.MethodsA cross-sectional survey was administered in 33 primary schools in June and July of 2016. Trained interviewers administered surveys to adolescents ages 10–14 regarding SRH knowledge, information-seeking, sexual behavior, and relevant covariates. Continuous variables were summarized as means (SD) or medians (IQR) whereas categorical variables were summarized as proportions (percentages).ResultsA total of 1096 adolescents were included in this analysis, 81.8% of which were from rural areas, with a median age of 12. Regarding sexually transmitted infections (STIs) knowledge; 95% knew HIV while 37% knew other STIs apart from HIV. Although 47% knew at least one way in which HIV is acquired only 8% knew at least four ways. Regarding contraceptive knowledge, 56% mentioned at least one modern method of preventing pregnancy (condoms, pills, intrauterine devices, implants, or injections). The majority (85%) of VYAs reported accessing SRH information in the media with 35% reporting accessing media with sexual content while 10% vs 22% consulted their father or mother respectively and 31% a school source. At least 7.6% of VYAs had ever had sexual intercourse, 90% of which were not using any protection.ConclusionComprehensive SRH knowledge was low among VYAs in this study. Media remains an important source of information for SRH for this age group though it may be misused as some adolescents reported accessing sexual content that may be inappropriate. A large proportion of sexually active VYAs reported sexual risky behaviors. This study highlights the need for an accurate and more comprehensive SRH education approach for VYAs in Uganda at an opportune age before the majority engage in sexual behavior.
Highlights
In most Sub-Saharan African countries, little is known about young adolescents’ sexual and reproductive health (SRH)
We found that most students are aware of HIV, but few have detailed knowledge of how HIV is acquired, what other STIs exist, and what methods of pregnancy prevention are available
The majority of very young adolescents (VYAs) had been exposed to SRH information in the media with at least one third of them accessing media with sexual content, while far fewer had received such information in schools or from their parents
Summary
In most Sub-Saharan African countries, little is known about young adolescents’ sexual and reproductive health (SRH). Over half of the population is the under age of 18 years [2] This youthful population presents unique challenges, especially with regard to sexual and reproductive health (SRH). Despite great initial success in decreasing HIV prevalence and incidence throughout the 1990s and early 2000s [6], HIV/AIDS remains the leading cause of death in Uganda [7], and the majority of new infections occur among adolescent women [3]. In this young population, comprehensive access to sexual and reproductive health knowledge and services is of upmost importance
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