Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience

Abstract

BackgroundResearch from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited.ObjectiveTo identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality.DesignIn 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex.ResultsFindings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7–5.7; OR 2.0, 95% CI: 1.3–3.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1–4.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.7–3.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9–5.8), and number of sexual partners (OR 1.9, 95% CI: 1.04–3.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1–8.5; AOR 2.8, 95% CI: 1.3–5.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6–7.1; AOR 2.7, 95% CI: 1.4–5.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking.ConclusionsThese findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental health and trauma response are critical to meet the health needs of this population.

Healthcare providers’ attitudes towards care for men who have sex with men (MSM) in Malawi

“…In Malawi, MSM are among the key populations in relation to HIV acquisition and transmission [17, 18]. In addition to the recognition of MSM as a key population in HIV prevention, studies have documented the unmet health needs of MSM [19, 20]. Men who have sex with men need comprehensive HIV prevention services [10, 11].…”

Risk of poor mental health and experience of violence among a young adult population with same-sex sexuality: a cross-sectional study in southern Sweden

“…Sexual coercion was determined by an instrument used in a number of previous studies in Sweden and elsewhere. [29][30][31] This instrument contains the following response alternatives: 'You have been forced to show your sexual organ', 'Someone has forced you to let them touch your sexual organ', 'Someone forced you to let them suck or lick your sexual organ', 'Someone has forced you to let them show you their own sexual organ', 'You have been forced to watch someone masturbate', 'You have been forced to masturbate someone', 'You have been forced to take part in oral sex or to lick someone's sexual organ', Open access 'You have been forced to take part in sexual intercourse with the penis in the vagina, or someone has inserted an object into your vagina', 'You have been forced to take part in sexual intercourse with the penis in the anal, or someone as inserted an object into your anal' and 'You have been forced to pose for a sex photo or sex film'. The measure was dichotomised as 'Experience of sexual coercion' if the respondent had a positive response to at least one of the items, and 'no experience of sexual coercion' if all answers were negative.…”

Evangelicalism in Uganda: Implications for Public Health and Bioethics

“…Researchers conducting a study of stakeholder perceptions of patient-centered primary care reported that many patients are afraid to ask questions of their providers (Waweru, Sarkar, Ssengoba, Gruénais, Broerse, & Criel, 2019). Yet another study found that more than one-half of 570 university students with a same-sex sexual orientation reported unmet health care needs, which was associated with poor mental health (Larsson, Ross, Tumwine, and Agardh, 2016). Almost one-third reported unmet sexual health needs, exposing them to an increased risk of poor mental health, frequent episodic drinking, and sexual coercion.…”