Multiple sexual partnerships and associated factors among young psychoactive-substance-users in informal settlements in Kampala, Uganda

Ssekamatte, Tonny; Tetui, Moses; Kibira, Simon P. S.; Isunju, John Bosco; Mugambe, Richard K.; Nabiwemba, Elizabeth; Wafula, Solomon Tsebeni; Buregyeya, Esther; Bukenya, Justine

doi:10.1371/journal.pone.0239323

Cited by 20 publications

(19 citation statements)

References 54 publications

(65 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study using nested health and the demographic survey also corroborates our findings [ 24 ]. Having multiple sexual partners provides an opportunity for transmission of STIs [ 20 , 35 ]. Improving partner notification supports and practices may therefore be of paramount importance in miinmizing the risk of STIs/HIV.…”

Section: Discussionmentioning

confidence: 99%

Trends and correlates of sexually transmitted infections among sexually active Ugandan female youths: evidence from three demographic and health surveys, 2006–2016

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Female adolescents and young women have the highest risk of curable sexually transmitted infections (STIs) globally. Data on the prevalence of STIs among young women in Uganda are limited. In this study, we investigated the time trends and correlates of STIs among adolescent girls and young women (15–24 years) in Uganda. Methods We estimated the percentage of women 15–24 years from three recent consecutive Uganda Demographic and Health Surveys (2006, 2011, and 2016), who reported suffering from genital sores, and or genital discharge or any other varginal complaints acquired after sexual intercourse within 12 months of the studies and examined the changes over time. A pooled multivariable logistic regression was used to examine the correlates of reporting an STI in the last 12 months preceding the study. Svyset command in Stata was used to cater for the survey sample design. Results The pooled self-reported STI prevalence was 26.0%. Among these young women, 22.0, 36.3, and 23.1% reported a sexually transmitted infection in 2006, 2011, and 2016 respectively. Between 2006 and 2011, there was evidence of change (+ 14.3%, p < 0.001) in STI prevalence before a significant reduction (− 12.0%, p< 0.001) in 2016. Youths aged 20–24 years reported a higher STI prevalence (27.3%) compared to young participants (23.6%). Correlates of reporting an STI among rural and urban young women were: having multiple total lifetime partners (adjusted odds ratio (aOR 1.6, 95% CI 1.4–1.6), being sexually active in the last 4 weeks (aOR 1.3, 95% CI 1.1–1.6), and being affiliated to Muslim faith (aOR 1.3, 95% CI 1.1–1.6) or other religions (aOR 1.8, 95% CI 1.1–2.9) as compared to Christian were more likely to report an STI. Living in Northern Uganda compared to living in Kampala city was found protective against STIs (aOR 0.5, 95% CI 0.3–0.7). Conclusion The prevalence of STIs was high among female youths, 15–24 years. This highlights the need for a comprehensive STIs screening, surveillance, and treatment programme to potentially reduce the burden of STIs in the country.

show abstract

Section: Discussionmentioning

confidence: 99%

Trends and correlates of sexually transmitted infections among sexually active Ugandan female youths: evidence from three demographic and health surveys, 2006–2016

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Sex work, which is the main source of livelihood for majority of the trans-women [ 4 , 5 ], is usually associated with high-risk behaviours such as incorrect and inconsistent condom use, having sex under influence of drugs and other substances [ 6 , 7 ], and multiple sexual partnerships/relationships [ 8 ], which are all known to escalate the risk of HIV transmission [ 9 , 10 ]. Thus, trans-women sex workers, who are the focus of this study, experience higher rates of STIs including HIV compared to non- trans-women sex workers [ 5 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda

Ssekamatte

Isunju

Naume³

et al. 2020

BMC Infect Dis

Self Cite

View full text Add to dashboard Cite

Background Trans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with access to and utilisation of HIV/STI prevention services. This study explored barriers to access and utilisation of HIV/STI prevention services and associated coping mechanisms. Methods This exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. A total of 22 in-depth interviews, 6 key informant interviews and 9 focus group discussions were conducted to obtain data on barriers to access and utilisation of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analysed through thematic analysis using a hybrid of inductive and deductive approaches. Results Individual level barriers to access and utilisation of HIV/STI prevention and care services included internalised stigma and low socio-economic status. Healthcare system barriers included social exclusion and lack of recognition by other key population groups; stigmatisation by some healthcare providers; breach of confidentiality by some healthcare providers; limited hours of operation of some key population-friendly healthcare facilities; discrimination by straight patients and healthcare providers; stockout of STI drugs; inadequate access to well-equipped treatment centres and high cost of drugs. At community level, transphobia hindered access and utilisation of HIV/STI prevention and care services. The coping strategies included use of substitutes such as lotions, avocado or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to hide their preferred gender identity. Conclusions Individual, community and healthcare system barriers hindered access and utilisation of HIV/STI prevention and care services among the trans-women sex workers. There is a need to create an enabling environment in order to enhance access to and utilisation of HIV/STI prevention and care services for trans-women sex workers through sensitisation of healthcare providers, other key population groups and the community at large on the transgender identity.

show abstract

“…Sex work, which is the main source of livelihood for majority of the trans-women (4,5), is usually associated with high-risk behaviours such as incorrect and inconsistent condom use, having sex under in uence of drugs and other substance abuse (6,7), and multiple sexual partnerships/relationships (8), which are all known to escalate the risk of HIV transmission (9,10). Thus, trans-women sex workers, who are the focus of this study, experience higher rates of STIs including HIV compared to non-transwomen sex workers (5,11).…”

Section: Introductionmentioning

confidence: 99%

Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.

Ssekamatte

Isunju

Muyanga³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundTrans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with access to and utilisation of HIV/STI prevention services. This study explored barriers to access and utilisation of HIV/STI prevention services and associated coping mechanisms. MethodsThis exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. A total of 22 in-depth interviews, 6 key informant interviews and 9 focus group discussions were conducted to obtain data on barriers to access and utilisation of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analysed through thematic analysis using a hybrid of inductive and deductive approaches.ResultsIndividual level barriers to access and utilisation of HIV/STI prevention and care services included internalised stigma and low socio-economic status. Health system barriers included social exclusion and lack of recognition by other key population groups; stigmatisation by some healthcare providers; breach of confidentiality by some healthcare providers; limited hours of operation of some key population-friendly healthcare facilities; discrimination by straight patients and healthcare providers; stockout of STI drugs; inadequate access to well-equipped treatment centres and high cost of drugs. At community level, transphobia hindered access and utilisation of HIV/STI prevention and care services. The coping strategies included use of substitutes such as lotions, avocado or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to hide their preferred gender identity. Conclusions Individual, community and health system level barriers hindered access and utilisation of HIV/STI prevention and care services among the trans-women sex workers. There is a need to create an enabling environment in order to enhance access to and utilisation of HIV/STI prevention and care services for trans-women sex workers through sensitisation of healthcare providers, other key population groups and the community at large on the transgender identity.

show abstract

Multiple sexual partnerships and associated factors among young psychoactive-substance-users in informal settlements in Kampala, Uganda

Cited by 20 publications

References 54 publications

Trends and correlates of sexually transmitted infections among sexually active Ugandan female youths: evidence from three demographic and health surveys, 2006–2016

Trends and correlates of sexually transmitted infections among sexually active Ugandan female youths: evidence from three demographic and health surveys, 2006–2016

Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda

Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.

Contact Info

Product

Resources

About