Sexual partner types and related sexual health risk among out-of-school adolescents in rural south-west Uganda

Abstract

This paper defines the range of sexual partners chosen by out-of-school adolescents from Masaka District in rural south-west Uganda, and implications for sexual and reproductive health discussed. Data are drawn from a sexual health needs assessment using applied anthropological techniques with 31 adolescents, their parents, guardians and community leaders. Data were analysed using inductive thematic methods. Out-of-school adolescents are exposed to risk both stable and casual sexual relationships. Young men and women want a stable relationship with one reliable partner. Young men seek a "steady" relationship with younger schoolgirls; some also seek multiple "casual" relationships with young women easily convinced with gifts. Young women accept "permanent" partnerships with traders or transport workers one-three years older than themselves; some accept "casual" relationship with age mates, others have "casual" relationships with older men. All relationships involve the exchange of gifts and money. Older partners, or "sugar daddies", are valued, despite the knowledge they are more likely to be HIV positive, because they offer greater financial rewards than age mates. Though far less common, some older women seek relationships with younger men, but are treated with suspicion by young men, who believe they are seeking to "infect" them "maliciously" with AIDS. The community sees these relationships as a source of AIDS in adolescents, and condemn older men, whom they believe to be "killing" the younger generation. Both young men and women are exposure to sexual health risk in their primary partnerships; young men in partnerships with schoolgirls who have concurrent partnerships with older men, unlikely to use condoms and young women with partners who work, and have casual relationships in urban trading centres. Health promotion encouraging partnership with age mates, discouraging sex with older partners and 100% condom use before marriage are most appropriate for out-of-school adolescents in this context.

Sexual and reproductive health of women living with HIV in Southern Brazil

“…For older women, negotiation of condom use is nearly inconceivable in the context of sexual relations. For younger women, difficulty in condom use has been associated with risk perception 45,46 , cultural issues 47 , and difficulty in negotiation of use with older partners 30,48,49,50,51,52 , where the smaller the difference in age, the higher the adherence to condom use. And although there are indications that women who have sex with older men are less inclined to use contraceptive methods 27 , further research is needed on the sexual and reproductive health of women in these relations and how gender inequality issues appear in this context.…”

Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda

“…(29) This has left a gap in the process of acquiring knowledge about sex for young girls, and in role models who support adolescents in avoiding risky sexual behavior. (25,29,30)…”

‘Virginity is a Virtue: Prevent Early Sex’ – Teacher perceptions of sex education in a Ugandan secondary school

“…The commonplace nature of pre-marital sexual activity among young people is also suggested by the assertion of married young men and women in this same study that 'it is very unlikely that a girl would reach 18 years without losing her virginity', and that 'it is hard to find a girl who is still a virgin' (Bohmer and Kirumbira 2000, 276). More recent work with young people in Uganda (for example, Birungi et al 2009;Råssjö and Kiwanuka 2010;Nobelius et al 2011;Katz et al 2013) reveals that young people continue to be interested and involved in sexual relationships (and transactional relationships in particular) despite the existence of conservative social norms.…”