Sexual Victimization, Self-Efficacy to Refuse Sex While Drinking, and Regretting Alcohol-Involved Sex among Underserved Youth in Kampala, Uganda

Abstract

The purposes of this study were to determine whether youth who have experienced sexual victimization (SV) have lower self-efficacy to refuse sex and to identify intervention strategies for rape survivors to mitigate further health-risks and harm. Cross-sectional data from the 2014 Kampala Youth Survey (n = 1134) of youth aged 12 to 18 years recruited from Uganda Youth Development Link drop-in centers were used to conduct the analyses. Multivariable statistics were computed to determine the correlates (i.e., sex, education, homelessness, problem drinking, and SV) for (1) self-efficacy to refuse sex, (2) self-efficacy to refuse sex while drinking, and (3) regretting sex due to alcohol use. Among participants, 16.9% reported SV (79% were female and 21% were male). In the final adjusted model, self-efficacy to refuse sex while drinking was only associated with homelessness (OR: 0.52; 95% CI: 0.36, 0.74). Previous SV was not associated with lower self-reports of self-efficacy to refuse sex compared to those who had not experienced SV. Additionally, SV was not associated with increased reports of regrets for sex attributed to alcohol use. Alcohol prevention strategies for the most at-risk youth, including homeless youth, are warranted to improve self-efficacy to refuse sex among youth living in the slums of Kampala.

How Self-Efficacy and Agency Influence Risky Sexual Behavior among Adolescents in Northern Uganda

“…That is, if agency declines, then people are less likely to be empowered to make informed decisions regarding SRH decisions [2]. Some of the literature has suggested that early sexual debut is largely a result of poor self-efficacy to negotiate refusal sex [21], which can be in the form of delayed sex [22] or sexual abstinence [23,24]. Low self-efficacy may lead to low or non-condom use [25][26][27][28] or non-use of contraception [29,30].…”