Factors associated with condom use among unmarried sexually active adolescent girls and young women (AGYW) aged 15-24 years: analysis of the Uganda Demographic Health Survey 2016.

Abstract

Background: Adolescent girls and young women (AGYW) in Uganda face a disproportionate burden of HIV and unintended pregnancies, with low condom use exacerbating these risks. Despite efforts to promote condom use, uptake remains inconsistent among this young demographic. Additionally, there is limited research on the factors influencing condom use among unmarried sexually active AGYW in Uganda. This study aimed to assess the prevalence and factors associated with condom use in this high-risk group using data from the 2016 Uganda Demographic and Health Survey (UDHS), to inform targeted interventions aimed at improving sexual health outcomes for this specific demographic.

Methods: A cross-sectional analysis was conducted using secondary data from the 2016 UDHS. The study included 2,132 unmarried sexually active AGYW aged 15-24. Data were analyzed using weighted logistic regression to identify factors associated with condom use, adjusting for survey design characteristics. The outcome of interest was condom use and some of the potential predictor variables examined were; age, region, education, wealth, marital status, and exposure to family planning messages. All data processing and analysis was done using STATA v14.

Results: Only 10.36% of AGYW participants reported using condoms. Factors significantly associated with condom use included region (lower use in Northern and Western regions), marital status (lower use among those ever in a union), exposure to family planning messages (higher use), and having multiple sexual partners (higher use). Recent sexual activity was also linked to increased condom use.

Conclusions/recommendations: The low prevalence of condom use highlights the urgent need for targeted interventions to address barriers such as regional disparities, limited access to sexual health education, and gender dynamics. Recommendations include implementing region-specific sexual health programs, expanding family planning messaging, and establishing youth-friendly health services. Empowering AGYW to negotiate condom use and addressing socio-economic barriers are crucial for improving sexual health outcomes.