Sexual, Reproductive Health Needs, and Rights of Young People in Slum Areas of Kampala, Uganda: A Cross Sectional Study.
Sexual, Reproductive Health Needs, and Rights of Young People in Slum Areas of Kampala, Uganda: A Cross Sectional Study.
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乌干达坎帕拉贫民区的年轻人的性，生殖健康需求和权利：一项横断面研究。
DOI：
10.1371/journal.pone.0169721
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Kamanga G
中科院分区：
文献类型：
--
作者：
Renzaho AM;Kamara JK;Georgeou N;Kamanga G
乌干达青年面临各种性健康和生殖健康风险，特别是生活在城市贫民窟的青年。这项研究的目的是审查与性健康和生殖健康综合类别有关的因素，包括性行为;性教育和获得避孕服务;计划生育;预防性传播疾病;性同意是一项权利;基于性别的暴力;以及艾滋病毒检测、咨询、披露和支持。该研究采用横断面设计，于2014年7月在乌干达坎帕拉市的Makindye和Nakawa区进行。通过系统随机抽样，收集了坎帕拉城市贫民窟663名年龄在13至24岁之间的参与者的数据。62%的参与者报告曾经有过性行为，初次性行为的平均年龄为16岁（95%CI：15.6，16.4岁，范围：5-23岁）。独居者报告有过性行为的几率（OR：2.75; 95%CI：1.35，5.61; p<0.01）高于生活在核心家庭中的受访者。然而，避孕套的使用率仅为54%。在调查前的最后12个月内，性伴侣的数量平均为1.8名（95%CI：1.7，1.9;范围1-4），18.1%的人报告年龄差距为10岁或以上。超过四分之三（80.6%）的性活跃参与者报告说，他们的第一次性行为是双方自愿的，这表明大多数年轻人选择何时进行首次性行为。自愿第一次性行为的低发生率与年轻有关（OR = 0.48，95%CI：0.25，0.90，p<0.05），有残疾（OR = 0.40，95%CI：0.16，0.98，p<0.05），与非亲属同住（OR = 0.44，95%CI：0.16，0.97，p<0.05），仍在上学（OR = 0.29，95%CI：0.12，0.67，p<0.01）。这些结果在调整协变量后仍然显着，除了残疾和参与者的年龄。女性因劝说（13.2%vs.2.4%，p<0.001）、被欺骗（7.1%vs.2.9%，p<0.05）和被强迫或强奸（9.9%vs.4.4%，p<0.05）而不愿意进行第一次性行为的比例显著高于男性。从数据中可以看出，性虐待的程度很高，34.3%的人肯定，如果男孩对女孩有感情，强迫女孩发生性关系是可以的; 73.3%的人肯定，陌生人和亲戚强迫年轻女性在未经同意的情况下与他们发生性关系是常见的; 26.3%的人表示，只要他们彼此相爱，男孩打女朋友有时是情有可原的。这项研究探讨了坎帕拉市区一个特定地区青年人目前的性行为。青年人的性健康和生殖健康在乌干达仍然是一个挑战。为了消除这些障碍，迫切需要建立一个全面、协调的性健康和生殖健康系统，该系统对青年人友好，并考虑到当地的社会文化背景。
Young people in Uganda face various sexual and reproductive health risks, especially those living in urban slums. The aim of this study was to examine factors associated with comprehensive categories of sexual and reproductive health, including sexual behaviours; sexual education and access to contraceptive services; family planning; prevention of STDs; sexual consent as a right; gender based violence; as well as HIV testing, counselling, disclosure and support. The study was cross-sectional in design and was carried out in July 2014 in Makindye and Nakawa Divisions of Kampala City, Uganda. Using systematic random sampling, data were collected on 663 participants aged between 13 and 24 years in Kampala’s urban slums. Sixty two percent of participants reported having ever had sex and the mean age of sexual debut was 16 years (95%CI: 15.6, 16.4 years, range: 5–23 years). The odds of reporting ever having had sexual intercourse were higher among respondents living alone (OR: 2.75; 95%CI: 1.35, 5.61; p<0.01) than those living in a nuclear family. However, condom use was only 54%. The number of sexual partners in the last 12 months preceding the survey averaged 1.8 partners (95%CI: 1.7, 1.9; range 1–4) with 18.1% reporting an age gap of 10 years or older. More than three quarters (80.6%) of sexually active participants reported that their first sexual encounter was consensual, suggesting that most young people are choosing when they make their sexual debut. Low prevalence of willing first sexual intercourse was associated with younger age (OR = 0.48, 95%CI: 0.25, 0.90, p<0.05), having a disability (OR = 0.40, 95%CI: 0.16, 0.98, p<0.05), living with non-relatives (OR = 0.44, 95%CI: 0.16, 0.97, p<0.05), and being still at school (OR = 0.29, 95%CI: 0.12, 0.67, p<0.01). These results remained significant after adjusting for covariates, except for disability and the age of participants. The proportion of unwilling first sexual intercourse was significantly higher among women for persuasion (13.2% vs. 2.4%, p<0.001), being tricked (7.1% vs 2.9%, p<0.05) and being forced or raped (9.9% vs 4.4%, p<0.05) than men. A high level of sexual abuse emerged from the data with 34.3% affirming that it was alright for a boy to force a girl to have sex if he had feelings for her; 73.3% affirming that it was common for strangers and relatives to force young females to have sexual intercourse with them without consent; 26.3% indicating that it was sometimes justifiable for a boy to hit his girlfriend, as long as they loved each other. This study has explored current sexual practice among young people in a specific part of urban Kampala. Young people’s sexual and reproductive health remains a challenge in Uganda. To address these barriers, a comprehensive and harmonised sexual and reproductive health system that is youth friendly and takes into account local socio-cultural contexts is urgently needed.