Dynamics of abstinence and condom use among unmarried youth aged 15-24 in Uganda : a case of Mukono and Kabale districts

Abstract

This thesis establishes the current levels of, and changes in, sexual abstinence and condom use among young unmarried people and determines factors associated with them. Abstinence is considered in two ways: primary abstinence refers to delayed onset of sexual intercourse, whilst secondary abstinence refers to periods during which sexual intercourse did not take place amongst those who had already been sexually active. The study analyses quantitative data from 786 respondents in a stratified cluster survey and qualitative data from focus group discussions and key informants. The survey used both a questionnaire and an Event History Calendar (EHC). Logistic regression is used to analyse the probabilities of abstaining and condom use while piecewise constant hazards models are used to analyse duration of secondary abstinence. Consistency of condom use at both first and latest events is analysed using multinomial logistic regression. Multilevel modelling is used to explore cluster level variation. The results show that young people are more likely to have never had sex if they reside in Kabale, avoid parties/clubs, avoid alcohol consumption, are not indecently assaulted and have a positive attitude towards abstinence. Being in age group 15-16, not taking alcohol and avoiding parties/clubs are associated with secondary abstinence. Residence in Mukono, being female, being in school, attainment of secondary education, listening to radio, positive attitude to condom use, higher age at first sex and having had two or more relationships are associated with condom use. Condom use level varies by sexual event and relationship. Consistency of condom use is associated with residence in Mukono, secondary education and higher age at first sex. There is a significant random variation in secondary abstinence at village level. In conclusion, there appear to be dynamic changes in levels of condom use and abstinence among young people in Uganda. An EHC can be reliably used to collect data on sexual abstinence episodes. Some patterns of condom use and sexual abstinence are different from results reported in other studies.

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