Vulnerability and risk factors for sexually transmitted infections and HIV among adolescents in Kampala, Uganda

Abstract

Three hundred and six sexually experienced adolescents participated in a study on sexually transmitted infection (STI) prevalence and associated risk factors. The prevalence of Neisseria gonorrhoea (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV) and syphilis was 4.5%, 9%, 8% and 4% for females and 4.7%, 5.7%, 0% and 2.8% for males. HIV-seropositivity was found in 15.2% of females and 5.8% of males. Structured face-to-face interviews were used to obtain information about social background, sexual experience and genital symptoms. Four focus-group discussions were used in order to validate the interview data. Females were more likely to be infected by the four treatable STIs and HIV, despite risky behavior being more common among males. Unemployment, little formal education, the presence of bacterial STIs and post-coital bleeding or a bad smell from the vagina was highly associated with the risk for HIV in females. The higher prevalence of STIs, including HIV, among adolescent girls cannot be explained by sexual behavior only, as boys reported more risk behavior and were still less affected by STIs. Biological and social factors are definitely of importance.

Keywords:

• HIV infection
• sexually transmitted infections
• adolescents
• risk factors Uganda

Acknowledgments

We wish to thank the staff of Muvubuka Agunjuse youth clinic for their dedicated work and the youth who shared their experiences with us, the staff at the STD laboratory at Mulago Hospital for their hard work, Miss Erin Culbertson for checking the manuscript for errors in language, the Ministry of Health, Buganda Kingdom for encouraging this study and SIDA Department for Research Cooperation and the Center for Clinical Research for financial support.