Gender, transactional sex, and HIV prevention cascade engagement among urban refugee and displaced adolescents and youth in Kampala, Uganda

Figures & data

Table 1. Factors associated with transactional sex engagement among urban refugee and displaced youth living in informal settlements in Kampala, Uganda (N = 412).

	Adolescent boys and young men (N = 88)			Adolescent girls and young women (N = 324)
Indicators	No transactional sex engagement (n = 46; 52.3%) N (%)/ Mean (SD)	Transactional sex engagement (n = 42; 47.7%) N (%)/ Mean (SD)	P value	No transactional sex engagement (n = 238;71.5%) N (%)/ Mean (SD)	Transactional sex engagement (n = 86; 26.5%) N (%)/ Mean (SD)	P value
Age	20.96 (2.71)	20.57 (2.64)	0.502	18.89 (2.44)	20.52 (2.56)	0.000
Education			0.927			0.001
> secondary school	16 (34.8)	15 (35.7)		148 (62.2)	36 (41.9)
Secondary school	30 (65.2)	27 (64.3)		90 (37.8)	50 (58.1)
Time in Uganda			0.019			0.011
<1 year	5 (10.9)	5 (11.9)		16 (6.7)	6 (7.0)
1–5 years	38 (82.6)	25 (59.5)		124 (52.1)	60 (69.8)
>5 years	3 (6.5)	12 (28.6)		98 (41.2)	20 (23.3)
Employment			0.103			0.000
Unemployed	15 (35.7)	18 (54.5)		130 (54.6)	18 (20.9)
Employed/Student	27 (64.3)	15 (45.5)		108 (45.4)	68 (79.1)
Food insecurity			0.195			0.500
No	13 (28.3)	7 (16.7)		70 (29.4)	22 (25.6)
Yes	33 (71.7)	35 (83.3)		168 (70.6)	64 (74.4)
PrEP awareness			0.612			0.062
No	41 (97.6)	44 (95.7)		80 (93.0)	231 (97.5)
Yes	1 (2.4)	2 (4.3)		6 (7.0)	6 (2.5)
Knowledge of PrEP access			0.504			0.062
No	40 (97.8)	45 (97.8)		80 (93.0)	231 (97.5)
Yes	2 (4.8)	1 (2.2)		6 (7.0)	6 (2.5)
Recent PrEP uptake						0.792
No	42 (100)	46 (100)		85 (98.8)	2 (0.8)
Yes	0 (0.0)	0 (0.0)		1 (1.2)	235 (99.2)
HIV testing (ever)			0.036			0.088
No	13 (28.3)	21 (50.0)		114 (47.9)	32 (37.2)
Yes	33 (71.7)	21 (50.0)		124 (52.1)	54 (62.8)
Past 3-month consistent condom use			0.128			0.000
No	7 (26.9)	14 (46.7)		74 (68.5)	21 (26.3)
Yes	19 (73.1)	16 (53.3)		34 (31.4)	59 (73.8)
Condom efficacy	23.59 (5.13)	22.81 (5.96)	0.513	16.69 (7.98)	21.92 (7.13)	0.000

Figure 1. Past 3-month consistent condom use and lifetime HIV testing by gender and transactional sex engagement among urban refugee and displaced youth aged 16–24 in Kampala, Uganda (N = 412). Legend: adolescent girls and young women: AGYW; adolescent boys and young men: ABYM.

Figure 2. Condom efficacy by gender and transactional sex engagement among urban refugee and displaced youth aged 16–24 in Kampala, Uganda (N = 412). Legend: adolescent girls and young women: AGYW; adolescent boys and young men: ABYM.

Table 2. Association between transactional sex engagement and HIV prevention cascades among urban refugee and displaced youth living in informal settlements in Kampala, Uganda (N = 412).

	Condom Efficacy			Recent (past 3-month) Consistent Condom Use			HIV testing (ever)
	Beta	95% CI	p-value	aOR	95% CI	p-value	aOR	95% CI	p-value
Findings for adolescent girls and young women (N = 324)
Transactional sex vs no transactional sex engagement
No transactional sex (Ref)
Transactional sex engagement	0.21	2.07, 5.89	0.0001	7.83	3.63, 16.92	0.0001	0.76	0.42, 1.37	0.368
Age	0.02	−0.33, 0.45	0.754	1.36	1.15, 1.61	0.0001	1.23	0.99, 1.27	0.051
Time in Uganda (ref > 1 year)
1–5 years	−0.07	−4.44, 2.02	0.462	2.65	0.67, 10.49	0.164	1.08	0.39, 2.96	0.876
<5 years	−0.07	−4.54, 2.11	0.471	3.86	0.91, 16.25	0.065	0.84	0.30, 2.35	0.743
Employment/student (ref unemployed)	−0.23	−1.07, 0.70	0.686	0.78	0.51, 1.18	0.240	1.69	1.29, 2.19	0.0001
Secondary school and above (ref > secondary school)	0.38	4.32, 8.07	0.0001	0.93	0.58, 1.47	0.747	1.13	1.03, 3.18	0.039
Findings for adolescent boys and young men (n = 88)
Transactional sex (TS) vs no transactional sex engagement
No transactional sex (Ref)
Transactional sex engagement	−0.09	−3.35, 1.26	0.368	0.49	0.14, 1.74	0.268	0.32	0.11, 0.89	0.029
Age	0.24	−0.10, 1.02	0.055	1.17	0.88, 1.54	0.279	1.40	1.11, 1.77	0.005
Time in Uganda (ref > 1 year)
1–5 years	0.08	−2.59, 4.45	0.600	1.03	0.16, 6.45	0.977	1.62	0.34, 7.74	0.545
<5 years	0.22	−1.12, 7.49	0.145	2.65	0.21, 34.02	0.455	3.46	0.50, 23.95	0.208
Secondary school and above (ref > secondary school)	0.20	−0.57, 5.19	0.114	2.93	0.71, 12.19	0.139	0.95	0.27, 3.33	0.936