Transactional sex and HIV risks – evidence from a cross-sectional national survey among young people in Uganda

Figures & data

Table 1 Sociodemographic characteristics of sexually active young people in Uganda 12 months prior to the survey

	Men 15–24 (N=1,516)		Women 15–24 (N=2,824)
Characteristics	Did not pay for sex (N=1,437) n (%)	Paid for sex (N=79) n (%)	Received no gifts, favors, or money for sex (N=2,719) n (%)	Received gifts, favors, or money for sex (N=105) n (%)
Age groups
15–19	459 (31.9)	24 (30.8)	915 (33.7)	54 (51.4)
20–24	978 (68.1)	54 (69.2)	1,804 (66.3)	51 (48.6)
Area of residence
Urban	315 (21.9)	17 (21.5)	641 (23.6)	22 (21.0)
Rural	1,122 (78.1)	62 (78.5)	2,077 (76.4)	83 (79.0)
Educational attainment
>Primary school	598 (41.6)	26 (32.9)	927 (34.1)	20 (19.0)
≤Primary school	839 (58.4)	53 (67.1)	1,791 (65.9)	85 (81.0)
Marital status
Never married	873 (60.8)	48 (60.7)	681 (25.0)	46 (43.8)
Married	501 (34.9)	24 (30.4)	1,830 (67.3)	42 (40.0)
Divorced/widowed/separated	63 (4.3)	7 (8.9)	208 (7.7)	17 (16.2)
Employment status in past year
Working	1,177 (81.9)	68 (86.1)	1,785 (65.6)	65 (62.5)
Not working	260 (18.1)	11 (13.9)	934 (34.4)	39 (37.5)
Household wealth index
Richest two quintiles	642 (44.7)	38 (48.3)	1,292 (47.5)	49 (46.7)
Middle quintile	265 (18.4)	26 (32.9)	459 (16.9)	21 (20.0)
Poorest two quintiles	530 (36.9)	15 (18.8)	968 (35.6)	35 (33.3)
Religious affiliations
Catholic	590 (41.1)	29 (37.2)	1,055 (38.8)	45 (42.9)
Protestant	477 (33.2)	33 (42.3)	918 (33.8)	41 (39.0)
Other Christians	131 (9.1)	7 (9.0)	334 (12.3)	8 (7.6)
Muslim	226 (15.7)	9 (11.5)	394 (14.5)	10 (9.5)
Other religion	12 (0.9)	0 (0.0)	17 (0.6)	1 (1.0)

(All percentages are weighted).

Table 2 Sexual behaviors and HIV status of sexually active young people in Uganda 12 months prior to the survey

	Men 15–24 (N=1,516)		Women 15–24 (N=2,824)
Characteristics	Did not pay for sex (N=1,437) n (%)	Paid for sex (N=79) n (%)	Received no gifts, favors, or money for sex (N=2,719) n (%)	Received gifts, favors or money for sex (N=105) n (%)
Life time number of sexual partners
≤2 partners	595 (41.4)	8 (10.1)	2,047 (75.3)	52 (49.5)
3–5 partners	549 (38.2)	19 (24.1)	624 (22.9)	40 (38.1)
>5 partners	294 (20.4)	52 (65.8)	48 (1.8)	13 (12.4)
Multiple and concurrent sexual partnerships in the past 12 months
<2 partners	1,143 (79.6)	28 (35.9)	2,605 (95.8)	76 (72.4)
≥2 partners but not concurrent	110 (7.7)	15 (19.2)	35 (1.3)	13 (12.4)
≥2 partners and concurrent	183 (12.7)	35 (44.9)	79 (2.9)	16 (15.2)
Age at sexual debut
≥15	1,194 (83.1)	51 (64.6)	2,231 (82.1)	68 (64.8)
<15	243 (16.9)	28 (35.4)	488 (17.9)	37 (35.2)
Condom use at the last sexual activity with the recent partner
Yes	966 (67.2)	51 (65.4)	2,306 (84.8)	82 (78.1)
No	471 (32.8)	27 (34.6)	413 (15.2)	23 (21.9)
Sexual coercion^a
No	442 (89.7)	20 (71.4)	751 (77.6)	21 (63.6)
Yes	51 (10.3)	8 (28.6)	217 (22.4)	12 (36.4)
HIV status
Negative	1,375 (98.0)	66 (83.5)	2,490 (94.0)	92 (88.5)
Positive	28 (2.0)	12 (15.2)	160 (6.0)	12 (11.5)
Condom use at the last sexual activity with transactional partner
Yes	–	41 (68.0)	–	53 (51.0)
No	–	20 (32.0)	–	52 (49.0)

All percentages are weighted.

^aData include respondents questioned about sexual coercion (n=522 men and n=1,010 women).

Table 3 Bivariate association (Crude Odds Ratio [OR_crude]; 95% Confidence Interval [CI]) between risky sexual behaviors and reporting transactional sex among sexually active young people in Uganda 12 months prior to the survey

	Men 15–24 Paid for sex in the past 12 months		Women 15–24 Received gifts, favors, or money for sex in the past 12 months
Characteristics	ORcrude	95% CI	ORcrude	95% CI
Life time sexual partners
≤2 partners	1 (Ref)		1 (Ref)
3–5 partners	2.73	1.16–6.40	2.53	1.66–3.86
>5 partners	14.00	6.44–30.45	10.80	5.50–21.14
Multiple and concurrent sexual partnerships in the past 12 months
<2 partners	1 (Ref)		1 (Ref)
≥2 partners but not concurrent	5.60	2.92–10.80	13.38	6.85–26.11
≥2 partners and concurrent	7.80	4.64–13.12	6.78	3.75–12.24
Age at sexual debut
≥15 years	1 (Ref)		1 (Ref)
<15 years	2.40	1.43–4.05	2.44	1.62–3.70
Condom use at the last sexual activity with the recent partner
Yes	1 (Ref)		1 (Ref)
No	1.13	0.70–1.90	1.55	0.97–2.50
Sexual coercion^a
No	1 (Ref)		1 (Ref)
Yes	4.73	2.00–11.13	1.93	0.94–4.00

^aData include respondents questioned about sexual coercion (n=522 men and n=1,010 women).

Figures in bold are significant at 5% level.

Table 4 Multivariate logistic regression analysis (Adjusted Odds Ratio [OR_adjusted]^a; 95% Confidence Intervals [CI]) for reporting transactional sex among sexually active young people in Uganda 12 months prior to the survey

	Men 15–24 Paid for sex in the past 12 months		Women 15–24 Received gifts, favors, or money for sex in the past 12 months
Characteristics	ORadjusted	95% CI	ORadjusted	95% CI
Age groups
15–19	1 (Ref)		1 (Ref)
20–24	1.60	0.50–5.02	1.50	0.65–3.36
Area of residence
Urban	1 (Ref)		1 (Ref)
Rural	0.83	0.25–2.70	1.25	0.46–3.44
Educational attainment
>Primary school	1 (Ref)		1 (Ref)
≤Primary school	3.25	1.10–9.60	1.73	0.65–4.60
Marital status
Never married	1 (Ref)		1 (Ref)
Married	0.40	0.13–1.20	0.60	0.22–1.60
Divorced/widowed/separated	1.25	0.30–5.80	1.50	0.40–6.00
Multiple and concurrent sexual partnerships in the last 12 months
<2 partners	1 (Ref)		1 (Ref)
≥2 partners but not concurrent	5.32	1.70–16.04	8.90	2.50–31.20
≥2 partners and concurrent	5.60	2.08–14.95	8.04	2.55–25.37
Age at sexual debut
≥15 years	1 (Ref)		1 (Ref)
<15 years	0.50	0.20–1.59	1.34	0.60–3.20
Condom use at the last sexual activity
Yes	1 (Ref)		1 (Ref)
No	0.84	0.32–2.23	2.15	0.80–5.95
Sexual coercion^b
No	1 (Ref)		1 (Ref)
Yes	2.83	1.07–7.47	1.86	0.85–4.08

^aAll variables mutually adjusted.

^bData include respondents questioned about sexual coercion (n=522 men and n=1,010 women).

Figures in bold are significant at 5% level.

Table 5 Unadjusted odds ratio (OR_crude) and adjusted odds ratio (OR_adjusted) at 95% confidence interval (CI) for HIV-positive sero-status among sexually active young people in Uganda 12 months prior to the survey

	Men 15–24		Women 15–24
Characteristics	ORcrude (95% CI)	ORadjusted (CI)^a	ORcrude (95% CI)	ORadjusted (95% CI)^a
Transactional sex in the last 12 months^b
No	1 (Ref)	1 (Ref)	1 (Ref)	1 (Ref)
Yes	8.72 (4.30–18.00)	8.30 (3.65–18.86)	1.97 (1.05–3.70)	1.65 (0.82–3.33)
Lifetime number of sexual partners	1 (Ref)	1 (Ref)	1 (Ref)	1 (Ref)
≤2
3–5	2.09 (0.90–4.93)	1.46 (0.62–3.44)	2.57 (1.87–3.53)	2.12 (1.50–3.03)
>5	3.40 (1.42–8.08)	1.60 (0.62–4.08)	2.60 (1.13–6.00)	2.24 (0.99–5.01)
Age of sexual debut
≥15	1 (Ref)	1 (Ref)	1 (Ref)	1 (Ref)
<15	0.82 (0.35–2.00)	0.62 (0.24–1.60)	1.20 (0.85–1.80)	1.14 (0.76–1.70)
Age of recent partner^c	–	–
Younger or same age			1 (Ref)	1 (Ref)
Older by 5–9 years			1.06 (0.74–1.53)	1.04 (0.72–1.50)
≥10 years older			1.78 (1.22–2.60)	1.50 (0.99–2.30)

^aAll variables mutually adjusted for each other and for age, area of residence, educational attainment, and marital status.

^bTransactional sex in men was defined as paying for sex and in women was defined as receiving gifts, favors, or money for sex.

^cData unavailable for male respondents.

Figures in bold are significant at 5% level.