Adolescent sexual behaviour in a refugee setting in Uganda

Abstract

Background: Children under 18 years old constituted more than half (52%) of the refugee population in 2017. Adolescent Sexual and reproductive health is an essential component of primary health care. Yet, not every refugee adolescent is able to access sexual and reproductive health services. Methods: Using quantitative data from 356 refugee adolescents and qualitative data (17 in-depth interviews and nine key informant interviews), we examine refugee adolescent sexual behaviour in Bidibidi settlement—the largest refugee settlement in Uganda using a binary logistic regression model. Results: The results show that 25% of refugee adolescents in Bidibidi refugee settlement had ever had sex. After controlling for all factors, results show that refugee adolescents aged 16–18 years (OR = 3.47; 95% CI = 1.09–10.94), males (OR = 17.59; 95% CI = 4.48–69.07), not in school (OR = 14.57; 95% CI = 2.20–96.35) were more likely to engage in sexual behaviour than their counterparts. Refugee adolescents who do not agree that a girl cannot get pregnant if she has sex while standing up (knowledge about getting pregnant) were significantly less associated with sexual behaviour (OR = 0.30; 95% CI = 0.10–0.85). Conclusions: Results from this study show that keeping refugee adolescents in school and providing sexual and reproductive health information are likely to delay refugee adolescents’ engagement in sexual behaviour. Therefore, there is need to promote keeping refugee adolescents in school in order to improve sexual and reproductive health of adolescent refugees living in low-income countries such as Uganda. Sexual and reproductive health is an essential component of primary health care. Limited access to sexual and reproductive health (SRH) services for adolescent refugees particularly in low income countries can affect their reproductive health. Similarly, limited knowledge of the determinants of sexual behaviour of adolescent refugees in low income countries puts them at risk of SRH challenges. This study uses quantitative data from 356 adolescent refugees and qualitative (17 in-depth interviews with adolescent refugees and nine key informant interviews with service providers) to examine the factors that influence the sexual behaviour of adolescent refugees in Bidibidi refugee settlement. The findings show that older age, male sex, not being in school and having knowledge of getting pregnant were associated with sexual behaviour among adolescent refugees in Bidibidi refugee settlement in Uganda. There is need to promote keeping refugee adolescents in school and providing them with relevant SRH information to contribute to improving sexual and reproductive health of adolescent refugees living in low-income countries such as Uganda.