title: Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda.
abstract: With more than half of new infections occurring among youth, HIV/AIDS remains a major contributor to morbidity and mortality in Uganda. Semi-structured interviews were performed with 48 adolescents and 15 adult key informants in a rural Ugandan community to identify influences on adolescent sexual decision-making. Inductive data analytic methods revealed five thematic influences: (1) social pressure, (2) decline of the Senga (a familial figure who traditionally taught female adolescents about how to run a household), (3) cultural barriers to condom use, (4) knowledge of HIV transmission and modes of prevention, and (5) a moral injunction against sex before marriage. Influences were classified as HIV/AIDS risk and protective factors and organized to form an explanatory framework of adolescent sexual risk-taking. Risk factors pull youth toward risky behavior, while protective factors push them away. Predominance of risk over protective influences explains persistent sexual risk-taking by Ugandan youth. HIV prevention programs designed for Ugandan adolescents should take competing factors and sociocultural and economic influences into account.
authors: Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA. ikatz2@partners.org
authors: Ingrid T
authors: IT
authors: Katz
authors: Michele L
authors: ML
authors: Ybarra
authors: Monique A
authors: MA
authors: Wyatt
authors: Julius P
authors: JP
authors: Kiwanuka
authors: David R
authors: DR
authors: Bangsberg
authors: Norma C
authors: NC
authors: Ware
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology* / Q000523:psychology; D000328:Adult; D000368:Aged; D003469:Culture; D003657:Decision Making; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations / Q000208:ethnology; D010379:Peer Group; D036301:Qualitative Research; D012307:Risk Factors; D012309:Risk-Taking; D012424:Rural Population; D012725:Sexual Behavior / Q000208:ethnology* / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda