Peer-reviewed article
Profiling the plight of adolescent girls and young women: risks and pathways for intervention in rural Uganda.
Bindeeba DS, Nakawesi JS, Mugisa A, Senyimba C, Mulebeke R et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study profiled 124,259 adolescent girls and young women in rural Uganda to identify those at highest risk of HIV, unintended pregnancy, and gender-based violence. Researchers used screening data and statistical analysis to classify participants into high-risk and low-risk groups. Being in school was strongly protective against high-risk classification, while engagement in transactional sex was the strongest predictor of vulnerability. The findings highlight that older adolescents aged 20-25 who are out of school face compounded risks from poverty and violence.
Key points
- 24.7% of 124,259 adolescent girls and young women screened were classified as High-Risk
- High-risk group was predominantly aged 20-25, out of school, engaged in transactional sex, and exposed to violence
- School enrollment was strongly protective (adjusted odds ratio 108.15 of being Low-Risk)
- Transactional sex was the strongest predictor of high-risk classification (adjusted odds ratio 1599.97)
- Younger girls aged 9-14 largely clustered as Low-Risk due to delayed sexual debut and stronger school retention
Limitations
This is a cross-sectional analysis of screening data collected during program enrollment, so it describes risk profiles at a single timepoint rather than tracking outcomes over time. The study identifies associations between characteristics and risk classification but does not evaluate whether any specific intervention reduces these risks.
Abstract
Background Adolescent girls and young women (AGYW) in rural Uganda face overlapping socio-economic, educational, and behavioral vulnerabilities that heighten their risks of HIV, unintended pregnancies, gender-based violence (GBV), and other adverse health outcomes. Establishing baseline risk profiles is essential for designing targeted interventions. Methods This study analyzed secondary data collected through the Uganda DREAMS and OVC Tracking System (UDOTS) during program enrollment between July 2017 and December 2023 in four districts of Central Uganda (Mubende, Mityana, Luwero, and Kassanda). UDOTS screening tools captured socio-economic, educational, and behavioral indicators. K-means cluster analysis was applied to classify participants into High-Risk and Low-Risk groups, followed by bivariate validation. Logistic regression was used to identify predictors of high-risk classification. Results Of the 124,259 AGYW screened, 24.7% were categorized as High-Risk. This group was predominantly aged 20-25, out of school, engaged in transactional sex, and exposed to violence. In contrast, the 9-14 age group largely clustered as Low-Risk, reflecting delayed sexual debut, stronger school retention, and lower exposure to economic pressures. Education was strongly protective: AGYW enrolled in school had substantially greater odds of being classified as Low-Risk (AOR = 108.15, 95% CI: 93.84-124.65, p < 0.001). Conversely, transactional sex strongly predicted High-Risk classification (AOR = 1599.97, 95% CI: 769.09-3328.47, p < 0.001). Conclusion AGYW in rural Uganda particularly those aged 20-25, face compounded vulnerabilities linked to poverty, violence, and school dropout. Strengthening education, economic empowerment, and GBV prevention is critical to reducing these risks and fostering resilience.