Peer-reviewed article
Pregnancy risk behaviour among sexually active adolescent girls aged 10-17 years in high HIV prevalence districts in Uganda: a cross-sectional secondary analysis of the 2018 AGYW survey data.
Mulyowa A, Namutundu J, Wanyenze RK, Matovu JKB ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed data from 323 sexually active girls aged 10-17 years in high HIV prevalence districts in Uganda to understand pregnancy risk behaviour. Nearly 64% of these girls engaged in pregnancy risk behaviour, defined as sex without effective pregnancy protection. Girls with secondary or higher education were less likely to engage in risky behaviour, while those with multiple sexual partners were at higher risk. The study highlights that keeping girls in school is important for preventing early pregnancy.
Key points
- 63.8% of sexually active girls aged 10-17 years engaged in pregnancy risk behaviour in the past year
- Two-thirds (66.3%) of the 10-17 year old girls were out-of-school
- Secondary or higher education was protective against pregnancy risk behaviour (adjusted prevalence ratio 0.67)
- Having two or more sexual partners in the past year increased likelihood of pregnancy risk behaviour
- Among 8,236 adolescent girls and young women enrolled, 9% were girls aged 10-17 who had sex in the past year
Limitations
This is a secondary analysis of survey data which is cross-sectional, so it cannot establish causality or determine the direction of relationships. The study focuses only on sexually active girls in high HIV prevalence districts, which may not be representative of all adolescent girls in Uganda or other contexts.
Abstract
Introduction Although global adolescent birth rates steadily declined over the past decade, they remain persistently high within the African region. However, there is limited evidence on why they remain high. We estimated the prevalence of pregnancy risk behaviour and associated factors among sexually active adolescent girls (AG) aged 10-17 years in high HIV prevalence districts in Uganda. Methods This was a secondary analysis of data collected as part of a large cross-sectional study conducted among AGs and young women (AGYW) aged 10-24 years in July 2018. This analysis focused on AGs aged 10-17 years reporting sexual intercourse in the past 12 months. The primary outcome was prevalence of pregnancy risk behaviour, defined as engaging in sex without using pregnancy protection or using ineffective pregnancy prevention methods. Descriptive analysis and modified multivariable Poisson regression were used to determine the prevalence and factors associated. Statistical significance was set at p<0.05. Analyses were performed using Stata V.16. Results Of the 8236 AGYW enrolled into the large study, 53.6% (n=4414) had ever had sex. Of these, 80.6% (n=3560) had sex in the past year, of whom 9% (n=323) were AGs aged 10-17 years. Two-thirds of the 10-17 years old (66.3%, n=214) were out-of-school. Of 323 AGs, 63.8% (95% CI: 58.5% to 69.0) engaged in pregnancy risk behaviour in the past year. Being Anglican (adjusted prevalence ratio (aPR)=1.28; 95% CI: 1.01 to 1.61) and having two or more sexual partners in the past year (aPR=1.20; 95% CI: 1.02 to 1.43) increased the likelihood of engaging in pregnancy risk behaviour while having secondary or higher education was protective (aPR=0.67; 95% CI: 0.45 to 0.98). Conclusion 6 in 10 AGs aged 10-17 years engaged in pregnancy risk behaviour. Findings suggest that attaining higher levels of education is beneficial against pregnancy risk behaviour and underscore the need of keeping girls in school longer.