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Background: Early sexual initiation is associated with increased susceptibility to HIV. Youth living in urban slums are especially vulnerable. However, little is known about the social factors among these adolescents that may help protect against HIV. The study aim was to identify personal and social protective factors for HIV risk among older adolescent (ages 16-18 years) abstainers compared to non-abstainers living in high-risk communities.
Methods: Data were from the 2014 Kampala Youth Survey conducted using ak convenience sample of youth (N=1,134) living in slums in Kampala, Uganda. HIV-related measures included personal factors (sexual risk behaviors, intentions, self-efficacy), and social factors (peer norms and parental support for abstinence). Abstainers were those who reported never having had sex. Chi-square and odds ratios were conducted.
Results: Sixty-seven percent of the participants were older adolescents, age 16-18, used in the analyses (n= 761). Abstainers comprised 32% of the youth (n=330). There were no significant demographic differences. Compared to non-abstainers, abstainers reported significantly more perceived parental disapproval (94% vs. 73%), adult disapproval (90% vs. 76%), and peer support for abstaining (70% vs.33%) for sex (p=.000). Twice as many abstainers (66%) reported that their friends planned to delay sex (p=.000). Self- efficacy to refuse sex was higher (91% vs. 84%)(p=.002), and 88% of abstainers vs. 78% of non-abstainers felt that they could avoid situations that encouraged sex (p=.001). More abstainers than non-abstainers reported intentions to use condoms (84% vs. 74%), (p=.005). Older abstainers were also 86% less likely to have intention to have sex within the following 6 months (OR .138 95% CI .103-.186 p=. 000).
Conclusions:The results reveal significant differences in the personal and social influencers among abstaining and non-abstaining youth. These factors may be protective against early sexual initiation and could be modified in future prevention efforts to reduce HIV transmission risk among these vulnerable youth.