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      Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, substance use history, and family environment

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          Abstract

          Background

          University students are known to have risky sexual behaviours (RSBs). The severity of the RSB is influenced by many factors, including the family environment, exposure to adverse childhood events (ACEs), and the use of addictive substances. However, there is limited information about the influence of ACEs and the family environment of these students in low-and medium-income countries (LMICs). Therefore, a pilot study was conducted among university students from a LMIC, Uganda.

          Methods

          The present study comprised a cross-sectional online survey among Ugandan students at a public university (N = 316; 75% male; 52.2% aged between 18–22 years). The survey included questions relating to socio-demographic information, family environmental information, the Sexual Risk Survey (SRS), and the Adverse Childhood Experiences-International Questionnaire (ACE-IQ).

          Results

          Over half (53.8%) reported having had sexual intercourse. Males reported over two times higher mean total SRS score compared to females ( χ 2 = 4.06, p = 0.044). Approximately one-sixth of the sample had drunk alcohol or used illicit psychoactive substances in the past six months (16.1%). Among four regression analysis models, sociodemographic variables predicted the highest variance (13%), followed by family environment variables (10%), and both psychoactive substance use history (past six months) and ACEs individually explained approximately 5% variance in total SRS score, with the final model predicting 33% of the variance in RSB.

          Conclusions

          The present study demonstrated a gender disparity with males involved in more RSB than females, as has been reported in most previous RSB studies. Family environment, sociodemographic factors, substance use, and ACEs all appear to contribute to RSB among university students. These findings will benefit other researchers exploring factors associated with RSB among university students and will help develop interventions to reduce RSB to protect students from unwanted pregnancies, sexually transmitted diseases, and HIV/AIDS.

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          Most cited references61

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          HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities

          Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included.
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            Declines in Unintended Pregnancy in the United States, 2008-2011.

            The rate of unintended pregnancy in the United States increased slightly between 2001 and 2008 and is higher than that in many other industrialized countries. National trends have not been reported since 2008.
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              Adolescent sexual risk behavior: a multi-system perspective.

              Adolescents are at high risk for a number of negative health consequences associated with early and unsafe sexual activity, including infection with human immunodeficiency virus, other sexually transmitted diseases, and unintended pregnancy. As a result, researchers have attempted to identify those factors that influence adolescent sexual risk behavior so that meaningful prevention and intervention programs may be developed. We propose that research efforts so far have been hampered by the adoption of models and perspectives that are narrow and do not adequately capture the complexity associated with the adolescent sexual experience. In this article, we review the recent literature (i.e., 1990-1999) pertaining to the correlates of adolescent sexual risk-taking, and organize the findings into a multisystemic perspective. Factors from the self, family, and extrafamilial systems of influence are discussed. We also consider several methodological problems that limit the literature's current scope, and consider implications of the adoption of a multisystemic framework for future research endeavors. We conclude with a discussion of the implications of the available research for practitioners working to reduce sexual risk behavior among adolescents.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: VisualizationRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: ValidationRole: Writing – review & editing
                Role: VisualizationRole: Writing – review & editing
                Role: MethodologyRole: ValidationRole: Writing – review & editing
                Role: ValidationRole: VisualizationRole: Writing – review & editing
                Role: MethodologyRole: ResourcesRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                16 November 2022
                2022
                : 17
                : 11
                : e0277129
                Affiliations
                [1 ] Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, Uganda
                [2 ] African Centre for Suicide Prevention and Research, Mbarara, Uganda
                [3 ] Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
                [4 ] Faculty of Medicine, Mbarara University of Science & Technology, Mbarara, Uganda
                [5 ] Makerere University, College of Health Sciences, Kampala, Uganda
                [6 ] CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh
                [7 ] Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
                [8 ] Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
                University of Nairobi, KENYA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                ‡ SA and MDG also contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-4733-154X
                https://orcid.org/0000-0002-7760-7535
                https://orcid.org/0000-0002-1728-8966
                https://orcid.org/0000-0001-8880-6524
                Article
                PONE-D-22-01495
                10.1371/journal.pone.0277129
                9668123
                36383509
                c9295812-1a38-4938-9737-f8cef7c0db34
                © 2022 Kaggwa et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 January 2022
                : 21 October 2022
                Page count
                Figures: 0, Tables: 3, Pages: 21
                Funding
                The author(s) received no specific funding for this work.
                Categories
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                Custom metadata
                The data underlying the results presented in the study are available from https://doi.org/10.6084/m9.figshare.18485417.

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