Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda

Ingrid T. Katz, Michele L. Ybarra, Monique A. Wyatt, Julius P. Kiwanuka, David R. Bangsberg, Norma C. Ware

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)258-264
Number of pages7
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number2
StatePublished - Feb 1 2013
Externally publishedYes


  • HIV prevention
  • Uganda
  • adolescents
  • sexual risk-taking

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health


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