The link between being subjected to sexual coercion and engaging in risky sexual behaviour by making an early sexual debut and having many sexual partners is significant in the work to prevent HIV, in the view of to Anette Agardh, the researcher who has led the study.
“African HIV campaigns are primarily aimed at young people who are sexually active. However, if the reasons for risky sexual behaviour are found to lie in experiences of sexual coercion, it is equally important to target those who commit such assaults. This doesn’t have to be other young people; it is just as likely to be relatives, neighbours, teachers or other adults”, she says.
It is not possible to discern time and causal relationships from the study, that is to say, we cannot know whether the sexual coercion preceded the behaviour of having many sexual partners. However, other studies have shown that such a pattern exists.
“There are a number of studies which show that assaults also have a harmful effect on self-confidence”, Dr Agardh adds. “Victims often have lower self-worth afterwards and tend to take less care of themselves, their integrity and their bodies.”
Surprisingly, almost as many young men as young women said that they had been subject to sexual coercion – 29.9 per cent of men compared with 33.1 per cent of women. This was an unexpected result, because in Ugandan society there is high inequality between the sexes and strong opposition to homosexuality. Homosexual acts are illegal and are punishable with up to 14 years in prison. In the spring a bill to increase the sentence to the death penalty was shelved after strong international protests, but it still looms as a possibility.
“Previous international research on sexual coercion has primarily studied women, since it was believed that it is primarily girls and women who are affected. We did not expect to find such a high percentage among the young men in our study”, says Dr Agardh.
The study took the form of a questionnaire distributed to all 1 220 undergraduate students at Mbarara University of Science and Technology in south-western Uganda 80 per cent of whom responded to the questionnaire. Sexual coercion was defined as “a sexual act which you have been forced to perform”, with examples given including oral sex.
However, not all the young people who had been subject to sexual coercion displayed risky sexual behaviour. Factors which appeared to protect against this risky sexual behaviour were good mental health, a high level of trust in others and a family background in which religion played a major role. The researchers believe that these risk factors could also be taken into consideration in future efforts to combat HIV in Uganda.
The study is entitled “Experience of Sexual Coercion and Risky Sexual Behavior among Ugandan University Students” and has been published in the journal BMC Public Health. It is available at www.biomedcentral.com/bmcpublichealth; enter ‘Agardh’ in the search field.