Correlates of ever had sex among perinatally HIV-infected adolescents in Uganda

BACKGROUND The objective of this study was to explore the correlates of ever had sex among perinatally HIV-infected (PHIV) adolescents. METHODS A cross-sectional survey of sexual behaviour was conducted with 624 PHIV adolescents living three regions (12 districts) of Uganda. Data was collected on socio demographic characteristics (age, sex, occupation, religion and education status), sexual practices and behaviours (Intimate relationships, sexual intercourse, age of sexual debut, condom use, multiple and concurrent sexual partners), consequences of sexual behaviours (pregnancy and STI's) and life style factors (use of alcohol, psychoactive substances and peer influence). Multivariable logistic-regression was used to ascertain the determinants of sexual activity. RESULTS The majority of PHIV were female (59.3 %) and the mean age of the sample was 16.2 (±2.1) years. The mean age of sexual debut was 15.8 years; 16.2 % (101/624) reported symptoms for sexually transmitted infections (STI) and more than a third (213/624) reported ever had sex.Of these 76.5 % (165/213) used condoms inconsistently; and 49.3 % (105/213) had been pregnant or made someone pregnant. Of those in relationships, 56.3 % (223/396) did not disclose and were not aware of their partners' HIV status. Adolescents aged 15-19 years were more likely to have ever been sexually active (Adjusted odds ratio (AOR) 6.28, 95 % Confidence interval (CI): 2.63-14.99) compared to those aged 10-14 years. Adolescents who were living alone were more likely to have ever been sexually active compared to those living with one or both parents (AOR 4.33, 95 % CI: 1.13-16.62). The odds of being sexually active were lower among adolescents in school compared to those out of school (AOR 0.2, 95 % CI: 0.13-0.30), who had never been treated for STI (compared to those who had never been treated for STI) (AOR 0.19, 95 % 0.11-0.32) and adolescents who never drank alcohol (AOR 0.49, 95 % CI 0.28-0.87). CONCLUSION PHIV adolescents have risky sexual behaviours characterized by being sexually active, inconsistent condom use, and having partners of unknown status. Risk reduction interventions are required to minimize unplanned pregnancies, STI, and HIV transmission by PHIV adolescents.