Kwagala Betty, Chidwick Hanna, Mensah Deborah, Asiimwe John Bosco, Wandera Stephen Ojiambo, Mutabazi Miriam, Ngabirano Fred, Osei Lydia, Kapiriri Lydia
Department of Population Studies, Makerere University, Kampala, Uganda.
Global Health, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
BMC Public Health. 2025 May 24;25(1):1921. doi: 10.1186/s12889-025-23159-4.
The artisanal and small-scale mining (ASM) sector has become an important employer in mineral rich countries of sub Saharan Africa where women constitute up to half of the labour force. However, gender and socio-economic marginalization negatively impact the sexual and reproductive health (SRH) of the adolescent girls and young women (AGYW) who work in the ASM sector. Despite the growing literature on adolescents' SRH, there is a paucity of literature on the SRH of this last mile population. This paper fills this gap in the literature by examining the prevalence and determinants of self reported sexually transmitted infection (STI) status among AGYW in the ASM gold mining sectors of Uganda.
The paper is based on 636 AGYW working in the mining sectors in Uganda who had ever had sex. Descriptive analysis involved frequency distributions and chi squared tests. Multivariable analysis involved fitting a binary logistic regression model to assess the determinants of self reported STI status of the AGYW.
Almost half (47%) of the respondents had a self reported STI during the 12 months preceding the study. The odds of reporting an STI were higher among adult young women compared with minors (AOR = 3.35; 95% CI 1.82 - 6.16); AGYW with primary level of education compared to those with none (AOR = 2.89; 95% CI 1.24 - 6.75); who drank alcohol (AOR 1.59; 95% CI 1.06-2.39); and engaged in transactional sex (AOR 2.42; 95% CI 1.37 - 4.28).
The results highlight the urgent need to respond to the high prevalence of self reported STIs among AGYW in ASM. The risk factors constitute multiple and intersecting vulnerabilities that require both preventive and curative interventions targeting female and male ASM workers and host communities, with emphasis on behavioral change and promotion of viable alternative sources of income. The ministries of Health, Gender, Labour and Social Development and key development partners should adopt a multi sectoral approach that effectively engages key stakeholders, including mining host communities, given the close interrelations between gender, health and economic aspects of the AGYW's lives.
在撒哈拉以南非洲矿产丰富的国家，手工和小规模采矿（ASM）部门已成为重要的雇主，其中女性占劳动力的一半。然而，性别和社会经济边缘化对在ASM部门工作的少女和年轻女性（AGYW）的性与生殖健康（SRH）产生了负面影响。尽管关于青少年SRH的文献越来越多，但关于这一最边缘人群SRH的文献却很少。本文通过研究乌干达ASM金矿开采部门AGYW中自我报告的性传播感染（STI）状况的患病率和决定因素，填补了文献中的这一空白。
本文基于乌干达采矿部门636名有过性行为的AGYW。描述性分析包括频率分布和卡方检验。多变量分析包括拟合二元逻辑回归模型，以评估AGYW自我报告的STI状况的决定因素。
在研究前的12个月里，近一半（47%）的受访者自我报告感染了性传播感染。与未成年人相比，成年年轻女性报告感染性传播感染的几率更高（调整后比值比[AOR]=3.35；95%置信区间[CI]1.82-6.16）；与未接受教育的AGYW相比，接受小学教育的AGYW（AOR=2.89；95%CI 1.24-6.75）；饮酒的AGYW（AOR 1.59；95%CI 1.06-2.39）；以及从事交易性行为的AGYW（AOR 2.42；95%CI 1.37-4.28）。
研究结果突出表明，迫切需要应对ASM中AGYW自我报告的性传播感染高发问题。这些风险因素构成了多重且相互交织的脆弱性，需要针对男性和女性ASM工人及所在社区采取预防和治疗干预措施，重点是改变行为和促进可行的替代收入来源。鉴于AGYW生活中的性别、健康和经济方面存在密切的相互关系，卫生部、性别、劳动和社会发展部以及主要发展伙伴应采取多部门方法，有效吸引包括采矿所在社区在内的关键利益攸关方参与。
