乌干达艾滋病高流行地区10 - 17岁性活跃少女的妊娠风险行为：对2018年青少年女性调查数据的横断面二次分析

Pregnancy risk behaviour among sexually active adolescent girls aged 10-17 years in high HIV prevalence districts in Uganda: a cross-sectional secondary analysis of the 2018 AGYW survey data.

作者信息

Mulyowa Alex, Namutundu Juliana, Wanyenze Rhoda K, Matovu Joseph K B

机构信息

Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.

Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda.

出版信息

BMJ Public Health. 2025 Aug 24;3(2):e002673. doi: 10.1136/bmjph-2025-002673. eCollection 2025.

DOI:10.1136/bmjph-2025-002673

PMID:40919016

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12410629/

Abstract

INTRODUCTION

Although global adolescent birth rates steadily declined over the past decade, they remain persistently high within the African region. However, there is limited evidence on why they remain high. We estimated the prevalence of pregnancy risk behaviour and associated factors among sexually active adolescent girls (AG) aged 10-17 years in high HIV prevalence districts in Uganda.

METHODS

This was a secondary analysis of data collected as part of a large cross-sectional study conducted among AGs and young women (AGYW) aged 10-24 years in July 2018. This analysis focused on AGs aged 10-17 years reporting sexual intercourse in the past 12 months. The primary outcome was prevalence of pregnancy risk behaviour, defined as engaging in sex without using pregnancy protection or using ineffective pregnancy prevention methods. Descriptive analysis and modified multivariable Poisson regression were used to determine the prevalence and factors associated. Statistical significance was set at p<0.05. Analyses were performed using Stata V.16.

RESULTS

Of the 8236 AGYW enrolled into the large study, 53.6% (n=4414) had ever had sex. Of these, 80.6% (n=3560) had sex in the past year, of whom 9% (n=323) were AGs aged 10-17 years. Two-thirds of the 10-17 years old (66.3%, n=214) were out-of-school. Of 323 AGs, 63.8% (95% CI: 58.5% to 69.0) engaged in pregnancy risk behaviour in the past year. Being Anglican (adjusted prevalence ratio (aPR)=1.28; 95% CI: 1.01 to 1.61) and having two or more sexual partners in the past year (aPR=1.20; 95% CI: 1.02 to 1.43) increased the likelihood of engaging in pregnancy risk behaviour while having secondary or higher education was protective (aPR=0.67; 95% CI: 0.45 to 0.98).

CONCLUSION

6 in 10 AGs aged 10-17 years engaged in pregnancy risk behaviour. Findings suggest that attaining higher levels of education is beneficial against pregnancy risk behaviour and underscore the need of keeping girls in school longer.

摘要

引言

尽管全球青少年生育率在过去十年中稳步下降，但在非洲地区仍然居高不下。然而，关于其居高不下的原因的证据有限。我们估计了乌干达艾滋病毒高流行地区10至17岁性活跃少女（AG）中怀孕风险行为及其相关因素的患病率。

方法

这是对2018年7月在10至24岁的AG和年轻女性（AGYW）中进行的一项大型横断面研究收集的数据进行的二次分析。该分析重点关注过去12个月内报告有性行为的10至17岁的AG。主要结果是怀孕风险行为的患病率，定义为在不采取怀孕保护措施或使用无效的避孕方法的情况下进行性行为。采用描述性分析和修正的多变量泊松回归来确定患病率及其相关因素。统计学显著性设定为p<0.05。使用Stata V.16进行分析。

结果

在纳入大型研究的8236名AGYW中，53.6%（n=4414）曾有过性行为。其中，80.6%（n=3560）在过去一年中有过性行为，其中9%（n=323）是10至17岁的AG。10至17岁的AG中有三分之二（66.3%，n=214）辍学。在323名AG中，63.8%（95%CI：58.5%至69.0）在过去一年中存在怀孕风险行为。信奉英国国教（调整患病率比（aPR）=1.28；95%CI：1.01至1.61）以及在过去一年中有两个或更多性伴侣（aPR=1.20；95%CI：1.02至1.43）会增加发生怀孕风险行为的可能性，而接受中等或高等教育则具有保护作用（aPR=0.67；95%CI：0.45至0.98）。