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Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience

Larsson, Markus LU ; Ross, Michael W ; TUMWINE, GILBERT LU and Agardh, Anette LU orcid (2016) In Global Health Action 9.
Abstract
Background: Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited.

Objective: To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality.

Design: In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who... (More)
Background: Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited.

Objective: To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality.

Design: In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about,
or sexually engaged with someone of the same sex.

Results: Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.75.7; OR 2.0, 95% CI: 1.33.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI:
2.14.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.73.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.95.8), and number of sexual partners (OR 1.9, 95% CI: 1.043.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.18.5; AOR 2.8, 95% CI: 1.35.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.67.1; AOR 2.7, 95% CI:1.45.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking.

Conclusions: These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental health and trauma response are critical to meet the health needs of this population. (Less)
Abstract (Swedish)
Background: Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited.

Objective: To identify determinants of unmet healthcare and sexual health counselling needs, respectively,
among Ugandan university students with experience of same-sex sexuality.

Design: In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic
factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those... (More)
Background: Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited.

Objective: To identify determinants of unmet healthcare and sexual health counselling needs, respectively,
among Ugandan university students with experience of same-sex sexuality.

Design: In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic
factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex.

Results: Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs,
respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual
coercion (OR 3.9, 95% confidence intervals [CI]: 2.75.7; OR 2.0, 95% CI: 1.33.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI:2.14.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.73.9), frequent heavy episodic drinking (OR 3.3,
95% CI: 1.95.8), and number of sexual partners (OR 1.9, 95% CI: 1.043.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.18.5; AOR 2.8, 95% CI:1.35.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.67.1; AOR 2.7, 95% CI:1.45.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking.

Conclusions: These findings indicate that exposure to sexual coercion and poor mental health may influence
healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that
integrate mental health and trauma response are critical to meet the health needs of this population. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
East Africa, sexuality, young people, healthcare access, East Africa, Sexuality, young people, healthcare access
in
Global Health Action
volume
9
article number
30790
pages
10 pages
publisher
Co-Action Publishing
external identifiers
  • scopus:84969285270
  • wos:000376074400001
  • pmid:28157030
ISSN
1654-9880
DOI
10.3402/gha.v9.30790
project
Becoming your own doctor: Healthcare-seeking, stigma, and related challenges among persons with same-sex sexuality in East Africa
language
English
LU publication?
yes
id
76d3b6b0-7867-4851-9483-c414962ac247
date added to LUP
2016-04-21 14:30:04
date last changed
2022-03-08 17:59:35
@article{76d3b6b0-7867-4851-9483-c414962ac247,
  abstract     = {{Background: Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited.<br/><br/>Objective: To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality.<br/><br/>Design: In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about,<br/>or sexually engaged with someone of the same sex.<br/><br/>Results: Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.75.7; OR 2.0, 95% CI: 1.33.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI:<br/>2.14.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.73.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.95.8), and number of sexual partners (OR 1.9, 95% CI: 1.043.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.18.5; AOR 2.8, 95% CI: 1.35.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.67.1; AOR 2.7, 95% CI:1.45.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking.<br/><br/>Conclusions: These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental health and trauma response are critical to meet the health needs of this population.}},
  author       = {{Larsson, Markus and Ross, Michael W and TUMWINE, GILBERT and Agardh, Anette}},
  issn         = {{1654-9880}},
  keywords     = {{East Africa; sexuality; young people; healthcare access; East Africa; Sexuality; young people; healthcare access}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Co-Action Publishing}},
  series       = {{Global Health Action}},
  title        = {{Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience}},
  url          = {{http://dx.doi.org/10.3402/gha.v9.30790}},
  doi          = {{10.3402/gha.v9.30790}},
  volume       = {{9}},
  year         = {{2016}},
}