Risk and Protective Factors for Coercive First Sex in Rakai, Uganda

Michael Koenig, Johns Hopkins University
Tom Lutalo, Rakai Project
Nelson Sewankambo, Makerere University
Jennifer Wagman, Rakai Project

A central feature of the HIV epidemic in many developing countries is the pronounced gender differential in age at acquisition, with young women having significantly higher rates of HIV. Although a potentially important factor, little attention has thus far focused on the role of coercive sex. Our study analyzes data from approximately 2000 sexually active young women in Rakai, Uganda, interviewed during 2001-2002 concerning sexual coercion, both recently as well as athe time of first sex. Our paper initially presents data on the prevalence and nature of coercive first sex in this population. We then investigate the individual, familial, and community factors which influence the risk of coercive first sex-- both factors which elevate as well as protect against such risk. Our findings will illuminate an important risk behavior which may be contributing to the continued HIV/AIDS epidemic in settings such as Uganda.