Sexual partner types and related sexual health risk among out-of-school adolescents in rural south-west Uganda.

This paper defines the range of sexual partners chosen by out-of-school adolescents from Masaka District in rural south-west Uganda, and implications for sexual and reproductive health discussed. Data are drawn from a sexual health needs assessment using applied anthropological techniques with 31 adolescents, their parents, guardians and community leaders. Data were analysed using inductive thematic methods. Out-of-school adolescents are exposed to risk both stable and casual sexual relationships. Young men and women want a stable relationship with one reliable partner. Young men seek a "steady" relationship with younger schoolgirls; some also seek multiple "casual" relationships with young women easily convinced with gifts. Young women accept "permanent" partnerships with traders or transport workers one-three years older than themselves; some accept "casual" relationship with age mates, others have "casual" relationships with older men. All relationships involve the exchange of gifts and money. Older partners, or "sugar daddies", are valued, despite the knowledge they are more likely to be HIV positive, because they offer greater financial rewards than age mates. Though far less common, some older women seek relationships with younger men, but are treated with suspicion by young men, who believe they are seeking to "infect" them "maliciously" with AIDS. The community sees these relationships as a source of AIDS in adolescents, and condemn older men, whom they believe to be "killing" the younger generation. Both young men and women are exposure to sexual health risk in their primary partnerships; young men in partnerships with schoolgirls who have concurrent partnerships with older men, unlikely to use condoms and young women with partners who work, and have casual relationships in urban trading centres. Health promotion encouraging partnership with age mates, discouraging sex with older partners and 100% condom use before marriage are most appropriate for out-of-school adolescents in this context.

Delaying sexual debut amongst out-of-school youth in rural southwest Uganda.

This paper focuses on 'sexual debut' among out-of-school youth in Masaka District, Uganda, factors influencing its timing and assistance young people feel they need to delay sexual initiation. Data were drawn from a sexual health needs assessment using applied anthropological techniques with young people aged 13-19 years. Parents, guardians and community leaders were also consulted. All participants felt that young people begin their sexual lives too early. Young men feel under pressure from friends and older men to prove their masculinity. Most delay further activity after debut and want assistance to resist the pressure. Young women's debut after physical maturation prompts 'pestering' for sex from boys and men who offer gifts. After debut, young women remain sexually active but believe younger women need assistance to resist pressure. Programmes are needed to help young people achieve these goals. Structurally, the community needs to develop means of preventing men from pestering young women for sex and of redeveloping both the social role and pathway to marriage for young women who are marrying later than is traditional.

"The young ones are the condom generation": condom use amongst out-of-school adolescents in rural southwest Uganda.

This article reports on factors influencing condom use among out-of-school adolescents in rural southwest Uganda. Despite an abundance of negative discourses and myths about condoms in the community, these adolescents believe condoms protect them from sexually transmitted infections, HIV, and premarital pregnancies. Girls want partners to use condoms, but most lack the confidence to insist. Girls aged 13 to 14 reported the least difficulty asking for condoms; older girls attributed this to coming-of-age in the era of AIDS when condom use is the norm. Boys under 16 years want to use condoms, but lack confidence in application skills. Boys over 17 years always use condoms with casual partners, but only occasionally for pregnancy prevention with steady partners. Girls need skills training to improve confidence in negotiating condom use. Younger boys require training to improve confidence in skills with condom application. These findings are compared with studies conducted with in-school adolescents in the same study area. Health promotions that provide this skills training and focus on the need to think of the health of future family would be most effective for out-of-school adolescents. This study shows that it is self-confidence, rather than years of schooling, that has the greatest impact on condom use in this cohort.

"You still need to give her a token of appreciation": the meaning of the exchange of money in the sexual relationships of out-of-school adolescents in rural southwest Uganda.

This article challenges the pervasive assumption that exchanging gifts and money in adolescent sexual relationships is transactional. Data were derived from a multi-method, qualitative sexual health needs assessment of 31 out-of-school adolescents in rural southwest Uganda. Grounded theory analysis allows contextual meanings of exchange to emerge. Adolescents have developed gendered courting and exchange models that parallel marital relationships in this cultural context. Whereas exchange is considered transactional and immoral in some types of relationships, in adolescent relationships, it is not. Young women are not ashamed of, or stigmatized by, the exchange; they are proud of it. The exchange signifies several things: self-respect and a partner's willingness to wait for the relationships to become sexual and, therefore, that they are valued and respected by their partners. This demonstrates commitment from a partner, whose role is as a provider. To expect no gift or to have sex for pleasure are the hallmarks of the worst kind of woman-a malaya. "Need" is the only acceptable rationale for extramartial sex for any woman in this sexual value system. Interventions promoting longer courting and sustained support for one partner would encourage a delay in debut for young women and encourage greater monogamy in young men.

Mobility, sexual networks and exchange among bodabodamen in southwest Uganda.

In order to examine the sexual behaviour of a highly mobile social group, qualitative data and quantitative data were elicited from 212 private motorbike taxi-men, locally called bodabodamen, from two study sites in Masaka, Uganda. Selection criteria were availability and willingness to participate in the study. Research techniques employed were a questionnaire, focus group discussions, in-depth interviews and case studies. Findings indicate that bodabodamen are a highly mobile group who engage in frequent seasonal rural-urban migration. Consequent to this, bodabodamen have a wide network of both occasional and regular sexual partnerships. Both serial and concurrent multiple partnerships are with adults, youths, widows, students, sugar-mummies, barmaids, commercial sex workers, tailors. Exchange plays a significant role in sexual negotiations but the act of giving to a sexual partner is ambivalent in its social interpretation. Since bodabodamen have regular access to cash, they have higher bargaining power for sex. Implications for HIV/AIDS prevention are discussed.