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Hypothesis and Theory ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Public Health | doi: 10.3389/fpubh.2018.00371

Application of core processes for understanding multiple concurrent sexual partnerships among adolescents in Uganda

 Judith Nalukwago1, 2, 3*,  Jane Alaii4,  Bart V. Borne1, Paul M. Bukuluki3 and  Rik Crutzen1
  • 1Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands
  • 2Family Health International 360 (Uganda), Uganda
  • 3Makerere University, Uganda
  • 4Context Factor Solutions, P.O Box 27598-00100, Kenya

Introduction: Adolescents in Uganda, as in other sub-Saharan countries, engage in sex with multiple concurrent partners, thus placing them at risk for HIV and unplanned pregnancies, but it is not clear why. This study explored why adolescents in Uganda engage in multiple concurrent sexual partnerships (MCSP).
Methods: This study used a Core Processes methodology. We used the processes of brainstorming, and identification of evidence and theoretical support, in various phases/steps of intervention planning, to provide possible explanations for adolescent MCSP.
Results: Adolescents were found to have limited knowledge of the risks associated with MCSP and perceived a low risk for HIV. Peer influence to engage in MCSP exacerbated the problem among adolescents. Poor communication with sexual partners and parents and societal indifference to multiple sexual partnerships increased permissive attitudes towards infidelity. The unclear adolescent sexual and reproductive health policies hampered access to services, and transactional sexual relationships with older (polygamous) sexual partners increased the HIV risk. Adolescents were found to be more concerned about unplanned pregnancies than HIV risk.
Discussion: From the empirical evidence, adolescent health programs in Uganda should incorporate comprehensive sexual health education on HIV and teenage pregnancy risk-reduction strategies. Programs should strengthen parental and community support through enhanced collaborative training on communication with and for adolescents. Forming strategic partnerships with various stakeholders for concerted efforts to address the MCSP problem among adolescents is critical.

Keywords: Adolescents, Multiple Concurrent Sexual Partnerships, Determinants, Core Processes

Keywords: adolescents, Multiple concurrent partnerships, determinants, Core processes, Uganda (sub Saharan Africa)

Received: 23 Aug 2018; Accepted: 04 Dec 2018.

Edited by:

Frederick R. Carrick, Bedfordshire Centre for Mental Health Research in association with the University of Cambridge (BCMHR-CU), United Kingdom

Reviewed by:

Chris Fradkin, Pontifical Catholic University of Rio de Janeiro, Brazil
Andrea E. Scaramuzza, Istituti Ospitalieri di Cremona, Italy  

Copyright: © 2018 Nalukwago, Alaii, Borne, Bukuluki and Crutzen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ms. Judith Nalukwago, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, 6229, Netherlands,