Determinants of age at first sex inequality between women and men youth in Uganda: A decomposition analysis

INTRODUCTION: Teenage pregnancies and sexually transmitted diseases are major public health problems in Uganda. Early sexual debut is one of the main routes of these public health problems. This study aimed to identify factors that explain age at first sex inequality between men and women Ugandan youth. METHODS: This study used secondary data from a cross-sectional Uganda demographic health survey (2016). Participants were 10 189 sexually experienced youth. Using Stata 14, intermediary analysis was done to assess the statistical association between explanatory variables and age at first sex in a multiple logistic regression analysis. Oaxaca decomposition was used to decompose factors that explain inequalities in age at first sex between men and women youth. RESULTS: Intermediary results showed Islam, many household members, residing in the eastern region, and being divorced/widowed were predictors of early age at first sex. While secondary education, higher education, blue-collar jobs, and being 20 to 30 years old were protective factors against early age at first sex. Material, behavior/cultural, psychosocial, and demographic explanatory factors jointly explained a statistically significant portion of the observed gap in early age at first sex between women and men youth. More women were at a disadvantage at an early age at first sex compared to men youth. About 96.37% of this gap was explained by unequal distribution of material, behavior/cultural, psychosocial, and demographic factors between men and women youth. Relationship to household head (49%), education (16.87%), occupation (8,94%), number of household members (8.57%), using the internet (7.99%), and reading newspapers or magazines (4.39%) made a significant contribution to the explanation of early age at first sex inequality between men and women youth. CONCLUSIONS: Results showed early age at first sex inequality between women and men youth that favored men. Programs designed to address early age at first sex and related health outcomes must combat inequities in education, employment opportunities, access to sexual reproductive information through internet, and newspapers or magazines between men and women youth. They should also foster household relationships and monitor girls.