Non-use of contraception: determinants among Ugandan university students

BACKGROUND: In Uganda, adolescent pregnancy often results in adverse maternal and neonatal health outcomes. In this context, low use of contraception and high rates of maternal mortality rate make preventing unwanted pregnancies critical. OBJECTIVE: The objective was to determine the relationship between non-use of contraception and socio-demographic factors, alcohol consumption, and types of partner(s) among Ugandan university students. DESIGN: In 2010, 1,954 students at Mbarara University of Science and Technology in southwestern Uganda participated in a cross-sectional study whereby a self-administered questionnaire was used to assess socio-demographic factors, alcohol consumption, and sexual behaviour including the use of contraceptives. Multivariable logistic regression was used for the analysis and data were stratified by sex. RESULTS: 1,179 students (60.3% of the study population) reported that they were sexually active. Of these, 199 (18.6%) did not use contraception in their last sexual encounter. Students currently not in a relationship had higher odds of non-use of contraception (odds ratio 1.8, 95% confidence interval 1.2–2.7). The association remained statistically significant for both males and females after controlling for age, sexual debut, area of growing up, and educational level of the household head. Socio-demographic determinants of age (22 or younger), early sexual debut (at age 16 years or earlier), and a rural background were significant for males but not for females. A synergistic effect between not currently being in a relationship and early sexual debut were also observed to have an effect on the non-use of contraception. CONCLUSION: Non-use of contraception among Ugandan university students differs for males and females, possibly due to gendered power relations. Sexual and reproductive health policies and programmes should be designed to take these differences into account.