Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, and family environment

<b>Background: </b>University students are known to have risky sexual behaviours (RSBs). The severity of the RSB is influenced by many factors including the family environment, exposure to adverse childhood events (ACEs), and the use of addictive substances. However, there is limited information about the influence of ACEs and family environment of these students in low-and medium-income countries (LMICs). Therefore, a pilot study was conducted among university students from a LMIC, Uganda. <b>Methods: </b>The present study comprised a cross-sectional online survey among Ugandan students at a public university (N=316; 75% male; 52.2% aged between 18-22 years). The survey included questions relating to sociodemographic information, family environmental information, the Sexual Risk Survey (SRS), and the Adverse Childhood Experiences-International Questionnaire (ACE-IQ). <b>Results: </b>Over half (53.8%) reported having had sexual intercourse. Males reported over two times higher mean total SRS score compared to females (<i>χ</i><i>²=</i>4.06<i>, p=</i>0.044). Approximately one-sixth of the sample had drunk alcohol or used illicit psychoactive substances in the past six months (16.1%). Among four regression analysis models, sociodemographic variables, psychoactive substance use history (past six months), and ACEs, all individually explained approximately 7% variance in total SRS score, with the final model predicting 24% of the variance in RSB. <b>Conclusions:</b> This pilot study demonstrated a gender disparity with males involved in more RSB than females, as has been reported in most RSB studies. Family environment, sociodemographic factors, substance use, and ACEs all appear to play a contributory role in RSB among university students. These findings benefit other researchers exploring factors associated with RSB among university students and will help in the implementation of initiatives to reduce RSB to protect students from unwanted pregnancies, sexually transmitted diseases, and HIV/AIDS.

研究背景： 大学生群体普遍存在危险性行为（risky sexual behaviours, RSBs）。此类危险性行为的严重程度受诸多因素影响，包括家庭环境、不良童年经历（adverse childhood events, ACEs）以及成瘾性物质使用情况。然而，目前针对中低收入国家（low-and medium-income countries, LMICs）大学生的不良童年经历与家庭环境影响的相关研究资料仍较为有限。为此，本研究针对来自中低收入国家乌干达的大学生开展了一项预试验研究。
研究方法： 本研究针对乌干达某公立大学的在校学生开展了一项横断面在线调查，共纳入316名参与者（样本量N=316），其中男性占比75%，52.2%的参与者年龄介于18至22岁之间。调查内容涵盖社会人口学信息、家庭环境相关问题、性风险量表（Sexual Risk Survey, SRS）以及不良童年经历国际问卷（Adverse Childhood Experiences-International Questionnaire, ACE-IQ）。
研究结果： 超过半数（53.8%）的参与者报告曾发生过性行为。男性的性风险量表总平均分较女性高出两倍以上（χ²=4.06，p=0.044）。约六分之一的参与者在过去六个月内饮酒或使用过非法精神活性物质，占比为16.1%。在四项回归分析模型中，社会人口学变量、精神活性物质使用史（过去六个月）以及不良童年经历各自均可解释性风险量表总得分约7%的方差，最终模型可解释危险性行为相关方差的24%。
研究结论： 本项预试验研究证实了性别差异的存在，男性参与的危险性行为多于女性，这与多数危险性行为相关研究的结论一致。家庭环境、社会人口学因素、物质使用情况以及不良童年经历均对大学生的危险性行为具有促进作用。本研究结果可为其他探索大学生危险性行为相关影响因素的研究者提供参考，并有助于推动相关干预举措的实施，以减少危险性行为，保护学生免受非意愿妊娠、性传播疾病以及HIV/AIDS的侵扰。