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The Straight Talk Campaign in Uganda:

Impact of Mass Media Initiatives

Full Report

Susan E. Adamchak1, Karusa Kiragu2, Cathy Watson3,


Medard Muhwezi4, Tobey Nelson5, Ann Akia-Fiedler4,
Richard Kibombo6, and Milka Juma7

1
Independent consultant
2
Horizons/PATH, Nairobi
3
Straight Talk Foundation Uganda
4
Formerly Straight Talk Foundation Uganda
5
Horizons/International Center for Research on Women, Washington DC
6
Makerere University, Uganda
7
Formerly Horizons, Nairobi
Acknowledgments

The principle investigators for this study were Karusa Kiragu (Horizons/PATH, Nairobi), Tobey Nelson
(Horizons/International Center for Research on Women (ICRW), Washington DC), Ann McCauley (formerly
with Horizons/ICRW, Washington DC), and Milka Juma (formerly with Horizons/Population Council,
Nairobi). Data collection was supervised by Richard Kibombo, an independent statistician consultant at
Makerere University. Scott Geibel (Horizons/Population Council, Nairobi) was the data analyst for the study.
Alison Lee (consultant, Washington DC) copy-edited the report, and Sherry Hutchinson (Horizons/Population
Council, Washington DC) oversaw the layout.

The research team would like to thank Straight Talk Foundation (STF) for their exceptional support including
Cathy Watson (STF Director), Anne Akia Fiedler (formerly STF Programme Director), Medard Muhwezi
(formerly Head, Monitoring and Evaluation Section, STF), and the entire Monitoring and Evaluation Section.

Special appreciation is extended to the adolescents and parents who answered the questions in this study.

This report was developed by Susan Adamchak, an independent consultant and adolescent specialist, with
Karusa Kiragu and Cathy Watson. The authors are grateful to the United States Agency for International
Development (USAID–Uganda) and the Department for International Development (DFID) for funding this
evaluation.

This publication was written by an independent consultant and produced by Horizons and Straight Talk
Foundation. This document was reviewed by members of the research team but it did not receive an external
technical review. The information, findings, and recommendations expressed herein do not necessarily represent
the views of Horizons/Population Council. This document is one of four background documents to the final
report, ―The Straight Talk Campaign in Uganda: Impact of Mass Media Initiatives,‖ which can be accessed at
www.popcouncil.org/pdfs/horizons/UgandaStraightTalk.pdf.

This study and final report were made possible by the President’s Emergency Plan for AIDS Relief
and the generous support of the American people through the United States Agency for International
Development (USAID) under the terms of Cooperative Agreement No. HRN-A-00-97-00012-00.
The contents do not necessarily reflect the views of USAID or the United States Government.

Published in September 2007.

This study was also supported by a grant from the UK Department for International Development.

This document may be reproduced in whole or in part without permission of the Straight Talk Foundation provided full source citation is
given and the reproduction is not for commercial purposes.
Table of Contents

Abbreviations

Executive Summary 1

Introduction and Background 5


Introduction 5
Background 5

Survey Overview 8
Goals and objectives 8
Definition of exposure to STF materials 8
Survey design and implementation 9

Sociodemographic Characteristics 12
Demographic characteristics 12
Schooling 13
Media utilization and intensity of exposure 15

Sources of Information on Reproductive Health 17


Sources of information 17
Exposure to Straight Talk Foundation products 24
What adolescents learned from Straight Talk Foundation products 27
Action taken due to exposure to Straight Talk Foundation products 28

Knowledge and Attitudes 29


Reproductive health knowledge 29
Reproductive health and HIV/AIDS attitudes 30
Gender attitudes 32
Self efficacy and self confidence 35

Health Seeking Behavior and STIs 38


Use of health facility services 38
Ever experienced an STI 40
Communication with Parents and Guardians 41
Comfort and confidence in speaking to parents 41
Topics discussed with parents 42
Reasons for not discussing ASRH with parents 43

Sexual Abuse and Defilement 45


Support if abuse attempted 45
Confidence in reporting abuse 46

Reproductive Behavior and HIV Risk Exposure 47


Sexual activity among adolescents 47
Transactional exchanges 49
Future plans with partner 50
Condom use 52
Reasons for never having had sex 55
HIV testing 57

Impact of Straight Talk Activities: Findings of Multivariate Analysis 58


Odds ratio of outcomes 58
Summary 62

Conclusions 64
Sources of information 64
Use of Straight Talk Foundation materials 65
Most important among sources of information 65
Straight Talk messages 66
ASRH knowledge 66
ASRH attitudes 66
Gender attitudes 67
Self efficacy and self confidence 67
Knowledge of STIs 67
Use of health facility services 67
Support if child sexual abuse attempted 68
Sexual activity among adolescents 68
Condom use at last sex 69
Reasons for never having sex 69
HIV testing 69

References 70

Appendices 71
Sample design 71
Variable definitions 73
Ugandan adolescents in context 75
2005 Straight Talk evaluation survey, Uganda 82
Abbreviations

ABC Abstinence, Be faithful, Use condoms


AGI Alan Guttmacher Institute
ASRH Adolescent sexual and reproductive health
BCC Behavior change communication
EA Enumeration area
GYC Gulu Youth Centre
HIV/AIDS Human Immunodeficiency Syndrome/Acquired Immune Deficiency Disease
OVC Orphans and vulnerable children
PT Parent Talk
PMCT Prevention of mother-to-child transmission (of HIV)
ST Straight Talk
STD Sexually transmitted diseases
STI Sexually transmitted infection
STF Straight Talk Foundation
UBOS Uganda Bureau of Statistics
UDHS Uganda Demographic and Health Survey
UNCST Uganda National Council for Science and Technology
USAID United States Agency for International Development
UHSBS Uganda HIV/AIDS Sero-Behavioral Study
VCT Voluntary counseling and testing
YT Young Talk
Straight Talk: Full Report

Executive Summary

This report presents the findings of an evaluation of the Straight Talk Foundation’s (STF) mass media
communication programs which have been implemented in Uganda since 1993. The programs largely
comprise three synergistic materials: i) Straight Talk (ST) radio programs broadcast to various districts in
English and 11 other Ugandan languages, aimed at in- and out-of-school youth; ii) ST newspapers in
English and six other Ugandan languages, primarily aimed at secondary school students; and iii) an
English language Young Talk (YT) newspaper primarily aimed at primary school students. STF also
implements a complementary array of school-based activities to engender a supportive school
environment. It has invested in many community activities such as health fairs, and has worked to support
youth-friendly health care services.

The evaluation described here employed several strategies including a cross-sectional household survey of
never-married adolescents, the main subject of this report. Other components included a household survey
of parents, an assessment of the school environment, and a cost study.1 Results from the adolescent
household survey are based on interviews with 2,040 males and females between the ages of 10 and 19
years. It was conducted in six districts: Apac, Arua, Ntungamo, Soroti, Kisoro, and Kamuli. While STF has
been active in all six districts, it has been particularly active in the first four, broadcasting local language
radio programs and providing cross-fertilizing local language ST newspapers. Thus STF has more intensive
―conversations‖ with its audience in those districts. On the other hand, low intensity districts mostly
received radio broadcasts and newspapers in English language. The study therefore assessed the impact of
STF activities by level of intensity. Using multivariate methods, the study also conducted dose response
analysis, i.e., impact of incremental exposure to STF activities on specific outcomes.

Data were gathered using face-to-face interviews after obtaining informed consent from the adolescent’s
parent or guardian, and from the adolescent himself or herself. The study was powered at 80 percent with a
confidence of 95 percent. Analysis employed bivariate and multivariate methods. Because the target
audience for most STF activities is unmarried adolescents, the study excluded ever-married young people.
And because the study’s ethical guidelines could not permit interviews with minors who did not have
parental or guardian consent, such adolescents, including those from child-headed households, are
excluded.

Description of the Sample

Of the 2,040 adolescents surveyed, half were male, and the mean age was 14.5 years. About a quarter of
the sample was residing in urban areas, higher than the average urban Ugandan population of 15 percent
(MOH and ORC Macro 2006). Approximately 80 percent were either Catholic or Protestant. Roughly 62
percent were living with both parents, and those that lived with only one parent were much more likely to
live with their mother rather than their father. There were not large gender differences between adolescent
males and females with regards to living arrangements. About 84 percent of respondents were currently in
school, with slightly more boys (86 percent) than girls (81 percent) reporting school attendance. Most (80
percent) in-school adolescents in the study were in primary schools, indicating that many adolescents were
rather old for their grade.

Use of STF Materials

To assess utilization of STF products, respondents were asked whether they had read, not merely seen, ST
or YT newspaper, or whether they had listened to any ST radio program. The most commonly-used STF

1
These reports are available from http://www.straight-talk.or.ug/downloads/downloads.html

1
product was the radio program, which had been listened to by 55 percent of all adolescents, but by 76
percent of those in the high-intensity districts (i.e. those receiving local language broadcasts). In
comparison, only 13 percent of respondents from low-intensity districts had listened to ST radio,
demonstrating the importance of adding local language broadcasts. The second most utilized STF product
was YT newspaper, which is aimed at primary schools and had been read by 49 percent of the study
respondents, including 53 percent in high intensity and 35 percent in low-intensity districts. However,
among those who had completed primary school and entered secondary school, 85 percent had read YT.
The third most utilized STF product was ST newspaper, which had been read by 39 percent of the study
sample including 45 percent of high-intensity and 25 percent of low-intensity district respondents. Among
secondary school respondents, who are the main target of ST newspaper, 90 percent had read it. Seventy
percent of respondents had been exposed to at least one of the three STF products, including virtually all
secondary and two thirds of primary school students, as well as 56 percent of out-of-school youth.
Exposure is fundamentally linked to STF’s use of local language materials—in the high-intensity districts
where vernacular products were used, 84 percent of respondents had been exposed to STF materials,
compared to 42 percent in districts without local languages.

STF materials were perceived as strongly supportive of abstinence, with 60 percent of exposed adolescents
reporting that this was the main message they had obtained from them. When asked what they did as a
result of exposure to STF products, 57 percent of boys and 64 percent of girls reported taking some action,
most commonly ―continuing to abstain.‖

Parent-child Communication

The survey indicates that parents are the most important, and frequently the most preferred, source of
information among young people. Mothers are by far the most preferred source of information among
females (45 percent), followed distantly by teachers (11 percent). Fathers are the most important source
among males (22 percent), followed by mothers (14 percent). However, youth question parental
communication abilities, with less than 25 percent feeling ―very confident‖ that they can answer questions
about sexuality. Nonetheless, nearly half of the respondents reported speaking to their parents about
sexuality, growing up, or relationships between boys and girls and among these, virtually all believed the
discussions were helpful. Multivariate analysis showed that exposure to STF materials was significantly
associated with ever having talked with parents among both males and females. Males and females at the
highest level of ST exposure were four times as likely to have talked to their parents about ASRH. This
also means that for many adolescents, STF is contributing to efforts aimed at forging a stronger
relationship between parents and their children

ASRH Knowledge

Greater exposure to STF materials is significantly associated with higher ASRH knowledge, and each
incremental exposure is associated with increased knowledge; this relationship holds for both males and
females. Adolescents at the highest level of exposure were 2.7 times more likely to have higher knowledge
than those with no exposure, controlling for covariates. The STF products seem to have been particularly
effective on the topic of STIs, with ST exposure associated with awareness of STIs. However, despite
years of intense media coverage and community dialogue about HIV/AIDS in Uganda, there remains room
for improvement in AIDS and reproductive health knowledge among young people. Many adolescents still
believe that AIDS can be cured, many believe that a girl cannot become pregnant the first time she has sex,
and fewer than half understand that pregnancy can occur if a girl is standing during sex. Four in ten youth
do not believe condoms are effective against STIs.

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Straight Talk: Full Report

Attitudes toward ASRH

Exposure to STF media activities generally is associated with a more balanced perspective on ASRH
attitudes. For example, both male and female adolescents exposed to all three STF items are three times
more likely to hold positive values toward condoms compared to those who had not been exposed.
However, even those exposed to the most STF materials maintain some concerns: for example, half of
those exposed to all three items still harbor misgivings that condom use is a sign of mistrust, and nearly 70
percent report feelings that girls who carry condoms are loose.

Attitudes Toward Gender

The data suggest that considerable work remains to create a more equitable gender perspective. For
example, sizeable minorities of both boys and girls think boys should be favored if family resources are
scarce, nearly half of the boys and a third of the girls believe men should have the final say about having
sex, half of the respondents believe that women occasionally deserve to be beaten, and nearly 60 percent
believe that women should tolerate abuse in order to keep the family together. Nevertheless, ST exposure
is associated with favorable gender attitudes among females, but the pattern is not as clear among males.
Females exposed to all three STF products were 1.7 times more likely to have favorable gender attitudes.

Self Efficacy and Self Confidence

The majority of young people feel happy the way they are, although a third lacks confidence in their
position in the household and a third feel that their friends are ―better‖ than them. In addition, about a third
doubt they have a bright future, particularly among those who are out of school or live in rural districts.
Adolescents, particularly girls, who were exposed to two or three ST items, are significantly more likely to
report higher self confidence than those who were not exposed to any item. Multivariate analysis shows
that girls exposed to all three materials are twice as likely to have favorable views about themselves
compared to their unexposed counterparts, but there is no difference among boys.

Use of Health Facility Services

Questions about health service utilization was restricted to the older adolescents (i.e., ages 15–19 years).
About 20 percent of these had visited a health facility for contraceptives, pregnancy tests, or voluntary
counseling and testing for HIV/AIDS; most used public facilities. Those in urban areas and those with high
exposure to STF products were more likely than their counterparts to visit a facility, probably due to the
accessibility of services in urban areas and the emphasis by STF encouraging health-seeking behavior.

Support if Child Sexual Abuse Attempted

Most young people say they have someone to tell if they were pressured to have sex. Living in high media
intensity districts and exposure to more STF materials is associated with higher proportions reporting
someone to tell, indicating that messages about turning to a trusted adult, in most cases identified by the
adolescents as a parent, are being heard and accepted. Girls seem to feel more confident that they can tell
some about abuse, and those exposed to STF products were more confident than those not exposed. Fewer
young boys report having someone to tell about abuse; they are also the group least likely to express
confidence in telling someone about it.

3
Sexual Activity and Condom Use

About a quarter of the respondents reported that they had a boyfriend or girlfriend, and 12 percent of the
study sample had ever had sex (15 percent of males and 9 percent of females). Multivariate analysis shows
a negative association between sexual activity and STF materials among males: those exposed to all three
STF items are only 39 percent as likely to be sexually active compared to their unexposed counterparts.
Among females, the pattern is not clear or statistically significant, in part due to the small percentage of
sexually active girls and the sometimes involuntary nature of female sexual behavior—19 percent of
sexually active girls said their first sexual encounter was ―forced‖. This means that STF activities have
contributed positively to significant proportions of males who are now not being exposed to heterosexual
transmission of HIV.

About 56 percent of the sexually active boys and 70 percent of sexually active girls have had only one
partner in their lives. Indeed, 38 percent of boys who have ever had sex and 41 percent of their female
counterparts had not had sex in the 12 months preceding the survey, and are thus practicing secondary
virginity. Multivariate analysis shows that exposure to ST is associated with secondary virginity among
males: males at the highest level of exposure are three times as likely to report practicing secondary
virginity compared to their unexposed counterparts. The pattern among females is not clear. Again, the
association between STF activities and secondary abstinence means that STF is helping many males avert
HIV by stopping sexual activity.

Just more than a quarter of the respondents plan to marry their current partner, with higher proportions of
older youth, those in secondary school, and those out of school saying this. Males exposed to all three STF
items are 20 times as likely as their unexposed counterparts to consider the current relationship ―serious‖,
but there is no difference among females. Thus it is possible that these youth are adopting norms of fidelity
promoted through STF as well as other sources in Uganda’s comprehensive HIV/AIDS prevention
campaign.

Exposure to STF products is also associated with some increase in condom use, but the relationship is not
statistically significant, largely due to the small sample size limiting statistical analysis. Half of the girls
and 41 percent of boys report having used condoms at their last intercourse. While two-thirds of the boys
report being responsible for using condoms, more than half the girls report taking the initiative to use them.

HIV Testing

Seven percent of the full sample, and 17 percent of the sexually active participants, had been tested for
HIV. Urban and older youth were more likely to have been tested. Exposure to STF products was
associated with having been tested, and with knowing whether a partner had been tested. Indeed
multivariate analysis shows that respondents exposed to all three STF items examined were more than
three times as likely to have been tested for HIV themselves.

4
Straight Talk: Full Report

Introduction and Background

Introduction

The Straight Talk (ST) program is perhaps one of the most successful ongoing media efforts to bring
information about sexual and reproductive health to youth in Africa. The Straight Talk Foundation
(STF) is widely recognized for grounding its programs in what young people want; it is careful not to
call its efforts ―campaigns,‖ but rather ―conversations‖ with adolescents. Consequently its activities
are popular with young people. They are innovative, widespread in reach, and have endured over
time. This report presents the findings of a program evaluation carried out in 2005–2006 to document
the effect of STF activities on young people and parents in Uganda.

Background

Straight Talk Foundation (STF) is a Ugandan health communications NGO that began work in 1997,
growing out of a Unicef-funded newspaper. The newspaper was called Straight Talk, and it was
launched in October 1993. It appeared as a monthly insert in the main daily newspaper, The New
Vision; extra copies were sent to secondary schools nationwide.

The first issues of Straight Talk attempted to communicate to several population groups: primarily
older adolescents but also younger adolescents and parents. The aim was to influence adolescents to
delay sex or practice safer sex if sexually active. The strategy was to talk directly to adolescents but
also to help influential adults to talk to them about safe behavior.

A critical influence on Straight Talk was a 1993 WHO survey of 35 sex education programs
worldwide (Grunseit and Kippax 1993), which had drawn three key conclusions.
Programs that succeeded in increasing the age of first sex were ones which urged youth to
―postpone‖ sex. ―Delay‖ was a more effective message than ―no sex.‖
Effective programs concentrated not just on facts about HIV transmission and reproduction but
also on skills such as decision making.
Sex education did not cause adolescents to start sexual activity or be more sexually active.

The first issues of Straight Talk received input from a small group of doctors and counselors who
gave credibility to the content. There was virtually no resistance to Straight Talk. This was the peak of
the HIV epidemic in the country, and there were few messages for adolescents at the time. Uganda
was open and seeking solutions.

Straight Talk was an immediate hit with older adolescents. Bright and deliberately non-frightening, it
found a niche that no one else was serving, and where the need was acute. By the end of its first year
in 1994, it was receiving over 400 letters a month, and local versions of Straight Talk were starting up
Kenya and Tanzania.

However, the original inclusion of parents could not be maintained. Almost no adults wrote in, and
combining content for parents and youth in one paper was editorially difficult. By May 1994 Straight
Talk had narrowed its focus to older adolescents. It had a print run of 95,000, of which 35,000 were
inserted into The New Vision, 32,000 into Ugandan-language newspapers, 15,000 posted to the 600
secondary schools then existing and 13,000 distributed through NGOs.

5
For the next three years Straight Talk operated from a desk at The New Vision, but began doing more
than just newspaper work. Following requests from head teachers, Straight Talk assembled a team and
began visiting secondary schools in 1996. By 1997 Straight Talk had become an NGO, the Straight
Talk Foundation. It began creating expanded systems to reach more adolescents.

With Straight Talk, a relatively ―high-literacy‖ newspaper, STF was reaching only the 400,000 or so
in-school, English-speaking, older adolescents aged 15–19 years. Two much larger groups were
getting no information:
Younger adolescents aged 10 to 14 years, about 700,000 of whom were in school; and
Out-of-school adolescents who could not access Straight Talk, either because they could not find a
copy, read English, or read at all.

To reach the younger in-school adolescents, STF started Young Talk in March 1998. Studies showed
that about 25 percent of upper primary pupils had had some sexual experience. Young Talk stressed
delaying sex, child rights, life skills, and staying in school. Primary schools numbered over 9,000 in
1997, so from the start distribution was Young Talk’s key challenge.

To reach out-of-school adolescents, STF began working in radio. The English Straight Talk Radio
Show started in 1999. Ugandan language radio shows were added soon after: Luo (2000); Runyakitara
(2001); Ateso (2002); Lugbara and Lumsamia (2003); Lumasaba, Luganda, and Lukhonzo (2004);
Lusoga and Lupsabiny (2005); and Ngakarimojong (2006).

For the literate but non-English reading adolescents, STF began to produce newspapers in Ateso, Luo,
Runyankole/Rukiga, Runyoro/Rutoro (the ―Four R’s‖), Luganda, and Lugbara. These were distributed
at health fairs attended by local NGOs, local youth officials, and out-of-school youth.

With all of the above activity, STF was producing something—a radio show or newspaper—for much
of the adolescent population, both in- and out-of-school and in urban and rural areas. By 2004 it was
also running sensitization workshops for thousands of primary school teachers a year and overseeing
over 700 Straight Talk clubs in schools.

In addition it added newspapers not strictly addressed to adolescents or sexual health: Tree Talk,
Teacher Talk, and Farm Talk in 2002; Kids Time in 2003 (addressing early childhood development);
and Parent Talk in 2004.

As it grew, STF continually took stock of itself. About half of STF’s staff comes from journalism and
mass communications backgrounds, and the NGO is the first organization in Uganda to carry out
public sex education through the media. However, STF began to think of itself less as a media and
increasingly as a behavior change organization.

As the HIV environment changed, STF sought innovative ways to reach young people and help them
to ―re-script‖ their lives. Initially concerned about the lack of adolescent sexual and reproductive
health (ASRH) information, it soon realized that information alone was not enough. It tried to address
the environment around adolescents and also tackle non-biomedical topics like love, jealously, leisure,
fun, and poverty.

STF attempted to be always tasteful and socio-culturally sensitive while staying forthright about
sexuality. It thought of itself as engaging in dialogue with adolescents, not executing a campaign. It
took pride in allowing its readers and listeners to drive the content, and hosted dozens of high school
and university volunteers. It saw itself as a voice for adolescents and by the mid 2000s was

6
Straight Talk: Full Report

broadcasting over 7,000 interviews a year with adolescents. It also saw itself as an advocate for
adolescents who are often stereotyped as reckless and stubborn.

Amid this growth, there were difficult questions to face about cost-effectiveness and focus. If STF
was really committed to reaching the majority, why were newspapers in English its biggest core
activity? STF was also worried about girls and the out-of-school youth: why were 90 percent of letters
to local language radio shows from boys? Why, if local language radio shows were for those out-of-
school, were 75 percent of the letters from in-school adolescents?

In 2004–5 the ―Abstinence, Be faithful, Use condoms‖ (ABC) controversy hit Uganda, causing two
years of intense soul searching. For the first time, STF had to be self-conscious about what it was
writing. There were hints from the government that illustrations of reproductive organs and frank talk
about condoms were no longer welcome in the school newspaper Straight Talk. How much should it
change its tone, STF asked itself? How much self-censorship should it exercise? Had it been over-
promoting condoms at the expense of abstinence? Or was it vice versa?

At the root of all these questions was impact. After many years of implementation without a formal
evaluation, STF wanted to assess its program. Were its activities changing the lives of adolescents? If
so, in what ways? Which of STF’s products were being used and how? What messages were being
recalled? Which adolescents were being reached? Which were not being reached? Did this vary
between boys and girls? Did it vary by whether they were in urban or rural areas? Did it vary by
whether they were in or out of school? STF had also started on a program to reach parents in order to
encourage supportive parent-child interaction. Therefore STF wanted to know more about parents:
what were their views about STF materials? Did they know about them? Did they use them? Would
they recommend them to their adolescent children? To answer these and other important questions, a
comprehensive evaluation of STF activities was undertaken in 2005–2006. The evaluation comprised
three components: 1) a community-based survey of never-married adolescents and a sub-sample of
their parents; b) a survey of teachers and youth; and c) a cost analysis.

This report presents the findings of the community-based survey of adolescents. The survey was
conducted in six districts in Uganda. Companion reports of the other evaluation components are
available on request.2 The second chapter of this report presents the methods used to implement the
survey. Subsequent chapters are arranged thematically and report data from the main topics, including
sources of ASRH information, knowledge and attitudes concerning reproductive health, HIV, gender
and self efficacy, and communication with parents. Data are also presented on experiences of sexual
abuse and reproductive behavior and risk of exposure to HIV/AIDS. Using key variables identified in
the descriptive analysis, multivariate analyses were performed to better assess the impact of the STF
program. The final chapters offer conclusions and recommendations for the future.

2
The companion reports can be obtained from http://www.straight-talk.or.ug/downloads/downloads.html

7
Survey Overview

Goals and Objectives

The community-based household survey was designed to answer several questions related to ST
campaigns, namely:
What proportion of youth is reached by each ST mass media, community, and school activity?
Do adolescents who are exposed to STF materials have higher knowledge and more positive
attitudes toward safe behaviors than those who are not exposed to these media activities?
Do adolescents who are exposed to STF materials practice more safe behaviors than those who are
not exposed?

Definition of Exposure to STF Materials

The main STF materials being assessed in this study are a) ST radio programs, b) ST newspapers, and
c) YT newspaper. In order to assess the dose-response association between exposure to STF materials
and the study outcomes, respondents have been classified into four groups: a) those not exposed to
any item, b) those exposed to one item, c) those exposed to 2 items and d) those exposed to all 3
items. This is the definition that will be used in the multivariate analysis (see below).

A second measure of exposure will be media intensity at the district level (see Box 1 below). STF has
been implementing its activities at varying levels of intensity in different districts, largely due funding
shortfalls. As Box 1 shows, all districts receive the English STF and the English YT3 newspaper. They
also receive the weekly English STF youth radio show. In addition, four districts, Apac, Arua,
Ntungamo, and Soroti receive weekly half hour radio shows in their local language . They also
receive occasional local language versions of the ST newspaper. This varying response has provided a
natural experiment whereby some districts have more activities than others. For the purpose of this
study, districts receiving just the English newspapers and English radio show are characterized as
―low intensity‖. These are Kamuli and Kisoro districts.Those receiving the English papers, English
radio shows, a local language radio show and the local language newspaper, are characterized as high
intensity.

Box 1 Definition of district media intensity by exposure to STF materials


High intensity districts Low intensity districts
(Apac, Arua, Ntungamo, and (Kamuli and Kisoro)
Soroti)
Radio English Straight Talk program English Straight Talk program
Local language Straight Talk None
program
Newspapers Young Talk (English) Young Talk (English)
Straight Talk (English) Straight Talk (English)
Local language Straight Talk None

3
YT newspaper is only published in English language.

8
Straight Talk: Full Report

Survey Design and Implementation

Sample design4

The community-based survey targeted 2,160 never-married adolescents ages 10 to 19 years in six
districts: Apac, Arua, Ntungamo, Kamuli, Kisoro, and Soroti (see map in front matter). These districts
were selected to provide a diverse geographic distribution of ST activities. The sample size was
powered at the 80 percent level, with 95 percent confidence. This required 342 households per
district, resulting in a total of 2,052 households in the survey. Each household was expected to yield
one interview of an adolescent and half of them an interview with a parent. The sample was designed
to accommodate refusals and not-at-homes by listing 20 percent more households per district for use
when an interview was not possible.

In each participating district, two counties were selected for data collection, and within each county,
two sub-counties were selected, and from them, two parishes were chosen. Thus a total of 12 counties,
24 sub-counties, and 48 parishes were included in the survey. The Uganda Bureau of Statistics
(UBOS) has divided each parish into an enumeration area (EA) which includes a list of all
households. The STF survey used the same list recently compiled for a household survey of
adolescents conducted by ORC/Macro and Alan Guttmacher Institute (AGI) (Neema et al. 2006).

Selection of respondents: The household listing process had generated a list of households in which it
was known that at least one of the occupants would meet the eligibility criteria for the study, which
was specifically to a) have never been married, b) to be between the ages of 10 and 19 years of age
and c) to normally reside in the identified dwelling. In each household, as many as two eligible
adolescents would be eligible for interviewing, as long as they were not of the same gender or age
grouping. A random numbers table was used to select one to be interviewed if there was more than
one eligible adolescent. In each household, efforts were made to interview at least one adolescent
between the age of 10 and 14 years, or 15 and 19 years, resulting in a 50/50 age group split. Alternate
households were to generate male and female adolescents, in order to achieve a 50/50 gender split.
Visiting adolescents were eligible if they spent the prior night at the household and if the consenting
adult was their parent or guardian. Households headed by children under the age of 18 years were
excluded, due to lack of adult consent. The study also excluded married adolescents, since STF’s
main evaluation interest was the never-married. Interviews were completed with 2,133 adolescents;
93 questionnaires were subsequently deleted due to missing data on key variables, resulting in a
sample of 2,040.

Interviews were conducted by same-sex interviewers; i.e. male interviewers interviewed male
respondents and female interviewers interviewed female respondents. In about a third of the
households, interviews of both a parent and an adolescent were conducted, matched by sex when
possible.

Ethical clearance and gatekeeper approvals

The questionnaires and consent forms were approved by the Uganda National Council for Science and
Technology (UNCST). The study protocol had also been reviewed and approved through Horizons’
ethical review procedures. In each district, the study also sought the approval of district officials,
community gatekeepers, and others as appropriate. Each respondent interviewed in the study provided

4
A full description of the sampling procedure is included in Appendix A.

9
written informed consent prior to commencement of the interview. Parental5 consent was obtained for
all interviews with adolescents, in addition to the adolescent himself/herself providing informed
consent. The questionnaires and consent forms were stored separately in order to ensure no
identifying information could be linked.

Study sites and populations

The survey was implemented in six districts: Apac, Arua, Ntungamo, Soroti, Kamuli, and Kisoro. The
first four districts were chosen because they had received more STF products, including English radio
and print materials, and local language radio and print materials. Kamuli and Kisoro were chosen as
districts with less exposure to STF products (i.e. no local language materials).

Study tools and administration

The community-based household survey used face-to-face questionnaires: one for adolescents and one
for parents (the adolescent questionnaire is found on Appendix IV). The adolescent questionnaire
included a number of sensitive questions, but in-built skip patterns moved younger respondents past
sections that were not appropriate for them. Each questionnaire took about 30 to 45 minutes to
complete. The questionnaires were translated into six languages: Ateso, Luo, Lugbara, Lusoga, 4Rs,
and Rufumbira. They were administered by interviewers fluent in the local language. The
questionnaires were pre-tested and revised twice before data collection. They were also reviewed by
the data entry team, in order to identify problems that could hamper data entry.

Interviewer training

Interviewers were trained over a four-day period, in August 2005. Sixty enumerators and 12
supervisors, including six STF monitoring and evaluation staff, were trained. Most of the enumerators
were university students or graduates who had conducted interview research before, and many had
worked with UBOS. Training topics included the research objectives, interviewing skills, household
listing, respondent selection, call-backs, quality control, obtaining consent, and ethics in research. The
interviewer training included a field practicum, after which the questionnaire was revised, finalized,
and printed. In each district, the research team comprised about ten interviewers and a supervisor.
Supervisors received training covering household listing, household selection, field work
management, and other aspects to enhance quality control. Because a purpose of the evaluation was
capacity building, STF staff from the Monitoring and Evaluation department was involved in all
aspects of data collection and fieldwork supervision.

Data collection

The survey plan called for interviewing 2,880 respondents in 2,160 households. This comprises 1,080
adolescents ages 10 to 14 years, 1,080 adolescents ages 15 to 19 years, and 720 parents or guardians
matched to an adolescent. The interviews included in-school and out-of-school youth. Interviews were
evenly distributed across all districts, resulting in about 480 interviews per district. Data collection
started on August 29, 2005 and ended on September 7, 2005. Each interviewer conducted at least four
interviews per day and each field team covered two villages per day with a few callbacks for the

5
―Parents‖ in this report includes guardians.

10
Straight Talk: Full Report

following day. There were no refusals; indeed field supervisors reported receiving requests from
members of the community who had found out about the study, and wished to be interviewed.

Data processing and analysis

Once the data were collected, the supervisor reviewed the questionnaires and identified any problems
needing correction. At the end of the day, the supervisor collated the questionnaires and entered them
into a data collection registry. Each batch of questionnaires identified district, county, sub-county, and
parish of origin. The consent forms were also collected, labeled, and stored in separate envelopes. The
items were stored in a secure and locked box or room and prepared for shipping to Kampala for data
entry.

Data entry at STF premises began as soon as data collection was over, using EPI-DATA software
version 3.02. The questionnaires were keyed twice to minimize data entry errors. Technical support
for the data entry process was provided by a Makerere University statistician with input from the
Horizons data analyst. Data cleaning yielded a small number of unusable and out of range
questionnaires, reducing the sample to 2,040 adolescents or 95 percent of initial target. Data were
analyzed using SPSS v. 11 and STATA v 9.0 software.

Data analysis included univariate, bivariate, and multivariate methods, specifically logistic regression.
In logistic regression, the measure of association is the odds ratio. The odds ratio compares how much
more likely (or unlikely) an outcome is present among those with the exposure variable compared to
those without (Hosmer and Lemeshow, 2000). The comparison group is usually assigned an odds
ratio of 1.00. Statistically significant values above 1.00 indicate a positive association between
exposure and the outcome, while a statistically significant value below 1.00 is indicative of a negative
association. As discussed earlier, exposure to STF activities will be categorized as a) no exposure, b)
exposed to 1 item, c) exposed to two items and 3) exposed to all 3 items. The comparison category
will be those who have not been exposed to any STF materials (OR 1.00).

Limitations of the survey

Because the main subject for this study was unmarried adolescents, it excluded ever-married young
people. So it does not provide information on the risk profiles of married adolescents, an important
and vulnerable population of its own. A second limitation is representativeness of the sample at the
district level. Because the survey did not purport to provide district estimates, no proportionate
allocations were attempted. Therefore conclusions at the district level should be made with caution. A
third study limitation was social desirability bias. Even though respondents were informed that the
interview was confidential and anonymous, and each respondent was interviewed in private, it is
possible that some of them gave socially desirable answers. The fourth limitation is exclusion of
certain adolescents: due to ethical concerns, the study excluded adolescents who did not have a parent
or guardian to provide informed consent. The final limitation derives from the fact that this was a
cross-sectional survey. Therefore it cannot provide evidence of ―causality‖. Rather it provides
evidence of associations between outcome and predictor variables. The reader is alerted to keep these
limitations in mind.

11
Sociodemographic Characteristics

Demographic Characteristics

Table 1 presents the demographic characteristics of the 2,040 adolescents in the survey. Half the
sample is male, half is female, and there is a near equal split between age groups. The mean age is
14.5 years, with boys being slightly older than girls (14.7 vs. 14.4, p = 0.02; data not shown). About
one quarter of the sample resides in urban areas, and the remaining three-fourths live in rural
communities. About 80 percent are either Catholic or Protestant. The data suggest that the
respondents practice their religion: when asked how many times they attend religious services in a
month, 75 percent said they attended three or more times, 20 percent said 1–2 times a month, and only
5 percent said they never or rarely attended (data not shown). When asked ―how important religion is
to you,‖ 81 percent said ―very important,‖ 18 percent said ―somewhat important,‖ and only 1 percent
said ―not important at all‖ (data not shown).

Table 1 also shows that slightly less than two-thirds of the youth live with both parents, and those that
live with only one parent were much more likely to live with their mother rather than their father.
However, nearly 85 percent of adolescents live with at least one of their parents. About one in six
young persons live with other relatives; this is slightly more the case for girls than boys.6 There are
not large gender differences between adolescent males and females with regards to living
arrangements.

6
Appendix 3 presents comparative data on youth from the recent Uganda HIV/AIDS Sero-Behavioral Survey (2004–05) and
other sources to establish a context for the findings of the current report.

12
Straight Talk: Full Report

Table 1 Sociodemographic characteristics of respondents


Male Female Total
Number % Number % Number %
Age
10–14 500 49.0 510 50.0 1,010 49.5
15–19 521 51.0 509 50.0 1,030 50.1
Total 1,021 100.0 1,019 100.0 2,040 100.0
Residence
Urban 257 25.2 249 24.4 506 24.8
Rural 764 74.8 770 75.6 1,534 75.2
Total 1,021 100.0 1,019 100.0 2,040 100.0
Religion
Catholic 353 34.6 333 32.8 686 33.7
Protestant 455 44.6 506 49.8 961 47.2
Muslim 97 9.5 73 7.2 170 8.3
Saved/born again 101 9.9 97 9.5 198 9.7
None, other 14 1.4 7 0.7 21 1.0
Total 1,020 100.0 1,016 100.0 2,036 100.0
Living arrangements
Both parents 646 63.5 618 60.8 1,264 62.1
Father only 54 5.3 48 4.7 102 5.0
Mother only 176 17.6 171 16.8 347 17.1
Grandparents 50 4.9 58 5.7 108 5.3
Aunt, uncle 54 5.3 75 7.3 129 6.3
Sister, brother 25 2.5 36 3.6 61 3.0
Other^ 12 1.2 11 1.1 23 1.1

Total 1,017 100.0 1,017 100.0 2,034 100.0

^Other includes boyfriend or girlfriend, brother, sister, cousin, other relative, friend, or alone.
∞Figures exclude missing values, which comprised 0.3 percent of respondents.

Schooling

Table 2 shows the schooling experiences of adolescents in the study. About 84 percent of respondents
are currently in school, with slightly more boys (86 percent) than girls (81 percent) reporting school
attendance.

13
Table 2 School attendance by various characteristics
Male Female Total
Number % Number % Number %
Currently in school
Yes 877 86.4 823 81.2 1,700 83.8
No 128 12.6 151 14.9 279 13.8
Never attended 10 0.1 39 3.8 49 2.4
Total 1,015 100.0 1,013 100.0 2,028 100.0
Current level of education
Primary 682 77.9 660 81.4 1,342 79.6
Post-primary 193 22.1 151 18.6 344 20.4
Total 875 100.0 811 100.0 1,686 100.0
Type of school
Mixed sex 850 96.9 770 93.4 1,620 95.2
Girls only 0 – 54 6.6 54 3.2
Boys only 26 3.0 0 – 26 1.5
Total 876 99.9 824 100.0 1,700 99.9
Type of student
Day student 744 87.5 697 85.7 1,441 86.7
Boarder 106 12.5 116 14.3 222 13.3
Total 850 100.0 813 100.0 1,673 100.0
Highest education hope to
achieve^
Primary 58 6.6 84 10.2 142 8.4
Secondary 279 31.9 316 38.5 595 35.1
Vocational school 31 3.6 29 3.5 60 3.5
University/college 390 44.6 301 36.7 691 40.8
Cannot tell 116 13.3 91 11.1 207 12.2
Total 874 100.0 821 100.0 1,695 100.0
Level at which stopped (among
those dropped out)
Primary 103 83.1 133 91.7 236 87.7
Secondary 18 14.5 11 7.6 29 10.7
Vocational 3 2.4 1 0.7 4 1.6
Total 124 100.0 145 100.0 269 100.0

^Among those currently in school

Roughly 2 percent of the adolescents have never attended school, with girls slightly more likely than
boys to have never attended. Most (80 percent) school-going adolescents in the study are in primary
schools, indicating that many adolescents are rather old for their grade—primary school attendance in
Uganda begins at the age of seven years (when the child is enrolled in standard 1), and ends at the age
of 13 years (when the student graduates from standard 7). The fact that nearly 80 percent of the study
group is still in primary school suggests a late start to school coupled with considerable repetition
within a grade. It also has implications for exposure to STF materials: although the adolescents in the

14
Straight Talk: Full Report

study are older and would probably benefit from ST newspapers, they are likely to get YT newspapers
which are distributed in primary schools.

When asked what the highest level of education they thought they would achieve, 41 percent of the
in-school respondents felt they would make it to college or university (see Table 2). However, a third
felt that they would just make it to secondary school. While boys had greater ambitions for themselves
than girls, the differences are not large, suggesting perhaps some element of realism among the
respondents. When asked how confident they were they could achieve the desired academic goal they
had stated, 54 percent felt very confident they could achieve it (51 percent among males and 58
percent among females; data not shown), 30 percent somewhat confident (35 percent among males
and 24 percent among females) and 5 percent not confident at all (3 percent among males and 7
percent among females).

Those who dropped out of school (n = 269) were asked at what class they dropped, and the results are
presented in Table 2. Nearly 88 percent dropped at primary school, including 83 percent of the boys
and 92 percent of the girls. Figure 1 shows that the main reason was financial for both males and
females. However a disproportionate percentage of females also dropped out because of ―work at
home,‖ illness, lack of school supplies, or lack of interest. The percentages reported by males
regarding these explanations were lower. On average, males dropped out of school at the age of 15.2
years and females at the age of 13.8 years (p = 0.000).

Figure 1 Reasons for dropping out of school^


80
67
70
60
50
Percent

40 33
30
17
20 12 12
7 6 6 8 11 7 5
10 4
0
0
Lack of To work at Illness Lack of Not Not a good Got
fees home supplies interested student pregnant

Reason

Males (n = 124) Females (n = 145)

^Among the 289 school drop-outs

Media Utilization and Intensity of Exposure

Respondents were asked how often they listen to the radio and the answers are presented in Table 3.
The data show that boys and girls have sharply different radio listener-ship patterns. Girls are three
times more likely than boys to report that they do not listen to the radio at all (26 percent versus 8
percent). Boys are 50 percent more likely than girls to report listening to broadcasts daily. Table 3

15
also shows that two-thirds of the sample reside in districts classified as having high media intensity in
terms of STF products, specifically Apac, Arua, Ntungamo, and Soroti districts.

Table 3 Media utilization


Male Female Total
Number % Number % Number %
Radio listening per week
None 76 7.5 253 25.6 329 16.5
1–2 times 186 18.4 205 20.7 391 19.6
3–6 times 293 29.0 229 23.2 522 26.2
Daily 449 44.5 302 30.5 751 37.6
Total 1,004 100.0 989 100.0 1,993 100.0
District media intensity
High exposure 675 66.1 680 66.7 1,355 66.4
Low exposure 346 33.9 339 33.3 685 33.6
Total 1,021 100.0 1,019 100.0 2,040 100.0
Number of STF items
exposed to
None 257 25.2 364 35.7 621 30.4
One 222 21.7 227 22.3 449 22.0
Two 230 22.5 180 17.7 410 20.1
All three 312 30.6 248 24.3 560 27.5
Total 1,012 100.0 1,019 100.0 2,040 100.0

As discussed in the Methods section of this report, respondents could have been exposed to three STF
items: ST radio, ST newspaper and YT newspaper. Table 3 also shows that 30 percent of respondents
had been exposed to zero items, 22 percent to one item, 20 percent to two items and 28 percent to
three items. In subsequent tables, data are presented in relation to intensity of exposure as well as the
number of items they are exposed to. In the last section of this report, multivariate analysis will
further present relationship between specific outcomes and number of STF items one is exposed to,
controlling for confounding variables.

16
Straight Talk: Full Report

Sources of Information on Reproductive Health

Sources of Information

Most important source of information

The survey participants were asked ―which one person‖ they considered to be their most important
source of information on body changes, sexual and reproductive health, and relationships. This was a
single response question; respondents could give only one answer. It was also unprompted;
respondents had to state the person, and were not offered a list to choose from. The results show that
mothers are by far the most important source for girls, with nearly half reporting this (see Table 4).
Mothers are distantly followed by teachers as an information source for girls. In contrast, boys report
fathers, teachers, and ―no one‖ as important sources in nearly equal proportions. The importance of
mothers, in particular, and fathers to a somewhat lesser degree, highlights the value of parent-child
communication efforts.

Table 4 Most important source of information on body changes, ASRH, and


relationships
Respondent n Mother Father Teacher Friend Aunt Health No Other^
characteristics % % % % % worker one %
% %
Sex
Male 1,018 13.9 20.4 18.8 9.4 1.2 4.1 18.7 13.7
Female 1,010 47.7 5.1 14.5 7.2 4.9 1.0 11.1 8.6
School status
In school 1,693 30.9 13.1 18.4 7.4 2.8 2.5 14.8 9.9
Primary 1,345 32.3 13.5 16.1 6.6 2.3 2.7 17.0 10.4
Secondary 346 25.1 11.0 26.6 11.3 4.3 2.3 6.4 14.8
Out of school 278 28.4 13.3 8.6 11.2 4.3 2.9 14.7 16.7
Age group
Males 10–14 500 16.2 22.2 18.4 6.6 0.4 2.4 22.4 11.4
Females 10–14 506 50.4 5.9 12.3 5.3 4.3 1.0 12.6 8.2
Males 15–19 518 11.6 18.7 19.1 12.2 1.9 5.8 15.1 17.9
Females 15–19 504 45.0 4.4 16.7 9.1 5.4 1.0 9.5 9.0
Current residence
Urban 416 31.0 9.9 21.4 7.5 4.3 3.4 8.9 13.7
Rural 1,583 30.4 13.8 15.4 8.5 2.7 2.4 16.5 10.4
District media intensity
High intensity 1,352 32.0 14.4 17.6 7.4 2.6 2.3 11.9 11.7
Low intensity 676 28.1 9.6 14.6 10.2 3.8 3.1 20.9 9.4
Exposure to STF materials
Not exposed 615 29.3 10.1 10.4 8.1 3.6 1.8 27.5 9.5
Exposed to 1 item 448 34.4 13.2 14.1 7.8 2.7 2.9 13.8 11.0
Exposed to 2 items 408 32.8 13.0 21.1 9.1 1.0 4.2 9.1 9.7
Exposed to 3 items 557 27.8 15.4 22.3 8.4 4.1 2.0 6.1 15.1
All respondents 2,028 30.7 12.8 16.6 9.3 3.0 2.6 14.9 10.8

^Includes sister, brother, grandparent, uncle, other relative, peer educator, Straight Talk worker, religious leader, and self.

17
Reflecting changes in traditional society where aunts were the main sources of ASRH information for
adolescent females, only 5 percent of girls report aunts as their most important source. Teachers are
considered an important source by a sizeable minority of young people. Higher proportions of young
people mention teachers as important as exposure to STF materials increases. Presumably this reflects
the distribution of ST newspapers and magazines in schools, and the discussions that they generate in
the classroom. Clearly, key adults play important roles in ASRH education of young people. Health
workers are reported by no more than 6 percent of youth as important sources, likely reflecting young
people’s limited interface with health facilities and staff. An important difference that emerges is the
high proportion of those not exposed to STF materials or programs reporting that they have no
important source of information (27.5 percent). This proportion declines appreciably as exposure to
STF materials and programs increases.

Preferred source of information

Respondents were asked who they preferred as their source of information. Once again, responses
were unprompted. The data show that young people reported only minor differences from the pattern
observed in the prior table, with mothers the preferred source for girls, and fathers the preferred
source for boys (see Table 5). Expectedly, small declines were seen in the proportion reporting ―no
one.‖

There was also a small decline in respondents citing teachers, mostly among older males. A smaller
portion of the respondents prefers teachers as their exposure to STF materials and media increases,
relative to the prior table. In most cases, the most important source is also the preferred source,
implying that young people are seeking information from their preferred source by choice.

18
Straight Talk: Full Report

Table 5 Preferred source of information on body changes, ASRH, and relationships


Respondent n Mother Father Teacher Friend Aunt Health No Other^
characteristics % % % % % worker one %
% %
Sex
Male 1,011 14.2 21.5 14.7 8.4 1.3 5.1 10.1 24.8
Female 996 45.3 5.4 11.3 8.2 7.4 2.2 4.4 15.6
School status
In school 1,672 30.1 14.7 14.5 7.1 4.1 3.7 7.1 20.0
Primary 1,329 31.5 14.7 14.3 6.2 3.9 3.3 8.1 19.5
Secondary 241 25.5 13.8 14.7 10.3 5.0 5.0 3.5 22.3
Out of school 274 25.5 8.1 6.2 13.1 3.6 3.6 1.1 28.5
Age group
Males 10–14 497 16.7 23.3 16.5 5.0 1.2 3.8 12.7 25.2
Females 10–14 496 46.8 6.3 11.5 5.8 7.5 1.4 4.2 10.2
Males 15–19 514 11.9 19.6 13.0 11.7 1.4 6.4 7.6 33.9
Females 15–19 500 43.8 4.6 11.2 10.6 7.4 3.0 4.6 15.8
Residence
Urban 409 28.4 13.9 17.8 7.1 5.6 3.2 5.9 18.1
Rural 1,571 30.0 13.6 11.4 8.7 3.8 3.9 7.6 20.6
District media intensity
High intensity 1,349 32.1 14.2 13.3 7.5 3.0 4.0 5.5 20.4
Low intensity 658 24.6 12.2 12.5 10.1 7.0 3.0 10.9 19.9
Exposure to STF
materials 605 27.1 10.7 10.7 9.3 6.1 2.1 14.5 19.3
Not exposed 443 34.8 13.5 13.1 7.2 3.2 4.3 5.4 18.6
Exposed to 1 item 402 31.8 16.4 14.4 7.7 2.5 4.0 4.5 18.4
Exposed to 2 items 557 26.8 14.4 14.5 8.6 4.7 4.7 2.9 23.3
Exposed to 3 items
All respondents 2,007 29.6 13.5 13.1 8.3 4.3 3.7 7.3 20.0

^Includes sister, brother, grandparent, uncle, other relative, peer educator, Straight Talk worker, religious leader, and self.

Newspaper and magazine sources

All respondents were asked which newspapers or magazines were their most important source of
adolescent reproductive health information and the data are presented in Table 6. This was an
unprompted single response question. The data show that 21 percent and 24 percent of respondents
considered YT or ST newspapers to be their most important sources, respectively, although 43 percent
said ―none.‖ When examined by gender, boys were more likely than girls to say YT or ST newspapers
are their most important source. When examined by schooling status, ST newspaper appeared to be
particularly significant to secondary school students, with 66 percent mentioning it as their most
important print source. When examined by urban-rural residence, respondents in urban areas were
more likely to consider YT or ST newspapers to be their most important print sources.

19
Table 6 Most important newspaper or magazine source of information on body
changes, ASRH, and relationships
Respondent characteristics n Young Straight Others Don‘t know None
Talk Talk % name %
% % %
Sex
Male 1,013 23.0 26.8 7.0 8.9 34.4
Female 1,010 19.0 20.7 3.8 4.8 51.8
School status
In school 1,687 23.4 24.4 5.2 7.2 39.8
Primary 1,337 24.6 13.6 4.5 8.8 48.5
Secondary 347 18.2 66.0 8.4 1.4 6.9
Out of school 278 10.4 22.7 7.2 4.7 55.0
Age group
Males 10–14 494 25.1 11.9 6.3 12.8 43.9
Females 10–14 504 17.9 10.7 2.6 6.5 62.3
Males 15–19 519 21.0 40.8 7.7 5.2 25.2
Females 15–19 506 20.2 30.6 4.9 3.0 41.3
Residence
Urban 409 24.9 35.0 8.7 5.3 26.1
Rural 1,571 20.0 20.9 4.6 7.2 47.3
District media intensity
High intensity 1,342 22.1 29.6 6.1 7.1 35.1
Low intensity 681 18.8 12.2 4.0 6.3 58.7
Exposure to STF materials
Not exposed 614 0.0 0.0 2.6 9.3 88.1
Exposed to 1 item 444 18.7 4.5 8.3 11.0 57.4
Exposed to 2 items 408 45.3 32.4 5.6 3.9 12.7
Exposed to 3 items 557 28.2 58.9 5.9 2.9 4.1
All respondents 2,023 21.0 23.7 5.4 6.8 43.1

For the 43 percent of the adolescents who said that ―none‖ of the newspapers were their most
important source of information, this could mean that they do not have access to newspapers and if
they do, they do not consider them an important source. The proportion who did not specify a
newspaper declined considerably by intensity of exposure to STF materials: while 88 percent of those
who were not exposed to any STF materials said that no newspaper was their most important source,
this dropped to 4 percent among those exposed to all three STF materials. Thus respondents who
received STF publications considered them an important source of information.

Radio sources

Adolescents were also asked what was their ―most important source of ASRH information in terms of
radio programs.‖ This was also a single-response unprompted question and the results are presented in
Table 7. The data show that 37 percent of adolescents specifically mention ST radio program as their
most important source, with boys (43 percent) more likely to do so than girls (31 percent). Older
males are by far more likely to mention ST radio compared to other age groups.

20
Straight Talk: Full Report

Table 7 Most important radio source of information on body changes, ASRH, and
relationships
Respondent characteristics n Straight Talk Other radio Does not know No radio
radio show name of show show
% % % %
Sex
Male 1,016 42.6 9.0 24.0 24.4
Female 1,014 30.7 8.3 22.4 38.7
School status
In school 1,692 37.6 8.7 24.1 29.6
Primary 1,342 31.6 7.5 26.8 34.1
Secondary 348 60.9 13.5 13.8 11.8
Out of school 277 35.0 9.4 20.6 35.0
Age group
Males 10–14 496 31.3 7.3 28.2 33.3
Females 10–14 506 26.9 6.5 23.9 42.7
Males 15–19 520 53.5 10.6 20.0 16.0
Females 15–19 506 34.4 10.0 20.9 34.6
Residence
Urban 504 42.7 10.6 23.6 23.1
Rural 1,526 35.2 8.1 23.1 33.5
District media intensity
High intensity 1,347 52.8 7.9 21.5 17.9
Low intensity 683 4.8 10.1 26.6 58.4
Exposure to STF materials
Not exposed 615 0.0 4.9 25.5 69.6
Exposed to 1 item 446 35.2 11.0 28.3 25.6
Exposed to 2 items 409 44.0 11.5 25.7 18.8
Exposed to 3 items 560 72.7 8.8 14.8 3.8
All respondents 2,030 36.7 8.6 23.2 31.5

In addition, much larger proportions of secondary school students report ST radio as important
compared with primary students or those not currently in school. This may reflect both differences in
access to a radio itself, as well as free time to listen to regular programming.

Finally, the content of the radio programs may appeal more to the older adolescents, particularly boys.
There is not much variation in those reporting another radio show as important, or in those not
knowing the name of show, with the exception of secondary students who were more likely to recall
the ―Straight Talk‖ name. Not surprisingly, identifying ST as an important radio source is strongly
associated with increased exposure to STF materials and products.

About a third of adolescents said that ―no radio program‖ in particular was the most important source
of ASRH, implying that these adolescents do not consider radio as their most important source of
information on ASRH. Females are more likely to report this than males, as are out-of-school youth
when compared to in-school. Nearly six of ten respondents in the low-intensity districts said that ―no
radio show‖ was an important source, compared to only 18 percent of their counterparts in high
intensity districts.

21
Most important among all sources of information

Respondents were then asked to assess all three sources of information: ―Of the three sources you
have mentioned above, that is person, newspaper, and radio, which one is the most important overall?
Is it the person, newspaper, or radio program?‖ The results are presented in Table 8 and show that on
aggregate, adolescents prefer person (39 percent), followed by radio (29 percent), then newspaper (19
percent). However, there are large differences by sex. In particular, girls of all ages favor a person far
more than males (48 percent vs. 29 percent). Males cite persons, print media, and radio in nearly equal
shares, ranging from just under a quarter to a third.

When examined by school status, primary students and those out of school prefer a person, followed
by radio and then newspapers and magazines. However, secondary schools students prefer
newspapers and magazines, followed by radio and then person. This may be a reflection of literacy
constraints, with primary and out-of-school youth at lower reading levels than their secondary school
counterparts. About one in eight primary students and out-of-school youth are also likely to report not
knowing any important source of ASRH information.

Older males exceed all others in their appreciation of media sources, both print and radio. Among the
youth living in low-intensity districts, a greater reliance on individuals, or lack of any source, is
reported. For those not exposed to STF products, newspaper and magazines are not important at all,
and there is a heavy reliance on personal contact. Radio appears to be very important by level of
exposure and relative to other sources, possibly because of its accessibility in local languages.

Primary place to seek information about growing up

Adolescents were also asked, ―If you needed information about growing up, relationships, and sexual
matters, which one place would you go to for information?‖ The data show that school is by far the
most commonly cited place to obtain information, across all characteristics, mentioned by 40 percent
of respondents (ranging from a third to half; see Table 9). This is followed by health facility (13
percent), respondent’s house (13 percent), and church (6 percent). Not surprisingly, the exception to
this pattern is out of school respondents, among whom only 15 percent mention school, with 19
percent seeking information at a health facility or in their homes. These findings appear to endorse
schools as an important and salient location for ASRH education.

22
Straight Talk: Full Report

Table 8 Most important source of information on body changes, ASRH, and


relationships
Respondent characteristics n Person Newspaper Radio Don‘t All are
% or magazine % know important
% % %
Sex
Male 998 29.4 23.4 33.2 12.8 1.2
Female 1,000 48.4 14.8 24.9 10.3 1.6
School status
In school 1,676 39.5 20.1 28.5 10.6 1.3
Primary 1,327 42.3 16.0 27.4 13.0 1.4
Secondary 347 28.0 36.9 33.1 1.2 0.8
Out of school 266 34.6 15.0 36.1 12.4 1.9
Age group
Males 10–14 487 32.4 19.3 28.1 18.9 1.2
Females 10–14 504 49.4 11.5 23.2 14.5 1.4
Males 15–19 511 26.4 27.4 38.0 7.0 1.2
Females 15–19 496 47.4 18.1 26.6 6.0 1.8
Residence
Urban 504 39.4 25.4 28.3 6.0 1.0
Rural 1,494 38.5 17.5 29.4 13.1 1.5
District media intensity
High intensity 1,341 34.1 21.6 37.1 5.9 1.3
Low intensity 657 48.7 14.0 12.5 23.1 1.7
Exposure to STF materials
Not exposed 587 53.8 1.5 11.2 32.4 1.0
Exposed to 1 item 446 38.3 14.6 40.1 5.6 1.3
Exposed to 2 items 407 36.1 27.8 32.2 2.2 1.7
Exposed to 3 items 558 25.6 34.9 36.6 1.3 1.6
All respondents 1,998 38.9 19.1 29.0 11.6 1.4

Some differences are apparent by exposure to any ST media versus none. Generally those with higher
exposure are more likely to name formal institutions such as schools or health centers as primary
places to seek information, and are less likely to rank their own home or someone else’s home as
important. The fact that boys are more likely than girls to name health facilities as important places to
obtain information may reflect that boys have more freedom to circulate in their communities, and
may be more familiar with these local resources. In contrast, a higher percentage of girls report their
own homes as an important place to seek information. Higher exposure to ST media is also associated
with less likelihood of youth saying they don’t know any source.

Despite ongoing efforts to engage religious communities and faith-based organizations in the
provision of ASRH information, only a small proportion of respondents name churches as important
places in this process (6 percent); the sole exception, though still not large, is among out-of-school
youth (11 percent).

About one in five young people say they do not know where they would go to seek this type of
information. Females are more likely to say so than males (24 percent vs. 19 percent). When assessed
by schooling status, out-of-school youth are more likely to say ―don’t know‖ compared to their in-
school counterparts (25 percent vs. 20 percent), as are rural compared to urban youth (23 percent vs.
15 percent).

23
Table 9 Primary place to seek information about growing up
Respondent n School Health My Church Don‘t Other^
characteristics % facility house % know %
% % %
Sex
Male 1,013 43.1 16.1 7.9 6.0 19.3 7.5
Female 1,012 37.5 10.7 17.4 5.0 23.9 5.5
School status
In school 1,682 45.5 12.3 11.8 4.6 20.2 5.6
Primary 1,332 45.8 9.2 13.0 4.9 22.1 5.0
Secondary 347 43.5 24.5 7.2 3.7 12.7 8.2
Out of school 275 15.3 19.3 18.9 10.5 25.1 10.9
Age group
Males 10–14 494 46.8 11.3 9.3 5.1 21.9 5.6
Females 10–14 503 38.6 7.6 19.1 5.0 26.0 3.8
Males 15–19 519 39.7 20.6 6.6 6.9 17.0 9.2
Females 15–19 499 36.5 13.8 15.6 5.0 21.6 7.2
Residence
Urban 504 40.9 20.1 13.8 2.9 15.3 7.0
Rural 1,511 40.0 11.7 12.3 6.0 22.5 6.4
District media intensity
High intensity 1,343 43.9 13.7 12.0 6.4 16.8 7.0
Low intensity 672 33.2 12.8 13.8 3.7 31.1 5.3
Exposure to STF
materials
Not exposed 605 30.1 8.3 12.9 5.6 37.2 5.9
Exposed to 1 item 446 42.4 9.2 15.5 5.4 21.1 6.5
Exposed to 2 items 406 49.0 14.3 13.8 5.2 11.3 6.2
Exposed to 3 items 558 43.5 21.7 9.1 5.7 12.5 7.4
All respondents 2,015 40.3 13.4 12.6 5.5 21.6 6.5

^“Other” includes “someone’s house”

However, it is when assessed by intensity of ST exposure that differences appear large—while 37


percent of those with zero ST exposure say they do not know where to go to obtain information, this
shrinks to 13 percent among those who are exposed to all three STF items, indicating the importance
of ST media as a source of information for adolescents.

Exposure to Straight Talk Foundation Products

Radio

All respondents were asked whether they ―have ever listened to a radio program called Straight Talk,‖
and the results are presented in Table 10. About 55 percent of respondents said they had ever listened
to this radio program, with males (60 percent) more likely to have done so than females (50 percent).
When examined by schooling level, secondary school students (82 percent) are by far the most likely
to have ever listened, and out-of-school youth the least likely (52 percent). When examined by age-
sex groupings, older males (69 percent) are the most likely to have ever listened to a ST radio
program, and younger females (45 percent) are the least likely. This may be a reflection of the amount
of leisure time available to males, as well as greater access to mass media. There are large differences

24
Straight Talk: Full Report

by type of districts, with 76 percent of those in ST high intensity districts having ever listened,
compared to 13 percent of those in low intensity districts.

Table 10 Ever listen to Straight Talk radio, and times per month among those saying
yes
Respondent characteristics n Listen to ST n who 3–4 1–2 Rarely
radio listen times times %
% % %
Sex
Male 1,021 60.1 612 66.1 26.1 7.7
Female 1,019 50.3 508 63.2 24.8 12.0
School status
In school 1,700 57.1 967 63.5 26.1 10.4
Primary 1,350 50.7 680 61.0 27.5 11.5
Secondary 348 81.6 287 69.0 23.2 7.4
Out of school 279 51.6 279 73.5 21.7 4.9
Age group
Males 10–14 500 51.0 254 59.5 31.5 9.1
Females 10–14 510 44.5 224 61.6 25.0 13.4
Males 15–19 521 68.9 358 71.0 22.3 6.7
Females 15–19 509 56.2 284 64.4 24.7 10.9
Residence
Urban 506 67.0 337 67.4 24.3 8.3
Rural 1,534 51.4 783 26.0 63.7 10.2
District media intensity
High intensity 1,355 76.4 1,028 65.1 25.6 9.3
Low intensity 685 13.4 92 62.0 25.0 13.0
Exposure to STF materials
Not exposed 621 0.0 0 0.0 0.0 0.0
Exposed to 1 item 449 63.5 283 58.6 31.4 9.9
Exposed to 2 items 410 68.8 278 60.8 27.4 11.9
Exposed to 3 items 560 100.0 558 70.1 21.7 8.2
All respondents 2,040 55.2 1,120 64.8 25.5 9.6

When asked how often they listen to the ST radio show, 65 percent of those who listen said they do so
three to four times a month (the show is broadcast weekly). Females who listen appear to listen as
frequently as their male counterparts. Out-of-school youth report more frequent listening than their in-
school companions, probably due to more free time during the day. There are large urban-rural
differences, with urban respondents (67 percent) more likely to listen three to four times a month
compared to rural respondents (26 percent), possibly due to access to programs and less time
committed to the chores and agricultural work common in rural areas. Finally, as expected,
respondents in high intensity areas are far more likely to report hearing ST radio programs;
nevertheless, 13 percent of the youth in low intensity areas report hearing the programs, reflecting
media ―bleed‖ that takes place across broadcast areas.

Use of Straight Talk Foundation products

Respondents were asked whether they had read, not merely seen, ST or YT newspaper, or whether
they had listened to any ST radio program. The most commonly-used ST F product was ST radio

25
program, which had been listened to by 55 percent of all adolescents, but by 76 percent of those in the
high-intensity districts (i.e. those receiving local language broadcasts). In comparison, only 13 percent
of respondents from low-intensity districts had listened to ST radio, demonstrating the importance of
adding local language broadcasts. The second most utilized STF product was YT newspaper, which is
aimed at primary schools and had been read by 49 percent of the study respondents, including 53
percent in high intensity and 35 percent in low-intensity districts. However, among those who had
completed primary school and entered secondary school, 85 percent had read YT. The third most
utilized STF product was ST newspaper, which had been read by 39 percent of the study sample
including 45 percent of high-intensity and 25 percent of low-intensity district respondents. Among
secondary school respondents, who are the main target of ST newspaper, 90 percent had read it.
Seventy percent of respondents had been exposed to at least one of the three STF products, including
virtually all secondary and two thirds of primary school students, as well as 56 percent of out-of-
school youth. Exposure is fundamentally linked to STF’s use of local language materials—in the
high-intensity districts where vernacular products were used, 84 percent of respondents had been
exposed to STF materials, compared to 42 percent in districts without local languages.

Table 11 Use of Straight Talk Foundation products


Respondent characteristics n Young Talk Straight Talk Straight At least one
newspaper newspaper Talk radio STF product
% % % %
Sex
Male 1,021 52.9 43.4 60.1 74.8
Female 1,019 44.3 34.7 50.3 64.3
School status
In school 1,700 51.6 41.1 57.1 72.2
Primary 1,350 43.0 28.7 50.7 65.3
Secondary 348 85.1 90.2 81.6 99.4
Out of school 279 37.6 32.6 51.6 55.8
Age group
Males 10–14 500 41.8 29.8 51.0 64.4
Females 10–14 510 34.9 23.5 44.5 55.9
Males 15–19 521 63.5 56.4 68.9 84.8
Females 15–19 509 53.6 46.0 56.2 72.7
Residence
Urban 506 68.0 60.1 67.0 85.2
Rural 1,534 42.2 32.1 51.4 64.1
District media intensity
High intensity 1,352 53.1 45.5 76.4 83.8
Low intensity 685 35.2 24.5 13.4 41.5
Exposure to STF materials
Not exposed 621 0.0 0.0 0.0 30.4
Exposed to 1 item 449 30.1 4.9 63.5 22.0
Exposed to 2 items 410 72.9 54.1 68.8 30.1
Exposed to 3 items 560 99.5 98.8 100.0 27.5
All respondents 2,040 48.6 39.1 55.2 69.6

Respondents who had ever read ST newspaper were asked how many issues they had read in a year,
out of 12 possible issues. About 20 percent said they could not recall the number they had read.
Among those who could recall a number (n = 605), respondents had read a mean of 4.5 different

26
Straight Talk: Full Report

issues. There were no differences by sex (males = 4.7, females = 4.4, p = 0.169), nor were there
differences by current schooling status (currently in school = 4.6, currently out of school = 4.1; p =
0.163). However, there were differences by the various age-sex groupings (p = 0.004), urban-rural
residence (p = 0.000) and by ST exposure (p = 0.025).

Figure 2 Mean number of ST issues read in the past months^

4.5

4.7
Exposed to 2 ST items 4.1
4
Exposed to 0 ST items 0

Rural 4.1
5.2

4.1
Age 10–14 males 3.9
4.5
Age 15–19 males 5

0 1 2 3 4 5 6
Mean number
^Among those ever read and gave quantifiable answer (n = 605)

Urban adolescents had read one more issue of ST newspaper than their rural counterparts (5.2 vs. 4.1,
p = 0.000). There were no differences in the number of issues read by readers in high intensity versus
low intensity districts (4.6 vs. 4.4 respectively; p = 0.479). And there were statistically significant
differences in the number of issues read by exposure (p = 0.025).

Respondents were asked where they had obtained their last issue of ST newspaper and the majority
(75 percent) of readers mentioned school. Seven percent got it from home, six percent from friends,
three percent from a health facility, and another 3 percent got it from a community center. A similar
set of questions were asked about YT newspaper, and like ST newspaper, the majority (82 percent)
found it at school, 6 percent from friends and 5 percent from home. Virtually all respondents who are
familiar with YT and ST newspapers would recommend them to other young people their age (98 and
97 percent, respectively, data not shown).

What Adolescents Learned from Straight Talk Foundation Products

All adolescents who had used any of the three STF products (i.e., ST radio, ST and YT newspapers)
were asked what they had learned from them. The most common response was abstinence, reported

27
by 60 percent of respondents. This was followed by delay of sex (11 percent) and HIV prevention (10
percent). All the other messages, including child defilement, how to prevent pregnancies, how to
avoid STIs, body changes, staying in school, parent-child communication, etc. accounted for less than
2 percent of respondents each. There were only minor percentage differences in the key messages by
age or gender groups: 63 percent of 15–19 year olds reported that the main message they had received
was abstinence, followed by delay of sex (10 percent), and HIV prevention (11 percent). By
comparison, 56 percent of 10–14 year olds reported that the main message they had received was
abstinence, followed by delay of sex (13 percent), and HIV prevention (9 percent). Thus many
adolescents see STF materials as strongly supportive of abstinence as a choice among adolescents.

Actions Taken Due to Exposure to Straight Talk Foundation Products

Respondents were asked what actions they took as a consequence of their exposure to STF products.
Among the 57 percent of boys and 64 percent of girls reporting taking some action, the most common
response was ―Continue to abstain,‖ with nearly 70 percent of both males and females offering this
reply (data not shown). There was little variation by age or level of exposure. About 15 percent of the
young people reported talking with a friend. Fifteen percent of boys and 12 percent of girls said they
stopped having premarital sex. Fewer than 10 percent said they spoke with parents, started to use
condoms, refused gifts for sex, ceased spending time with bad peers, or continued with their
education.

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Straight Talk: Full Report

Knowledge and Attitudes

Reproductive Health Knowledge

The survey included a series of true/false questions to assess the level of knowledge among
adolescents. The results show that despite years of intense media coverage and community dialogue
about HIV/AIDS in Uganda, there remains considerable room for improvement (see Table 12). One in
five adolescents believes that AIDS can be cured, with very little variation by respondent
characteristic. Only slightly more boys, secondary students, and older youth are aware that there is no
cure for AIDS, relative to their counterparts. We see little variation in this pattern by exposure to ST
media, although knowing that a person who looks healthy may be infected and that a mother can pass
the AIDS virus to her unborn child increases substantially with exposure to any STF product.

Similarly, there is woefully inadequate knowledge of basic sexual risks among this sample of young
people. Only 46 percent of adolescents believe that girls can get pregnant at first sex, only 45 percent
are aware that a girl can get pregnant if she has sex standing up, and only 61 percent of adolescents
believe that condoms are effective against STIs if used correctly. Knowledge about HIV is a bit
higher: 71 percent are aware that a healthy-looking person can be HIV-positive, 78 percent know that
AIDS cannot be cured, and 73 percent know that HIV can be passed from an infected mother to a
child.

Males are more knowledgeable than females across the board except on the question about vertical
transmission of HIV. The level of knowledge by schooling status is inconsistent, with more out-of-
school youth sometimes having correct knowledge compared to their in-school counterparts. As
expected, urban respondents are more knowledgeable than rural respondents, and students from high-
intensity districts are more knowledgeable than their low-intensity counterparts.

All indicators see improvement associated with higher levels of exposure to STF media. Those
exposed to three STF items are more likely to have the correct answers than those who are not
exposed, and there is a clear dose-response pattern. Nevertheless, it is noteworthy that even a large
proportion of those exposed to all three items remain uninformed: for example, only 58 percent are
aware that a girl can get pregnant at first sex, suggesting that the remaining 42 percent are uncertain of
this fact. Likewise, 56 percent are aware that a girl can get pregnant if she has sex standing up,
suggesting that the remaining 44 percent are not aware of this fact as well. And while 73 percent
believe that condoms can prevent STIs if used correctly, the remaining 27 percent are not so
informed. Thus there remains a great need to continue educating adolescents in Uganda, despite the
Herculean efforts of the past decades.

29
Table 12 Reproductive health and HIV/AIDS knowledge
Respondent Percent who know that:
characteristics
n Girls can Girls can Condoms A person AIDS AIDS can be
get get are who looks cannot passed from
pregnant pregnant effective healthy can be pregnant
at first if have protection be infected cured mother to
sex sex against with HIV % unborn baby
% standing STIs % %
% %
Sex
Male 1,019 50.0 51.1 69.9 75.1 78.9 69.8
Female 1,015 42.3 37.7 52.8 68.4 76.6 76.1
School status
In school 1,694 46.6 45.6 61.8 71.1 77.7 74.4
Primary 1,334 42.3 41.1 60.6 68.6 76.5 73.1
Secondary 348 67.0 62.4 66.4 81.3 81.3 80.2
Out of school 279 44.4 44.6 65.9 78.5 78.1 68.8
Age group
Males 10–14 499 43.5 47.5 63.1 68.3 74.5 68.4
Females 10–14 507 36.5 33.7 49.5 63.7 73.9 74.3
Males 15–19 520 56.2 56.4 76.4 81.6 83.0 71.2
Females 15–19 508 48.0 41.7 56.2 73.0 79.2 78.0
Residence
Urban 505 54.9 53.4 66.2 76.9 77.9 79.6
Rural 1,529 43.2 42.1 59.8 70.0 77.6 70.7
District media
intensity
High intensity 1,352 47.6 47.6 67.6 75.7 78.2 78.4
Low intensity 682 43.1 39.6 49.4 63.8 76.8 62.1
Exposure to STF
materials
Not exposed 620 34.1 31.0 40.8 60.7 74.5 58.8
1 item 449 44.8 43.7 65.8 72.6 78.0 77.2
2 items 410 49.3 52.7 71.1 72.9 80.0 79.3
3 items 560 58.0 55.6 73.0 82.3 79.4 80.5
All respondents 2,034 46.1 44.9 61.4 71.7 77.7 73.0

Reproductive Health and HIV/AIDS Attitudes

Respondents were read a series of attitudinal questions they could agree or disagree with, or if they
were not sure, they could also say so. The results show that adolescents demonstrate uncertainty
regarding many issues though somewhat progressive positions in other domains (see Table 13). For
example, about half the adolescents agree that girls who stay in school are less likely to have
unwanted pregnancies. However, it suggests that the remaining half either do not agree with the
statement or are uncertain (i.e., said ―don’t know‖), a rather large proportion when one considers the
role of education in adolescent well-being. The data also show that the study participants hold rather
negative views of condoms. For example, only a third disagree that ―using a condom is a sign that
your partner does not trust you,‖ indicating that the remaining two-thirds either agree with the
statement or are not decided. Likewise, only 38 percent disagree with the statement that ―buying

30
Straight Talk: Full Report

condoms is the responsibility of males only,‖ indicating that many do not feel that girls should buy
condoms. There seems a strong feeling that ―girls who carry condoms are loose,‖ with only 23 percent
of adolescents disagreeing with this statement.

Table 13 Reproductive health and HIV/AIDS attitudes


Respondent n Girls who stay in Condom use Buying condoms Girls who
characteristics school are less means is male carry
likely to have partner does responsibility condoms
unwanted not trust you only are loose
pregnancy (% disagree) (% disagree) (%
(% agree) disagree)
Sex
Male 1,019 51.6 36.2 43.3 26.0
Female 1,015 49.2 29.9 33.1 19.0
School status
In school 1,694 51.7 34.2 40.4 22.5
Primary 1,334 50.5 28.4 34.0 18.7
Secondary 348 56.0 56.9 67.5 36.9
Out of school 279 48.6 29.1 30.8 22.3
Age group
Males 10–14 495 50.1 30.9 34.5 20.8
Females 10–14 505 49.7 24.1 26.5 14.3
Males 15–19 518 53.1 41.3 51.8 30.9
Females 15–19 508 48.6 35.6 39.7 23.6
Residence
Urban 505 55.2 41.2 46.8 29.3
Rural 1,521 48.8 30.4 35.4 20.2
District media intensity
High intensity 1,345 51.9 32.8 42.6 26.0
Low intensity 681 47.4 22.9 29.5 15.5
Exposure to STF
materials
Not exposed 620 42.2 19.0 38.0 12.3
1 item 449 49.3 32.1 48.8 23.8
2 items 410 53.9 32.6 42.2 23.7
3 items 560 57.7 49.6 54.5 31.8
All respondents 2,026 50.4 33.1 38.2 22.5

Urban youth, secondary students, those in school, older males, and those in high intensity districts are
slightly more likely to recognize the protective influence of school on young women. But some of
these same three subgroups (urban youth, secondary students, and older males) are more conservative
than their counterparts when it comes to condom use. They are more likely to believe that using
condoms implies mistrust of one’s partner. They are also noticeably more likely to believe that it is
the male’s responsibility to obtain condoms.

Exposure to STF media generally is associated with a more balanced perspective: a larger percentage
of those with three exposures believe that girls who stay in school are less likely to become pregnant.
Likewise, those exposed to the most STF items also disagree that condom use means partner distrust,
a larger proportion disagree that buying condoms is a male-only responsibility, and a larger proportion
disagree that girls who carry condoms are loose. Nevertheless, the data indicate that adolescents in the

31
study, even those exposed to the most STF materials, harbor considerable misgivings about condom
use especially when initiated by females. This indicates the need for more attention to be paid to girls’
right to self-determination and self-protection in sexual exchanges.

Gender Attitudes

The participants were also asked a series of questions to assess gender attitudes. These were agree-
disagree questions, with a ―don’t know‖ option for those who could neither agree nor disagree. The
results show that adolescents are quite intolerant of schoolgirl pregnancies: nearly three-quarters of
both boys and girls agreed that girls who become pregnant should be expelled from school, with
slightly more girls holding this view (79 percent vs. 75 percent of boys). They are just as intolerant of
schoolboys who make schoolgirls pregnant: 79 percent of girls and 69 percent of boys thought that
boys who made girls pregnant should be expelled. The differences with exposure to STF products
were negligible.

Boys were somewhat more likely to express preferential attitudes that favored males; 41 percent said
that when money was scarce, boys should be sent to school before girls, compared with 31 percent of
girls. Forty six percent of boys also said that men should have the final say about having sex,
compared with 35 percent of girls. Equal proportions of boys and girls (57 percent) said that women
should tolerate abuse in order to keep the family together, and 51 percent of girls and 48 percent of
boys said there are times when a woman deserves to be beaten. STF products have not addressed
gender issues in detail until recently, so the lack of clear differences related to exposure is
understandable. However, in view of the high proportion of young people accepting gender
differences and tolerating violence against women, this may be an important programmatic subject in
the future.

Two-thirds of both boys and girls believe that both sexes are treated equally at home, and there is a
similar pattern when asked how they are treated at school (see Tables 14 and 15). Among those who
think one sex is favored over the other, approximately twice as many are likely to say that girls are
favored at home. For treatment is schools, the difference is much larger, with nearly five times as
many youth thinking that girls are favored. The perceived differences in treatment range from three to
nine times higher, favoring girls. There are few appreciable differences within categories, although a
slightly higher proportion of out of school youth believe boys are favored relative to girls. Slightly
more urban youth, and those in high media intensity areas, believe that boys and girls are treated
equally. Exposure to STF products is also somewhat associated with more egalitarian attitudes.

It is a common perception in Uganda that girls receive more affection, and in staying close to both
their mothers and grandmothers, have more familial intimacy than do boys. Boys work hard grazing
animals and spend more time away from home. Other chores, such as collecting water and firewood,
are done by both boys and girls. The perception that girls are favored may in part be a function of the
primary school status of most of the respondents, who have not yet been fully integrated into the
reality of adult life.

32
Straight Talk: Full Report

Table 14 Believe boys and girls are treated equally at home


Respondent characteristic n Treated Girls favored Boys favored Others^
equally % % %
%
Sex
Male 1,019 67.2 17.9 9.0 5.9
Female 1,017 62.9 21.5 10.3 5.2
School status
In school 1,696 67.0 19.3 8.9 4.8
Primary 1,346 66.6 19.5 8.8 5.1
Secondary 348 67.2 19.5 9.5 3.7
Out of school 279 53.8 22.9 14.0 9.3
Age group
Males 10–14 498 68.7 15.1 9.6 3.6
Females 10–14 508 62.6 22.6 10.0 4.7
Males 15–19 521 65.8 20.5 8.4 5.1
Females 15–19 509 63.3 20.4 10.6 5.7
Residence
Urban 503 71.2 17.9 7.0 4.0
Rural 1,533 63.1 20.3 10.6 6.0
District media intensity
High intensity 1,352 67.8 18.1 10.1 3.9
Low intensity 684 59.6 22.8 8.8 8.7
Exposure to STF materials
Not exposed 621 60.7 19.5 10.8 9.1
Exposed to 1 item 446 68.8 18.6 7.6 4.9
Exposed to 2 items 410 63.7 20.7 12.2 3.4
Exposed to 3 items 559 68.0 20.0 8.2 1.8
All respondents 2,036 65.1 19.7 9.7 5.5

^Unable to determine, or no boys/girls in household.

It is possible that boys are more likely to receive corporal punishment in schools, and hence perceive
themselves as not favored. However, indicators show that in general girls’ performance is not as good
as boys’ in school. The perception of favored status, at odds with reality, may be an obstacle to
improving conditions for both genders.

33
Table 15 Believes boys and girls are treated equally at school^
Respondents characteristic n Treated Girls Boys Can‘t determine/
equally favored favored can‘t recall
% % % %
Sex
Male 1,004 66.2 25.4 4.3 4.1
Female 992 63.6 23.6 4.7 8.1
School status
In school 1,685 66.6 24.9 4.3 4.1
Primary 1,348 67.7 24.0 4.4 3.9
Secondary 335 61.8 28.7 4.4 5.6
Out of school 264 53.8 23.5 5.7 17.1
Age group
Males 10–14 497 69.6 21.5 5.2 3.6
Females 10–14 503 64.6 24.5 4.3 4.1
Males 15–19 510 62.9 29.2 3.3 4.5
Females 15–19 489 60.3 21.9 5.7 12.1
Residence
Urban 497 66.8 25.8 2.6 4.2
Rural 1,485 64.3 24.1 5.1 6.5
District media intensity
High intensity 1,329 70.2 22.0 4.6 2.7
Low intensity 650 52.7 28.9 4.1 12.2
Exposure to STF materials
Not exposed 589 58.7 25.5 3.4 12.4
Exposed to 1 item 439 73.2 20.2 3.4 3.2
Exposed to 2 items 402 64.8 25.3 6.7 3.2
Exposed to 3 items 549 64.8 26.3 4.9 4.1
All respondents 1,979 65.0 24.6 4.5 5.9

^Those that attended school but are not now enrolled were asked about last school attended. The table excludes those who
never attended school and those in single sex schools.

Very few young people think it is appropriate for either boys or girls to have sex before marriage, and
there were few differences within categories (data not shown). Slightly more males (12 percent) than
females (9 percent) believed it is OK for boys to have sex before marriage; about the same level of
girls (9 percent) contend it is OK for girls to have sex before marriage, while the proportion of boys
expressing this declines (10 percent). A somewhat larger proportion of out of school youth thought
early sexual activity was acceptable (15 percent and 14 percent for boys and girls, respectively), but
the overall level is still low. Interestingly, students in secondary school were least likely to indicate
this is acceptable behavior, with only 8 percent approving pre-marital sex for boys, and 6 percent
approving it for girls, perhaps indicating a better comprehension of the implications of premarital sex
among this group.

Differences were not large, but young people exposed to two or three ST media were slightly less
likely to say premarital activity was appropriate for either sex.

34
Straight Talk: Full Report

Self Efficacy and Self Confidence

In order to assess the adolescents’ self-assuredness and social well-being, respondents were read a
series of statements with which they could agree or disagree, or state if they were not sure. The results
show that the vast majority of both boys and girls (90 percent) report feeling happy the way they are
(see Table 16). However, many boys and girls lack self-confidence in certain social domains. Despite
feeling favored at home and at school, 36 percent of the girls do not believe they are as important in
the family network as other family members. The rate for boys is somewhat higher, but about one in
four do not believe they are as important. One in four girls, and one in eight boys, wish they had been
born the opposite sex, reflecting (and perpetuating) a belief that males are favored in Ugandan society.
Nearly 40 percent of the adolescents also feel that their friends are better than they are.

About three-fourths of the boys and two-thirds of the girls feel they are as skilled and ―can do things
as well as most people my age.‖ Without more specialized data collection and analysis, it is difficult
to tell if this reflects self-doubt, or in fact an accurate perception of skill development. The data show
that already, young people are concerned about their life prospects. About a third of the respondents
doubt they have a bright future; this is especially apparent among out-of-school and rural youth, who
may realistically assess limited prospects.

While in most cases the differences are not large, the general trend is that exposure to STF products,
measured both through media intensity and through number of products known, is associated with
more positive views about self.

35
Table 16 Self efficacy and self confidence
Respondent n Feel happy Don‘t feel as Feel that my I can do Feel I don‘t I wish I Believe I
characteristics the way important to friends are things as have a was born can say
I am my family as better than well as bright a boy/girl ―no‖ if I do
(% agree) other family me most people future (opposite not want to
members (% agree) my age (% agree) gender) have sex
(% agree) (% agree) (% agree) (% agree)
Sex
Male 1,018 89.8 23.8 37.0 73.0 31.7 11.5 85.6
Female 1,016 89.9 36.4 35.0 65.7 34.4 23.8 85.3
School status
In school 1,697 91.0 29.3 34.2 70.6 32.5 16.6 85.5
Primary 1,346 90.6 30.8 36.9 67.6 34.2 17.6 83.9
Secondary 348 93.1 22.8 25.9 81.9 25.0 12.9 90.5
Out of school 277 83.5 36.8 45.5 65.5 37.8 23.8 84.6
Age group
Males 10–14 499 90.2 23.6 37.1 71.3 30.4 11.7 82.9
Females 10–14 510 90.8 37.1 34.6 64.2 33.3 20.2 84.4
Males 15–19 520 89.4 24.0 36.9 75.0 32.9 11.2 88.2
Females 15–19 505 89.0 35.6 35.4 67.2 35.6 27.4 86.1

36
Residence
Urban 505 90.5 25.0 32.2 70.9 28.8 17.4 87.7
Rural 1,529 89.6 31.8 37.2 68.9 34.5 17.6 84.7
District media intensity
High intensity 1,353 91.3 30.4 34.5 74.9 37.5 18.5 89.5
Low intensity 681 86.9 29.5 39.0 58.6 24.1 15.6 77.5
Exposure to STF
materials
Not exposed 617 87.0 30.7 41.7 61.5 27.8 18.9 76.1
Exposed to 1 item 449 89.3 32.5 36.2 69.6 40.1 18.8 88.4
Exposed to 2 items 410 91.2 28.9 39.6 72.7 34.6 16.5 89.3
Exposed to 3 items 558 92.3 28.3 26.9 75.7 32.1 15.9 90.5
All respondents 2,034 89.8 30.1 36.0 69.4 33.1 17.6 85.4
Straight Talk: Full Report

Knowledge about HIV and AIDS

Respondents were asked: ―Apart from HIV/AIDS, are there any other diseases that men and women
can get from having sexual intercourse?‖ This question was limited to adolescents ages 15 years and
above. The data, presented on Table 17, show that 72 percent of respondents are aware of such
diseases. Males, urban residents, and those in school are most likely to know that other diseases
besides HIV/AIDS are transmitted through sexual intercourse. The STF materials seem to have been
particularly effective on this topic, as a higher proportion of those living in high media intensity
districts, and those exposed to more of STF materials, are more likely than their counterparts to know
of other sexually transmitted infections (STIs). For example, 94 percent of respondents exposed to all
three STF materials were aware of STIs, compared to only 35 percent of those not exposed to any.
And 83 percent of those residing in high intensity districts were aware of STIs, compared to 52
percent of those in low intensity districts.

Table 17 Knowledge of STIs and STI symptoms


Respondent n Knows other diseases that are
characteristics transmitted through
intercourse besides HIV
%
Sex
Male 514 77.6
Female 503 67.0
School status
In school 739 76.3
Primary 414 64.4
Secondary 301 53.0
Out of school 236 66.1
Residence
Urban 258 89.5
Rural 759 66.5
District media intensity
High intensity 682 82.4
Low intensity 335 51.9
Exposure to STF materials
Not exposed 215 35.3
Exposed to 1 item 204 66.7
Exposed to 2 items 219 77.2
Exposed to 3 items 379 93.7
All respondents 1,017 72.4

37
Health Seeking Behavior and STIs

Use of Health Facility Services

Questions about health seeking behavior were confined to the 15–19 year olds. Respondents were
asked whether they had ever visited a health facility for contraceptives, pregnancy tests, or voluntary
counseling and testing for HIV/AIDS. About one in five reported that they had: 24 percent of boys
and 18 percent of girls, and 58 percent of those in secondary school (see Table 18). Three-fourths of
the young people who had visited had visited a government clinic, while about 10 percent reported
visiting a private doctor or clinic, and 8 percent had visited a youth center (data not shown). Youth in
urban areas were more likely to report visiting a clinic compared with those in rural areas, perhaps
reflecting accessibility of services. Youth reporting high exposure to STF products were far more
likely than their counterparts with lower exposure to visit a facility, likely reflecting the emphasis by
STF encouraging health-seeking behavior, and stressing the value of seeking information and help
from health care providers. Overall, the low proportion of youth seeking care is not surprising, as few
report being sexually active, and generally adolescence is a time of good health and well-being.

Table 18 Respondents ages 15 to 19 years who have visited a health facility for SRH
or VCT, and percent recalling Straight Talk sign among those visiting facility
Respondent characteristics n Percent who visited a n visiting Percent recalling
health provider for provider facility had Straight
contraceptives, Talk sign at facility
pregnancy tests or VCT %
%
Sex
Male 514 24.1 124 58.1
Female 503 18.3 91 52.7
School status
In school 738 21.0 151 61.7
Primary 441 10.4 45 68.9
Secondary 190 57.9 110 57.3
Out of school 237 24.5 58 41.4
Residence
Urban 257 32.7 48 57.1
Rural 760 17.4 72 55.0
District media intensity
High intensity 681 23.5 160 61.3
Low intensity 336 16.7 55 40.0
Exposure to STF materials
Not exposed 215 0.5 (11) –
Exposed to 1 item 199 8.5 31 41.9
Exposed to 2 items 218 8.7 45 37.8
Exposed to 3 items 370 17.0 128 68.8
All respondents 1,017 21.2 215 55.8

–Denominator too small for meaningful analysis

38
Straight Talk: Full Report

Slightly more than half the youth recalled whether the facility had a sign identifying itself as a
Straight Talk partner site. In-school students, youth in high intensity areas, and those with greater
exposure to STF products were more likely to recall seeing such a sign.

Attendance at particular facilities was clearly driven by convenience and familiarity. Forty-one
percent of the youth said they visited a facility because it was close, 31 percent because it was
affordable, 22 percent because it was recommended by a friend or family member, and 18 percent
because they ―knew about it‖ (data not shown). Nineteen percent said they opted to attend the clinic
because it was youth friendly. Only about 6 percent said they chose the facility because they were
prompted by STF. Differences by sex or by exposure to STF products were neither large nor
consistent.

About 39 percent of the young people who visited a health facility were seeking information,
followed by VCT (31 percent) and for advice on STIs (28 percent, see Table 19), highlighting the
important role these sites do or may serve in counseling young people. In-school students were much
more likely than their out-of-school counterparts to report this as their main reason for visiting
facilities (45 percent vs. 25 percent). In contrast, out-of-school youth were more likely to visit
facilities for voluntary counseling and testing (26 percent vs. 18 percent). Few young people reported
going to health facilities for STI treatment, contraceptives, or pregnancy tests, again, a not surprising
finding in view of the relatively low levels of sexual experience (see later chapters). Exposure to STF
products did not result in clear associations with reasons for visiting health facilities; the number of
youth not exposed was too small to calculate a percent distribution.

Table 19 Reason for last visit to health facility among youth ages 15 to 19 years
Respondent n Information VCT STI Contra- Pregnancy ANC Other
characteristics % % % ceptives test % %
% %
Sex
Male 124 43.5 33.9 25.8 8.1 – – 13.7
Female 92 33.7 27.2 30.4 9.8 12.0 4.3 13.0
School status
In school 154 44.8 17.5 4.5 10.4 0.6 0.6 3.2
Primary 46 45.7 13.0 8.7 13.0 2.2 2.2 2.2
Secondary 109 44.0 19.3 2.8 9.2 0.0 0.0 3.7
Out of school 57 24.6 26.3 8.8 8.8 3.5 3.5 7.0
Residence
Urban 82 42.7 23.2 14.6 3.7 7.3 3.7 4.8
Rural 132 36.4 18.2 22.7 6.8 2.3 0.0 13.6
District media intensity
High intensity 158 35.4 23.4 18.4 5.7 5.1 0.6 11.4
Low intensity 56 48.2 10.7 23.2 5.4 1.8 3.6 7.1
Exposure to STF
materials
Not exposed (11) – – – – – – –
Exposed to 1 item 32 43.8 37.5 25.0 6.3 6.3 3.1 9.4
Exposed to 2 items 45 31.1 17.8 31.1 4.4 6.7 2.2 20.0
Exposed to 3 items 128 42.2 35.9 26.6 10.9 3.9 1.6 11.7
All respondents 216 39.4 31.0 27.8 8.8 5.1 2.3 13.4

– Percentages not calculated due to small sample size

39
Ever Experienced an STI

Young people ages 15–19 years were asked whether they had ever had a sexually transmitted
infection (respondents were excluded if they did not know it was possible to contract diseases other
than HIV through intercourse, and if they did not know symptoms of STIs). Of the 1,017 youth aged
15–19 years, 578 were eligible to be asked if they ever had an infection. Only 29 (18 males and 11
females) reported having had an STI (5 percent, data not shown).7

Most sought treatment at a government health facility: 13 boys and seven girls. Four boys sought care
at a private clinic, herbalist, or pharmacy, as did one girl. One boy and two girls did not seek
treatment. No one reported attending a youth health facility for care.

7
This may underreport actual cases, as respondents who didn’t know symptoms were not asked if they had an infection.
They may have had an STI and not recognized it.

40
Straight Talk: Full Report

Communication with Parents and Guardians

Comfort and Confidence in Speaking to Parents

Many of Straight Talk Foundation’s efforts have focused on encouraging open, objective, and non-
threatening communication between parents and children. Indeed, parental interest in the early
editions of Straight Talk magazine and the Straight Talk radio broadcasts eventually resulted in the
development of a medium specifically targeting parents, ―Parent Talk.‖ However, Uganda is no
different from many other countries in that both parents and adolescents find it awkward and
embarrassing to speak about sexual and reproductive health matters.

The youth surveyed were asked, ―Have any of your parents or guardians ever talked to you about
issues related to sexuality, growing up, relationships between boys and girls, etc.?‖ Nearly half of the
respondents reported having had some conversation with a parent or guardian on these topics (see
Table 20). More girls than boys in both age groups reported speaking with parents, and nearly three-
fourths of secondary students reported having had a discussion.

Adolescents living in urban areas, in areas of high media intensity, and reporting exposure to more
STF materials were more likely to report speaking with their parents about ASRH, possibly prompted
by subjects raised in the STF interventions.

Regardless whether they had talked with their parents/guardians, adolescents were asked how
confident they felt their parent/guardian would be in answering the respondent’s questions about
sexuality issues. Answers were recorded on a three-point Likert scale ranging from ―very confident‖
to ―not confident at all‖, and also included ―don’t know‖. Regrettably, few adolescents are very
confident that their parents are able to answer these questions. While patterns are in expected
directions—urban youth, those in higher media density districts, those with exposure to more STF
products, and girls are all more likely to express confidence than their relative counterparts—overall
the level of confidence is low, at less than 25 percent. Nevertheless, among the respondents who
indicated they had spoken with their parents, there is virtual unanimity that the discussions were
helpful.

As might be expected, a higher proportion of boys than girls reported feeling comfortable speaking
with their male guardians, and vice versa. Few differences emerge when considering school status or
place of residence, implying that education and residence are secondary to gender when discussing
intimate subjects with a parent. Generally, higher exposure to ST materials is associated with feeling
more comfortable with a parent in these discussions.

41
Table 20 Communication with parents or guardians on growing up, relationships, and
sexuality
Among all youth with living parent or Among youth with living parent or
guardian (%) guardian who had discussion (%)
n Ever Very Very Discussion Very Very
Respondent talked confident confident was helpful comfortable comfortable
characteristics with father or mother or (n = 956) talking with talking with
parent male female father or mother or
or guardian guardian male female
guardian can answer can answer guardian guardian
(n = 2,010) sexuality sexuality about SRH about SRH
questions questions issues issues
(n = 1,704)^ (n = 1,869)* (n = 805) (n = 902)
Sex
Male 1,003 41.6 21.8 14.3 96.1 35.0 24.3
Female 1,007 54.0 14.0 33.3 97.4 18.8 45.4
School status
In school 1,679 48.8 18.6 25.0 97.1 27.0 37.2
Primary 1,333 43.1 16.9 23.3 96.5 26.2 28.1
Secondary 344 71.2 25.0 30.3 98.4 27.5 34.9
Out of school 271 45.8 17.3 20.4 95.1 24.0 36.0
Age group
Males 10–14 489 35.0 19.7 15.4 94.7 34.0 29.3
Females 10–14 506 47.8 12.9 29.5 96.7 19.9 44.5
Males 15–19 514 47.9 23.8 13.3 97.1 35.7 20.7
Females 15–19 501 60.3 15.2 37.2 98.0 17.9 46.3
Residence
Urban 497 63.0 19.9 29.0 98.1 26.1 38.3
Rural 1,513 42.8 17.4 22.4 96.3 26.5 36.1
District media
intensity
High intensity 1,330 54.4 20.6 28.5 97.5 26.3 36.5
Low intensity 680 35.0 13.1 15.7 94.9 26.3 37.7
Exposure to STF
materials
Not exposed 614 25.2 9.2 10.8 92.3 22.8 21.8
1 item 441 45.1 18.4 18.4 98.5 21.0 36.8
2 items 404 56.7 19.8 19.8 97.4 28.0 44.9
3 items 551 68.6 26.8 26.8 97.6 29.7 38.2
All respondents 100 47.8 18.0 24.1 96.9 26.3 36.8
(%)

^336 respondents (16 percent) did not answer question; *171 respondents (8 percent) did not answer question

Topics Discussed with Parents

The young people were asked, ―Which issues have your parents talked to you about?‖ A third of the
boys and 40 percent of the girls reported discussing boy-girl relationships (see Table 21). The
responses were not probed more deeply, so it is not clear whether parents merely chided their children
to stay away from members of the opposite sex, talked with them about current relationships, or
provided accurate, objective information about gender relations. A quarter of the boys and nearly 20
percent of girls mentioned that their parents spoke with them about abstinence. Similarly, about 20
percent of boys and 25 percent of girls discussed the relatively benign, yet important topic of personal
hygiene with their parents. All three of these topics can provide a non-threatening opening to deeper

42
Straight Talk: Full Report

and more informative conversations about important sexual and reproductive health topics if parents
are appropriately informed and guided to make use of these building blocks.

Table 21 Topics adolescents have discussed with parents (among those having
discussions with parents)
Topics Males Females
10–14 15–19 All 10–14 15–19 All
(n = 170) (n = 245) (n = 415) (n = 242) (n = 302) (n = 544)
% % % % % %
Personal hygiene 24.7 15.9 19.5 28.9 21.5 24.8
Boy/girl relationships 36.5 38.0 37.3 41.7 40.4 41.0
Body changes 2.4 3.3 2.9 7.0 5.3 6.1
Abstinence 20.0 26.9 24.1 15.7 21.9 19.1
Sexual behavior 7.1 9.4 8.4 3.3 6.3 5.0
STIs 1.2 1.6 1.4 0.4 1.0 0.7
HIV/AIDS 5.9 3.7 4.6 1.2 1.7 1.5

Thirty-five percent of those who have ever discussed sexuality topics with their parents only
discussed them one or two times during the 12 months preceding the study; a nearly equal proportion,
34 percent, had three or four conversations (data not shown).

Reasons for Not Discussing ASRH with Parents

Among the young people who did not discuss sexual and reproductive health topics with their parents,
the most commonly cited reason is embarrassment, particularly among the older adolescents (cited by
32 percent, see Table 22). This was particularly the case among 15–19 year old females, where nearly
40 percent cited embarrassment as a deterrent. Slightly more than one in five respondents also
mentioned fearing their parents’ reaction if they were to raise these sensitive subjects, with little
difference between boys and girls. About 17 percent of boys and 14 percent of girls indicate that they
are not interested in these topics, so they do not have a reason to discuss them, and about 10 percent
say they are too young to discuss these matters.

43
Table 22 Reasons cited why youth do not speak to parents about ASRH topics
(among those not having discussions with parents)
Topics Males Females Total
10–14 15–19 All 10–14 15–19 All (n = 1,029)
(n = 312) (n = 267) (n = 579) (n = 252) (n = 198) (n = 450) %
% % % % % %
Is embarrassed 27.9 31.5 29.5 30.1 39.4 34.2 31.6
Prefers to speak 5.8 13.1 9.2 3.2 7.6 5.1 7.4
with someone else
Does not have 12.2 6.7 9.7 7.9 7.6 7.8 8.8
enough information
Is not interested 16.0 18.7 17.3 14.7 12.6 13.8 15.7
Does not see parent 7.4 13.1 10.0 9.9 8.6 9.3 9.4
often
Parent is not 9.9 12.0 10.9 3.6 9.6 6.2 8.8
interested
Afraid of parent’s 23.1 21.7 22.5 22.2 25.8 23.7 23.0
reaction
Does not think 6.1 7.5 14.6 5.5 10.6 7.8 7.2
parent
knowledgeable
Still young 13.5 5.6 9.8 11.9 2.5 7.8 8.9
Don’t know 18.3 8.6 13.8 25.4 14.1 20.4 16.7

Note: Columns do not add to 100 percent; multiple responses allowed.

44
Straight Talk: Full Report

Sexual Abuse and Defilement

Support if Abuse Attempted

Sexual abuse and defilement of young people remains a salient social concern in Uganda, and Straight
Talk Foundation has devoted a number of stories to this topic to convey its inappropriateness. About
86 percent of girls and 74 percent of boys report having someone to tell if they were pressured to have
sex (see Table 23). Younger boys are less likely to report having someone to tell, consistent with the
assumption that boys will be able to take care of themselves. There is consistent improvement with
greater exposure to STF products and in high intensity areas, likely indicating that the sexual abuse
messages conveyed are salient to young people.

Table 23 Percent has someone to tell if someone tries to force sex


Respondents characteristic n Has someone to tell
%
Sex
Male 1,017 73.5
Female 1,118 85.9
School status
In school 1,696 80.6
Primary 1,348 78.3
Secondary 347 90.2
Out of school 279 76.0
Age group
Males 10–14 479 70.8
Females 10–14 510 83.3
Males 15–19 520 76.2
Females 15–19 508 88.4
Residence
Urban 506 86.8
Rural 1,529 77.4
District media intensity
High intensity 1,351 84.7
Low intensity 684 69.9
Intensity of exposure to STF materials
Not exposed 619 69.6
Exposed to 1 item 448 78.6
Exposed to 2 items 410 83.4
Exposed to 3 items 558 89.1
All respondents 2,035 79.7

Two-thirds of the young people said they would tell their mother if someone tried to force them to
have sex; girls were far more likely than boys to turn to their mothers (75 percent vs. 46 percent, data
not shown). Forty-one percent said they would tell their fathers; in this case more boys than girls gave
this response (54 percent vs. 33 percent). Exposure to STF products did not result in consistent
patterns. Higher exposure resulted in fewer reports of turning to mothers (65 percent for no exposure,
57 percent for exposure to three items) and more reports of turning to fathers (39 percent for no
exposure, 49 percent for exposure to three items). Compared with girls, boys were also more likely to
mention turning to their friends (24 percent vs. 15 percent) or brothers (20 percent vs. 8 percent). No

45
other source (other relatives, police, teacher, boyfriend, or girlfriend) was mentioned by more than 10
percent of the young people.

Confidence in Reporting Abuse

Females in both age groups appear more confident in sharing information about abuse, perhaps
reflecting greater socialization around the topic (see Table 24). Indeed the proportion least likely to
express confidence in disclosing abuse are the youngest males, where only 45 percent say they would
be very confident disclosing, compared to 59 percent of the oldest females. Those exposed to more
STF activities also are quite confident in their ability to disclose abuse: for example, while 43 percent
of those with no exposure said they would be ―very confident‖ disclosing abuse, this had risen to 60
percent among those exposed to all three STF items. Nonetheless, the data show that about a quarter
of the young people report not feeling confident, or feeling unsure they would tell someone of abuse,
with 30 percent of the younger boys feeling this way. This represents a large share of the population
that needs to be made to feel more secure in the safety of telling an adult about potential abuse.

Table 24 Level of confidence to tell someone of forced sex


Respondents characteristic n Very Somewhat Not Can‘t
confident confident confident decide/not
% % at all sure
% %
Sex
Male 988 48.5 22.9 18.2 10.4
Female 999 57.8 19.5 18.2 4.5
Age group
Males 10–14 483 44.9 24.0 17.8 13.3
Females 10–14 499 56.3 18.0 20.0 5.6
Males 15–19 505 51.9 21.8 18.6 7.7
Females 15–19 500 59.2 21.0 16.4 3.4
District media intensity
High intensity 1,325 58.0 19.8 17.6 4.6
Low intensity 662 43.5 23.9 19.5 13.1
Exposure to STF materials
Not exposed 599 42.6 22.2 21.4 13.9
Exposed to 1 item 435 54.9 21.8 17.7 5.5
Exposed to 2 items 406 57.1 21.2 17.2 4.4
Exposed to 3 items 547 60.3 19.6 15.9 4.2
All respondents 1,987 53.1 21.2 18.2 7.4

46
Straight Talk: Full Report

Reproductive Behavior and HIV Risk Exposure

Sexual Activity among Adolescents

The survey respondents were asked whether they have ever had a boyfriend or girlfriend, and 24
percent of girls and 29 percent of boys answered affirmatively (see Table 25). As might be expected,
there were large differences between younger and older respondents. Those reporting more exposure
to STF materials, and those living in high media density districts, were somewhat more likely to
report having a boyfriend or girlfriend, but this may also be confounded by residence in urban areas,
with its greater opportunities for boys and girls to meet, mix, and spend time together.

Table 25 Respondents who have ever had a boyfriend or girlfriend or had sex
Respondent characteristic n Ever had boyfriend Ever
or girlfriend had sex
% %
Sex
Male 1,014 29.4 15.2
Female 1,011 24.2 9.1
School status
In school 1,688 22.9 8.9
Primary 1,340 16.9 6.5
Secondary 348 45.7 17.9
Out of school 277 52.0 32.4
Age group
Males 10–14 496 12.3 5.6
Females 10–14 508 10.0 4.3
Males 15–19 518 45.8 24.4
Females 15–19 503 38.6 14.0
Residence
Urban 503 32.8 14.8
Rural 1,502 24.8 11.3
District media intensity
High intensity 1,347 28.5 11.6
Low intensity 678 23.5 13.3
Exposure to STF materials
Not exposed 614 15.3 10.0
Exposed to 1 item 446 21.7 10.5
Exposed to 2 items 408 27.0 12.2
Exposed to 3 items 558 43.4 15.9
All respondents 2,025 26.8 12.2

Respondents were also asked whether they have ever had sex, and 15 percent of boys and 9 percent of
girls reported that they had.8 We see large differences comparing those in school and out of school (9
percent vs. 32 percent), reinforcing the hypothesis that school attendance has a protective effect
against early sexual debut. As is commonly seen in evaluations of youth sex education programs,
greater exposure to the program is associated with somewhat higher reports of sexual activity, seen
here in exposure to STF products, but the percentage increase is small. It is likely that this reflects

8
The remaining tables in this chapter sample only the sexually active respondents.

47
self-selection among young people, who seek information because it is relevant to what they are doing
in their lives. It may also reflect age: older adolescents are likely to be exposed to more ASRH
information but are also more likely to be sexually active. Multivariate analysis, presented in the next
chapter, will control for these confounding variables to present a more accurate picture. The data also
suggest many adolescents do not immediately commence sexual relations, and this appears stronger as
exposure to STF materials increases. For example, while 15 percent of those not exposed to any STF
materials report a girlfriend/boyfriend, 10 percent also report ever having had sex. On the other hand,
while nearly 43 percent of those exposed to three items have ever had a boyfriend/girlfriend only 16
percent have had sex. This suggests that those exposed to more materials may be more careful about
the extent of their sexual involvement.

Respondents were asked why they had sex the first time, and data show that the most top five most
compelling reason was love (reported by 49 percent of the males and 48 percent of the females),
followed by curiosity (20 percent of males and 12 percent of females), ―don’t know‖ (13 percent of
males and 10 percent of females), forced (4 percent of males and 19 percent of females), and pressure
from friends (6 percent of males and 4 percent of females). The fact that one in five females said they
were forced to have sex the first time suggests that sexual debut among many adolescent females is
coerced, and therefore removes their ability to protect themselves from HIV/AIDS.

Among those who are sexually initiated, 61 percent have had only one lifetime partner, 55 percent of
boys and 70 percent of girls (Table 26). However, this means that 45 percent of the initiated boys and
30 percent of girls have had more than one partner, placing them at risk for HIV if these encounters
were not protected. Exposure to STF products generally shows mixed influence on the number of
partners, again reflecting that sexually active youth may seek more information to learn more about
their sexual behavior. More youth living in high media density districts report having only one
lifetime partner, indicating that they may be responding to safer sex messages promoting monogamy
if they are sexually active.

Table 26 Number of lifetime sexual partners^


Respondents characteristic n Number of lifetime sexual partners
One Two Three or more
% % %
Sex
Male 134 55.2 17.2 27.6
Female 80 70.0 20.0 10.0
Age group
Males 10–14 25 68.0 8.0 24.0
Females 10–14 17 88.2 11.7 0.0
Males 15–19 109 52.2 19.3 28.4
Females 15–19 63 65.1 22.2 12.7
District media intensity
High intensity 139 64.8 18.7 16.6
Low intensity 75 53.3 17.3 29.3
Exposure to STF materials
Not exposed 52 61.5 11.5 26.9
Exposed to 1 item 42 57.1 23.8 19.1
Exposed to 2 items 47 61.7 12.8 25.5
Exposed to 3 items 73 61.6 23.3 15.1
All respondents 214 60.8 18.2 21.0

^34 sexually active respondents (14 percent) did not answer this question

48
Straight Talk: Full Report

Nearly 40 percent of ever-sexually active adolescents, including 42 percent of ever-sexually active


girls and 38 percent of their male counterparts, have remained abstinent during the past 12 months and
are thus practicing secondary abstinence (see Table 27). Adolescents in high media districts are
somewhat more likely to practice secondary abstinence, as are those exposed to more than one ST
product, though the pattern was not as clear.

Table 27 Secondary abstinence—number of times had sex in past 12 months (among


those ever had sex)^
Respondents characteristic n Number of times had sex past 12 months
None Once or more
% %
Sex
Male 145 37.9 62.1
Female 82 41.4 58.6
Age group
Males 10–14 27 48.2 51.8
Females 10–14 21 61.9 38.1
Males 15–19 118 35.5 64.5
Females 15–19 61 34.4 65.6
District media intensity
High intensity 147 42.1 57.9
Low intensity 80 33.8 66.2
Exposure to STF materials
Not exposed 58 37.9 62.1
Exposed to 1 item 43 27.9 72.1
Exposed to 2 items 46 45.7 54.3
Exposed to 3 items 80 42.5 57.5
All respondents 227 39.2 60.8

^21 sexually active respondents (8.5 percent) did not answer this question

Transactional Exchanges

Adolescents were asked, ―In the past 12 months, have you had sex with someone from whom you
received gifts or money in exchange for sex?‖, and in a separate question, whether they had given
someone gifts or money in exchange for sex. Nearly equal proportions of males (29 percent) and
females (32 percent) report receiving gifts, but a far higher share of boys report giving gifts than girls
(43 percent vs. 10 percent) (see Table 28). There is also a large difference among boys by school
status: a third of those in school reported giving some one gifts or money, compared with nearly
double those out of school (62 percent). Similarly, 22 percent of in-school boys report receiving some
token in exchange for sex, while 42 percent of those out of school did so. Clearly transaction
exchange is an important strategy among those out of school.

It is difficult to draw any clear conclusions regarding the sexually active girls, as the sample sizes are
too small to produce stable percent distributions in many of the variables. We are able to observe that
a slightly higher proportion of girls reported receiving gifts compared to boys. However, girls were far
less likely to report having given money or a gift in exchange for sex, although more out-of-school
girls reported this compared with those still in school.

49
Looking at the males, and the sample as a whole, we see that a higher percentage of those not living in
low media intensity districts or exposed to fewer STF products are likely to report either giving or
receiving something in a sexual exchange. This appears to be one of the largest differences observed,
and it may indicate that a higher dose exposure to STF products may reduce acceptability of
transactional sex.

Table 28 Received or gave gifts or money for sex in prior 12 months


Respondent Males Females All
characteristic n Received Gave n Received Gave n Received Gave
gifts or gifts or gifts or gifts or gifts or gifts or
money money money money money money
% % % % % %
School status
In school 59 22.0 32.2 33 30.3 6.1 92 25.0 22.8
Primary 35 22.9 37.1 20 * * 55 27.3 25.5
Secondary 26 19.2 26.9 12 * * 38 21.1 21.1
Out of school 38 42.1 62.2 28 35.7 14.3 66 41.5 41.5
Age group
10–14 15 * * 9 * * 24 * *
15–19 85 31.8 44.0 53 34.0 9.3 38 32.6 30.4
Residence
Urban 29 27.6 39.3 19 * * 48 29.2 27.7
Rural 71 29.6 45.1 43 32.6 9.1 114 30.7 31.3
District media
intensity
High intensity 59 18.6 25.9 38 28.9 7.7 97 22.7 18.6
Low intensity 41 43.9 68.3 24 * * 65 41.5 44.7
Exposure to STF
materials
Not exposed 28 35.7 67.9 14 * * 42 38.1 50.0
Exposed to 1 17 * * 17 * * 34 29.4 31.4
Exposed to 2 19 * * 10 * * 29 24.1 17.2
Exposed to 3 36 25.0 31.4 21 * * 57 28.1 21.4
All respondents 100 29.0 43.4 62 32.3 9.5 162 31.0 30.6

*Denominators too small for meaningful analysis

Future Plans with Partner

The sexually active respondents were asked, ―Thinking about your last sex partner, what are your
plans with him/her?‖ Slightly more than a quarter of both boys and girls report planning to marry their
partner (see Table 29). Not surprisingly, older youth, and those in secondary school or out of school,
are more likely to report this (31–43 percent). Forty percent of the respondents have no future plans
with their partner (44 percent of males and 38 percent of females), and 14 percent report being ―just
friends.‖

Greater exposure to STF products, both in the number of products and in high media density districts,
is associated with higher percentages reporting planning to marry; it is possible that these youth are in
more stable relationships, and are adopting norms of fidelity promoted through STF activities as well

50
Straight Talk: Full Report

as other sources in Uganda’s comprehensive HIV/AIDS prevention campaign. Those with less
exposure are twice as likely to say they are simply friends with their partner.

Table 29 Plans with most recent sexual partner


Respondent n Plan to Dating Just Just met No plans Don‘t know
characteristic marry % friends % % %
% %
Sex
Male 153 28.6 3.3 14.4 2.0 43.8 9.8
Female 93 28.0 12.9 14.0 2.0 37.6 5.4
Schooling status
In school 151 16.6 6.6 16.6 2.6 49.0 8.6
Primary 88 5.7 8.0 19.3 2.3 58.0 6.8
Secondary 64 32.8 6.3 12.5 3.1 34.4 10.9
Out of school 88 43.2 6.8 11.4 1.1 29.5 8.0
Age group
Males 10–14 28 7.1 0.0 28.6 3.6 42.9 17.9
Females 10–14 22 – – – – – –
Males 15–19 125 31.2 4.0 11.2 1.6 44.0 8.0
Females 15–19 71 33.8 12.7 11.3 2.8 33.8 5.6
Residence
Urban 75 30.7 8.0 13.3 1.3 38.7 8.0
Rural 171 25.7 6.4 14.6 2.3 42.7 8.2
District media intensity
High intensity 157 30.6 7.0 11.5 3.2 40.1 7.6
Low intensity 89 21.3 6.7 19.1 0.0 43.8 9.0
Exposure to STF
materials
Not exposed 60 16.7 3.3 23.3 0.0 45.0 11.7
Exposed to 1 item 46 21.7 6.5 19.6 2.2 45.7 4.3
Exposed to 2 items 50 30.0 4.0 6.0 4.0 48.0 8.0
Exposed to 3 items 90 35.6 11.1 10.0 2.2 33.3 7.8
All respondents 246 27.2 6.9 14.2 2.0 41.5 8.1

– Percentages not calculated because of small sample size

When asked, ―What does your last partner do for a living?‖ 63 percent said that their sexual partner
was a student (see Table 30). A far higher proportion of males than females reported having sex with
schoolmates/age mates. Nearly three-fourths of males, compared with half the females, identified their
partner as a student. Indeed, none of the males said that their partner was employed. Nearly a third of
the females report that their partner is working or in business, and this is particularly the case for older
girls. Higher exposure to STF activities, both by living in high media density districts and through
awareness of more STF products, appears to be associated with relationships with students, perhaps
reflecting acceptance of the message to avoid older partners.

Particularly among the younger females, we see a sizeable minority who do not know the employment
status of their last partner. Without further investigation, we cannot determine whether this reflects
youthful naiveté and lack of concern, or whether these young girls were coerced into a one-time
sexual encounter with a relative stranger so they are unfamiliar with their job status.

51
Table 30 Employment status of last partner
Respondent n Student Working Not In Don‘t Other
characteristic % % working business know %
% % %
Sex
Male 152 71.7 0.0 12.5 2.6 5.9 7.2
Female 93 48.4 12.9 7.5 19.4 10.8 1.1
School status
In school 150 71.3 4.0 6.0 4.7 10.0 4.0
Primary 88 69.3 2.3 5.7 6.8 12.5 3.4
Secondary 63 76.2 6.3 4.8 1.6 6.3 4.8
Out of school 88 48.9 6.8 19.3 14.8 3.4 6.8
Age group
Males 10–14 28 78.6 0.0 3.6 3.6 10.7 3.6
Females 10–14 124 72.7 4.5 0.0 4.5 18.2 0.0
Males 15–19 22 70.2 0.0 14.5 2.4 4.8 8.1
Females 15–19 71 40.8 15.5 9.9 23.9 8.5 1.4
Residence
Urban 75 66.7 6.7 12.0 5.3 5.3 4.0
Rural 170 61.2 4.1 10.0 10.6 8.8 5.3
District media intensity
High intensity 155 67.7 4.5 9.0 7.7 6.5 4.5
Low intensity 90 54.4 5.6 13.3 11.1 10.0 5.6
Exposure to STF
materials
Not exposed 61 55.7 0.0 18.0 13.1 9.8 3.3
Exposed to 1 item 46 50.0 6.5 10.9 10.9 10.9 10.9
Exposed to 2 items 50 70.0 2.0 8.0 8.0 6.0 6.0
Exposed to 3 items 88 70.5 9.1 6.8 5.7 5.7 2.3
All respondents 245 62.9 4.9 10.6 9.0 7.8 4.9

Condom Use

The survey included several questions on condom use for sexually active youth. These respondents
were asked whether they had used condoms at their last sexual event. Half of the girls and 41 percent
of boys reported that they had used condoms (see Table 31). This indicator shows large differences by
age; indeed so few of the younger adolescents reported using condoms that there were insufficient
cases to calculate percentages (in part because of the small number of younger adolescents reporting
ever having had sex). There are very large differences among residents of urban and rural areas; this
probably represents issues of access, privacy, and availability of cash to purchase condoms. In one of
the strongest associations seen, dose exposure to STF products appears well associated with condom
use: 56 percent of those exposed to three STF products used condoms at last sex, compared with 24
percent who had no exposure to ST.

52
Straight Talk: Full Report

Table 31 Condom use at last sex, and who suggested use


Respondent characteristic Number % used Number Who suggested
sexually condom used condom be used (%)
active last sex condom
(n = 248) (n = 108) Respondent Partner Both
Sex
Male 155 40.6 63 66.1 19.4 14.5
Female 93 49.5 46 54.3 23.9 21.7
Age group
Males 10–14 28 14.3 4 – – –
Females 10–14 22 – 6 – – –
Males 15–19 127 46.5 59 65.5 19.0 15.5
Females 15–19 71 56.3 40 52.5 27.5 20.0
School status
In school 63 41.7 63 60.7 19.7 19.7
Primary 88 25.0 22 – – –
Secondary 64 68.8 44 62.8 16.3 20.9
Out of school 40 44.4 40 56.1 26.8 17.1
Residence
Urban 75 69.3 52 59.6 15.4 25.0
Rural 173 32.9 57 62.5 26.8 10.7
District media intensity
High intensity 156 44.9 70 63.2 20.6 16.2
Low intensity 92 42.4 39 57.5 22.5 20.0
Exposure to STF
materials 62 24.2 15 – – –
Not exposed 47 44.7 21 – – –
Exposed to 1 item 50 46.0 23 – – –
Exposed to 2 items 89 56.2 50 61.2 18.4 20.4
Exposed to 3 items
All respondents 248 44.0 109 61.1 21.3 17.6

– Percentages not calculated due to small sample size

The majority of young people (61 percent) report that they suggested using condoms themselves.
Importantly, there is not a large percentage difference between boys and girls on this indicator: 66
percent of boys and 54 percent of girls reported being responsible for using condoms.

Those who were sexually active but did not use condoms were asked to give the main reason why
they did not (see Table 32). Again, the reader is alerted to the small sample sizes. Nonetheless, the
data suggest that appreciable minorities said they did not use a condom due to unavailability, that they
trusted their partner, or that they don’t know why no condom was used. Somewhat surprisingly,
double the proportion of males compared with females said they did not know about condoms.

53
Table 32 Main reason condom not used at last sex
Respondent n Didn‘t Condom Trusted my Didn‘t Didn‘t I was Don‘t like Condom Partner Afraid to Don‘t
characteristics know not partner think it think forced condoms too objected suggest know
about available % necessary of it % % expensive % % %
condoms % % % %
%
Sex
Male 89 32.6 11.2 15.7 7.9 9.0 1.1 2.2 4.5 3.4 1.1 6.7
Female 49 16.3 24.5 6.1 6.1 4.1 6.1 6.1 0.0 2.0 4.1 20.4
School status
In school 90 34.4 11.1 8.9 6.7 5.6 4.4 4.4 2.2 4.4 1.1 13.3
Primary 66 34.8 10.6 4.5 7.6 6.1 6.1 6.1 1.5 4.5 1.5 12.1
Secondary 24 * * * * * * * * * * *
Out of school 47 12.8 25.5 19.1 8.5 10.6 2.1 2.1 4.3 – 4.3 8.5
Residence
Urban 24 * * * * * * * * * * *
Rural 114 26.3 15.8 13.2 7.9 7.9 5.3 2.6 3.5 2.6 0.9 11.4
District media
intensity
High intensity 87 35.6 16.1 6.9 3.4 8.0 6.9 2.3 2.3 3.4 2.3 9.2

54
Low intensity 51 11.8 15.7 21.6 13.7 5.9 0.0 5.9 3.9 2.0 2.0 15.7
Exposure to
STF materials
Not exposed 47 19.1 21.3 12.8 12.8 6.4 0.0 6.4 4.3 2.1 0.0 10.6
Exposed to 1 25 24.0 12.0 12.0 4.0 12.0 3.0 0.0 0.0 0.0 8.0 12.0
Exposed to 2 26 34.6 11.5 11.5 0.0 11.5 3.8 3.8 3.8 7.7 0.0 11.5
Exposed to 3 40 32.5 15.0 12.5 7.5 2.5 5.0 2.5 2.5 2.5 2.5 12.5
All respondents 138 26.8 15.9 12.3 7.2 7.2 4.3 3.6 2.9 2.9 2.2 11.6

Note: Fewer than 1 percent of respondents said another contraceptive was used.
* Means percentages not calculated due to small sample sizes
Straight Talk: Full Report

A relatively high proportion of those saying they were exposed to two or three STF products report
not knowing about condoms (35 percent and 33 percent, respectively). STF, moving cautiously during
the recent debate about the ―Abstain, Be Faithful, Use Condoms‖ campaign in Uganda, has
downplayed discussion of condoms in the past few years, but it is somewhat surprising to see this
finding among sexually active youth. Cost, partner’s objection, and dislike of condoms were
mentioned only infrequently. No one mentioned that condoms were embarrassing or for promiscuous
people.

Reasons for Never Having Had Sex

Those who have never had sex were asked the main reason they had not done so, and the results are
presented in Table 33. The data show that fear of HIV is the most salient reason, with a clear
association with exposure to higher numbers of STF products as well as residence in high media
density districts. This is followed by ―not ready,‖ ―don’t want to,‖ and ―not interested,‖ reminding us
that many adolescents are self-aware and able to monitor their sexual maturation responsibly. The risk
of pregnancy is lower priority, particularly for males; fewer than 2 percent cite this as a reason to
avoid sex, compared with 11 percent of females.
While it appears that exposure to more STF products is associated with smaller proportions of youth
saying they are not ready or do not want to have sex, this is partially due to the far larger share of the
total saying that they fear contracting HIV/AIDS. STF seems to have affected young people’s
awareness of the disease and their assessment of personal risk, allowing them to articulate this as a
specific concern shaping their decision to remain abstinent.

55
Table 33 Main reason for not having sex
n Fear Not Don‘t Finish Fear risk of No Fear Want to Advised Religious
HIV/STI ready want to education pregnancy interest parents‘ abstain against it beliefs
% % % first % % reaction until % %
% % marriage
%
Sex
Male 848 31.8 24.5 16.5 6.5 1.4 7.7 2.8 1.8 2.9 2.1
Female 890 26.7 20.4 17.1 8.2 10.6 4.5 3.0 3.1 1.7 2.2
School status
In school 1,508 29.4 23.1 16.4 8.1 5.5 5.8 3.1 2.3 2.3 1.9
Primary 1,223 26.9 25.8 18.4 6.8 4.0 6.1 3.3 2.0 2.3 1.9
Secondary 281 40.9 11.4 7.5 13.9 11.7 4.3 2.1 3.2 2.5 2.1
Out of school 184 29.9 17.9 17.9 2.7 8.7 8.7 2.7 3.3 2.2 3.8
Residence
Urban 420 31.7 19.8 13.3 9.3 8.6 5.0 2.9 2.4 2.6 2.1
Rural 1,318 28.5 23.3 17.9 6.8 5.3 6.4 3.0 2.5 2.2 2.2
District media

56
intensity
High intensity 1,178 34.9 21.3 13.8 9.2 5.5 5.1 2.6 2.5 1.9 1.7
Low intensity 560 17.3 24.8 23.0 3.6 7.3 8.0 3.6 2.5 3.2 3.2
Exposure to STF
materials
Not exposed 529 14.7 31.0 23.4 3.0 5.3 7.6 3.2 0.9 4.0 2.6
Exposed to 1 391 31.2 18.9 19.2 7.4 4.6 5.6 3.8 3.3 0.5 3.1
Exposed to 2 354 36.2 20.6 14.7 6.8 6.2 4.5 3.4 2.8 2.8 0.8
Exposed to 3 464 38.8 17.0 8.8 12.7 8.2 5.8 1.5 3.2 1.5 1.9
All respondents 1,765 29.2 22.4 16.8 7.4 6.1 6.0 2.9 2.5 2.3 2.2

Note: Among other responses, 1 percent or fewer reported that they were still young, no one had asked them to have sex, or they were far from their partner
Straight Talk: Full Report

HIV Testing

Assured that the interviewer did not want to know the results, all respondents, regardless their sexual
activity status, were asked whether they had been tested for HIV/AIDS. Sexually active respondents
were also asked whether their most recent partner had been tested. Among the total sample, 7 percent
reported having been tested (see Table 34). There are large differences by residence and by age, with
urban and older youth more likely to have been tested. Among the sexually active young people, 17
percent had been tested, with more girls than boys reporting being tested (22 percent vs. 14 percent).
About 18 percent of sexually active respondents also reported that their most recent partner had been
tested, 42 percent said s/he had not and 40 percent did not know. A higher proportion of sexually
active girls (24 percent) reported that their most recent partner had been tested compared to sexually
active boys (13 percent). Exposure to STF products was clearly associated with having been tested,
and with knowing whether a partner had been tested.

Table 34 Respondent or partner ever tested for HIV


n % ever tested Number % ever tested % say most recent
for HIV ever had for HIV among partner tested
(among all) sex ever had sex for HIV among
ever had sex
Sex
Male 993 7.5 154 14.3 13.4
Female 986 6.5 93 21.5 24.4
Age group
Males 10–14 482 2.5 27 0.0 8.0
Females 10–14 490 3.1 22 9.1 9.1
Males 15–19 511 12.1 127 17.3 14.5
Females 15–19 496 9.9 71 25.4 29.4
School status
In school 1,652 5.9 153 12.4 14.5
Primary 1,305 3.1 87 4.6 11.3
Secondary 343 16.9 56 23.4 16.4
Out of school 276 13.8 94 24.5 22.9
Residence
Urban 491 12.6 75 28.0 26.0
Rural 1,488 5.1 172 12.2 13.8
District media
intensity
High intensity 1,326 7.8 157 19.8 21.9
Low intensity 653 5.2 90 12.2 10.5
Exposure to STF
materials
Not exposed 587 2.2 62 8.1 6.9
Exposed to 1 item 435 4.6 47 14.9 14.0
Exposed to 2 items 402 6.2 49 20.4 20.8
Exposed to 3 items 555 14.4 89 22.5 25.3
All respondents^ 1,979^ 7.0 247¥ 17.0∞ 17.7

^Data missing for 61 respondents (3 percent); ¥Data missing for one respondent; ∞Data missing for 15 respondents (6 percent)

57
Impact of Straight Talk Activities:
Findings of Multivariate Analysis

Odds Ratio of Outcomes

The main objective of this research was to document the impact of STF activities on adolescent
reproductive health knowledge, attitudes, and behaviors. Because these outcomes can be explained by
many other factors, it was necessary to conduct multivariate analysis which allows for the control of
these factors. The variables used in the multivariate analysis are defined and explained in Appendix 2,
and the results of the multivariate analysis is presented in Tables 35 and 36, and summarized in Table
37. The measure of impact is the odds ratio, which was described in the methodology section of this
report. The results are controlled for the effects of the following variables: age (continuous variable in
years), access to radio (listens 0–3 days vs. 4–7 days), residence (urban vs. rural), living arrangements
(both parents vs. either parent vs. neither parent), schooling status (in school vs. out of school), and
sex (male or female where not self-adjusting).

The data suggest that exposure to STF materials is associated with several desirable outcomes, when
controlled for basic demographic characteristics as well as other mediating variables. The data also
show that the strength of the associations may differ by gender.

Knowledge

Greater exposure to STF products is significantly associated with higher ASRH knowledge, and each
incremental exposure is associated with increased knowledge. Adolescents who are exposed to two
items are 2.15 times more likely to score higher on the knowledge scale than those who are not
exposed, and those exposed to all three items examined are 2.72 times more likely to have higher
knowledge than their unexposed counterparts (see Table 35). The same pattern is observed by gender:
males exposed to more STF items are more likely to score highest on the knowledge scale, and those
exposed to all three STF items are three times more likely to have higher knowledge than those who
are not exposed to any items. Likewise, females who are exposed to all three STF items are 2.7 times
more likely to have higher knowledge than their unexposed counterparts.

Attitudes toward condoms

Exposure to ST is also associated with holding positive attitudes toward condoms, with adolescents
exposed to all three items being the most likely to hold positive values. This pattern holds among both
males and females.

58
Straight Talk: Full Report

Table 35 Adjusted odds ratio of specified outcome by exposure to STF materials


Outcome variable Males Females All
High level of ASRH knowledge^
Not exposed to any ST items 1.00 1.00 1.00
Exposed to 1 item 2.38* 1.44* 1.85*
Exposed to 2 items 2.78* 1.63* 2.15*
Exposed to 3 items 3.08* 2.46* 2.72*
n 1,021 1,019 2,040
Positive attitudes toward condoms^
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 2.21* 2.09* 2.16*
Exposed to 2 items 2.31* 2.22* 2.28*
Exposed to 3 items 3.14* 3.12* 3.15*
n 1,021 1,019 2,040
Attitudes toward gender^
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 1.46* 1.51* 1.51
Exposed to 2 items 1.23 1.63* 1.44
Exposed to 3 items 1.37 1.73* 1.59
n 1,021 1,019 2,040
Strong self confidence
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 0.96 1.31 1.15
Exposed to 2 items 0.93 2.11* 1.42*
Exposed to 3 items 1.03 2.15* 1.53*
n 1,021 1,019 2,040
Has ever talked to parents about RH
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 1.52 2.32* 1.90*
Exposed to 2 items 3.33* 2.67* 3.02*
Exposed to 3 items 4.25* 4.03* 4.13*
n 1,021 1,019 2,040
Been tested for HIV
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 2.37 0.94 1.44
Exposed to 2 items 2.75 1.22 1.77
Exposed to 3 items 3.98* 3.48* 3.41*
n 978 986 1,964
Has a boyfriend or girlfriend
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 0.52* 1.88* 1.01
Exposed to 2 items 0.85 1.74 1.22
Exposed to 3 items 1.23 3.50* 2.01*
n 1,014 1,011 2,025

^Adjusted for age (continuous variable in years), access to radio (listens 0–3 days vs. 4–7 days), residence (urban vs. rural),
living arrangements (both parents vs. either parent vs. neither parent), schooling status (in school vs. out of school), and sex
(male or female; for last column).
* Odds ratio statistically significant at p≤ 0.05

59
Attitudes toward gender

While ST exposure is associated with favorable gender attitudes among females, the pattern is not as
clear among males. Each incremental exposure to STF materials among females is significantly
associated with greater likelihood of scoring higher on the gender scale. Among males, the pattern is
in the desired direction but only exposure to one item is significantly associated with positive gender
attitudes.

Self confidence

Adolescents who are exposed to two or three STF items are significantly more likely to report higher
self confidence than those who are not exposed to any item. For example, those who are exposed to
two items are 1.42 times more likely to express positive self confidence while those exposed to three
items are 1.53 more times more likely to express positive self confidence. Gender analysis shows that
the pattern is particularly strong for girls but non-directional for boys.

Communication with parents/guardians about ASRH

ST exposure is significantly associated with ever having talked with parents about ASRH matters, and
the pattern is stronger for girls. Girls exposed to one item are 2.32 times more likely to have ever
talked with a parent or guardian, those exposed to two items slightly more likely (2.67 times) to have
done so, but those exposed to three items are most likely (4.03 times) to have ever talked with parents.
For males, the pattern is in the desired direction but significance is not achieved until exposure to two
or more items.

HIV testing

Adolescents who are exposed to STF activities are more likely to have ever been tested for HIV than
those who have never been exposed, and this is particularly significant for those exposed to all three
STF items examined. Males exposed to all three items are 3.98 times more likely to have been ever
tested for HIV, and females are 3.48 more likely.

Ever having a boyfriend/girlfriend

Exposure to STF materials does not seem to be associated with whether males have a girlfriend, but
appears to be slightly associated with whether females have a boyfriend. Thus STF materials appear
to be consumed by a cross-section of adolescents, including those in a relationship and those not
involved in one.

Ever having had sex

STF materials appear to be associated with a lower likelihood of ever having had sex among males,
but the pattern among females is not statistically significant. For example, males exposed to one STF
item are only 0.39 times as likely to have ever had sex compared to other males who have not
exposed, those exposed to two items are only 0.50 times as likely, and those exposed to all three items
are also only 0.39 times as likely. Among females, there is no association between ST exposure and

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Straight Talk: Full Report

sexual behavior; females exposed to ST are no more or less likely to engage in sexual activity than
their unexposed counterparts. This could be a reflection that females are generally sexually
conservative and are less likely to have engaged in sex, and so may have nothing to change. However,
because males are more likely to be sexually active, ST messages about abstinence may resonate with
them and they may be able to do something about it. In addition, the small sample size among females
may make it difficult to discern a clear pattern while the larger male sample size may make the pattern
easier to discern.

Use of condoms at last sex

Sexually active adolescents appear incrementally more likely to use condoms at last sex if they are
exposed to ST materials, though the pattern is not statistically significant.

Practicing secondary abstinence

The data suggest that once sexually active, males who are exposed to STF activities are more likely to
resume abstinence—for example, males exposed to two items are 3.57 times more likely to be
secondary virgins compared to unexposed males, and those exposed to all three items are 2.94 times
more likely to resume abstinence. This pattern is not as evident among females, in part because of the
small sample of sexually active females.

Seriousness of relationship

Males exposed to ST are significantly more likely to consider their present sexual relationships
serious, with marital aspirations, compared to those who are not exposed. Indeed adolescents exposed
to all three items are 20 times more likely to consider this relationship serious. This suggests less
casual sexual involvement among males exposed to STF activities compared to their unexposed
counterparts. On the other hand, the pattern for females is not as clear, in part because females in
general consider relationships serious and thus exposure to STF may not alter that anticipation.

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Table 36 Adjusted odds of safer sexual behavior by exposure to STF materials
Outcome variable Males Females All
Ever had sex

Not exposed to any STF items^ 1.00 1.00 1.00
Exposed to 1 item 0.39* 1.10 0.62
Exposed to 2 items 0.50* 0.81 0.64
Exposed to 3 items 0.39* 1.45 0.66
n 1,019 1,018 2,037
,¥,∞
Used condoms at last sex^
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 1.01 1.81 1.29
Exposed to 2 items 1.22 1.95 1.08
Exposed to 3 items 1.80 1.84 1.29
n 152 92 244
,¥,∞
Practicing secondary abstinence^
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 1.35 0.27 0.82
Exposed to 2 items 3.57* 0.27 2.17
Exposed to 3 items 2.94* 0.78 2.16
n 145 82 227
,¥,∞
Considers current sexual partner serious^
Not exposed to any STF items 1.00 1.00 1.00
Exposed to 1 item 4.14 0.41 1.07
Exposed to 2 items 6.54* 1.20* 1.81
Exposed to 3 items 20.18* 0.78* 3.04*
n 155 93 248

^Adjusted for age (continuous variable in years), access to radio (listens 0–3 days vs. 4–7 days), residence (urban vs. rural),
living arrangements (both parents vs. either parent vs. neither parent), schooling status (in school and out of school), and sex
(for last column).
¥
Adjusted for the above items as well as knowledge (0 = low, 1 = higher), attitudes toward gender (0 = negative, 1 = positive),
self confidence (0 = low confidence, 1 = higher confidence), and attitudes toward condoms (0 = negative attitudes, 1 = positive
attitudes), except when these are the outcome variables

Among those ever had sex (n = 248)
*p ≤ 0.05

Summary

In summary, exposure to STF materials is associated with certain positive outcomes in both males and
females, in certain positive outcomes among males alone, and others in females alone. It appears that
exposure to STF activities is significantly associated with positive outcomes with respect to
knowledge, attitudes toward condoms, parent-child communication, and awareness of one’s HIV
status, as summarized below.

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Straight Talk: Full Report

Table 37 Summary of outcomes by exposure to Straight Talk Foundation materials


Outcome Males Females
Greater knowledge + +
Positive attitudes toward condoms + +
Have talked to parents + +
Have taken HIV test + but only at 3 STF items + but only at 3 STF items
Have ever had sex – No difference
Now practicing secondary abstinence + No difference
Considers current sexual relationship serious + No difference
Greater self confidence No difference +
Positive gender equity attitudes No difference +
Have ever had a boyfriend/girlfriend No difference +
Used condoms at last sex No difference No difference

+ Indicates positive association between exposure and behavior


- Indicates negative association between exposure and behavior

Exposure to STF materials also appears to be associated with less likelihood of sexual activity among
males but not females, with a greater likelihood of secondary virginity among sexually experienced
males (but not females), and less likelihood of casual relationship among males (but not females).
These relationships are statistically significant.

On the other hand, exposure is associated with greater self confidence among females (but not males),
positive attitudes toward gender equity among females (but not males), and greater likelihood that a
female has ever had a boyfriend (but no impact on males).

Exposure is marginally associated with a greater likelihood of using a condom at last sex, but this
pattern does not achieve statistical significance (possibly because of the very small sample size).

It appears that exposure to STF materials is strongly correlated with positive outcomes when those
outcomes pertain to the respondent alone (e.g., knowledge, attitudes). But the impact is less when
others are involved (e.g., parents in parent-child communication, HIV testing, condom use).

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Conclusions

The findings of the bivariate and multivariate analysis demonstrate that Straight Talk Foundation has
served as an important influence on the reproductive knowledge, attitudes, and behaviors of Ugandan
adolescents exposed to its activities. There are different effects for males and females; these
differences can be used to inform future topics for publication or radio broadcast, as well as refining
the approaches used to target each sex with specific messages.

This chapter summarizes the key findings of the both analyses, and offers some interpretation of
findings.

Sources of Information

Parents

When compared to other individuals such as teachers and health workers, parents emerge as the most
important, and frequently the most preferred, source of information among young people, even while
youth simultaneously question their ability to provide accurate information. While nearly half of the
respondents report speaking to their parents about sexuality, growing up, or relationships between
boys and girls (particularly among girls and secondary students), few have great confidence that
parents are able to answer their questions. Nevertheless, among those speaking with their parents,
virtually all believe the discussions are helpful.

Controlling for demographic factors, multivariate analysis showed that exposure to STF materials was
significantly associated with ever having talked with parents about ASRH matters for both male and
female adolescents. Incremental exposure to STF materials was associated with an incremental
likelihood of having talked with parents, and at the highest level of exposure, both male and female
adolescents were four times as likely to have talked with their parents, compared to those who had not
been exposed. Finding ways to bridge the communication gap between children and parents is crucial,
more so during adolescence. Parents can have a chance to help their children set clear rules, talk about
what is right and wrong, delay sexual debut and provide a much-needed source of support during
these complex and vulnerable years. Therefore the association between exposure to STF materials and
parent-child communication is a welcome finding. At the same time, the finding that half the
adolescents have not spoken to parents suggests that more effort in this regard is needed. The STF
materials can be important vehicles through which to model good parent-child communication, to
provide accurate and age-appropriate information to parents, and to encourage both sides to reach out
to each other. The finding that fathers are rather distantly involved in communication with their
children, even though their sons and daughters (especially their sons) consider them a most important
source of information in the family, suggests that fathers could benefit from additional outreach.

Schools and teachers

As exposure to STF materials increases, higher proportions of young people mention teachers as
important information sources. Indeed school is by far the most commonly cited place to obtain
information about ASRH, when compared to other sources such as home, health facility, or church.
School is mentioned as the most important place by 40 percent of respondents, distantly followed by
health facility, home, and church. Not surprisingly, the exception to this pattern is out-of-school
respondents, among whom only 15 percent mention school. Teachers are particularly mentioned as

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important sources of information for males, even as they are less significant for females. These
findings therefore endorse schools as an important and salient location for ASRH education. STF
newspapers are directly mailed to schools, and this is an efficient way to reach the primary audience.
While not directly evaluated in this study, the STF newspaper Teacher Talk provides useful tips to
help teachers create a healthy and nurturing environment for students. (A more detailed evaluation of
STF’s efforts with teachers and the school environment is available on request from the authors of the
present report.) STF should continue its school-based efforts, and should continue strengthening the
responsiveness of schools to ASRH issues.

Use of Straight Talk Foundation Materials

STF materials are designed to be audience-specific, with YT newspaper aimed at primary schools, ST
newspaper at secondary schools, and ST radio at older adolescents including those who are out of
school and those who cannot read. The survey shows that STF materials have reached 70 percent of
all adolescents in the study, including virtually all secondary and two thirds of primary school
students, as well as 56 percent of out-of-school youth. About 84 percent of adolescents in high-
intensity districts have used at least one STF product, as have 42 percent of those in low-intensity
districts. The main difference between high intensity and low intensity districts is the presence of
local radio programs, and occasionally, local language newspapers. The fact that introduction of local
language materials doubles exposure supports the value of vernacular communication materials in a
multi-lingual environment like Uganda.

The most commonly-used STF product was the ST radio program, which had been listened to by 55
percent of all adolescents, but by 76 percent of those in the high-intensity districts. In comparison,
only 13 percent of respondents from low-intensity districts had listened to ST radio. The second most
utilized STF product was YT newspaper, which had been read by 49 percent of the study respondents,
including 53 percent in high intensity and 35 percent in low-intensity districts. However, among those
who had completed primary school and entered secondary school, 85 percent had read YT. The third
most utilized STF product was ST newspaper, which had been read by 39 percent of the study sample
including 45 percent of high-intensity and 25 percent of low-intensity district respondents. Among
secondary school respondents, 90 percent had read it.

ST materials were perceived as strongly supportive of abstinence, with 60 percent of exposed


adolescents reporting that this was the main message they had obtained from them. When asked what
they did as a result of exposure to STF products, 57 percent of boys and 64 percent of girls reported
taking some action, most commonly ―continuing to abstain.‖

Most Important Among Sources of Information

The study explored three main sources of ASRH information for adolescents: individuals (such as
parents and teachers), any radio programs, or any print materials. Respondents were asked to rank
which one they considered most significant of the three sources. The results show that individuals
were most preferred, followed by radio, then newspapers. Girls of all ages preferred individuals far
more than males, who cite individuals, print media, and radio in nearly equal shares. Primary students
and out-of-school youth prefer obtaining information from individuals; this may reflect limited
literacy, limited sexual experience spurring information needs, or less access to media.

65
About one in eight primary students and out-of-school youth are also likely to report not knowing any
important source of ASRH information. While it is unlikely that universal knowledge will ever be
achieved, this level may still be reduced by continued efforts to reach these marginalized groups.

Straight Talk Messages

STF materials were perceived as strongly supportive of abstinence. Adolescents who had used any
STF products were asked what they had learned from them. The most common response was
abstinence, reported by 60 percent of respondents. This was followed by delay of sex (11 percent) and
by HIV prevention (10 percent). There are only minor differences in the key messages by age or
gender groups.

When asked what they did as a result of exposure to STF products, 57 percent of boys and 64 percent
of girls reported taking some action, most commonly ―continuing to abstain.‖ There is little variation
by age or level of exposure. However, it is difficult to know, without further probing, whether these
young people made a conscious and active effort to abstain when confronted with the possibility of
engaging in intercourse, or whether they abstained because they had no temptation to do otherwise.

ASRH Knowledge

Greater exposure to STF activities is significantly associated with higher ASRH knowledge, and each
incremental exposure is associated with increased knowledge; this relationship holds for both males
and females.

Despite years of intense media coverage and community dialogue about HIV/AIDS in Uganda, there
remains room for improvement in AIDS and reproductive health knowledge among young people.
While it is unlikely that knowledge will ever become universal, continued efforts need to be directed,
for example, to reducing the number of youth who believe AIDS can be cured. Knowing that a person
who looks healthy may be infected, and that a mother can pass the AIDS virus to her unborn child,
increases substantially with exposure to any STF product. Urban residents are more knowledgeable
than rural counterparts. Nevertheless, a large proportion of adolescents remain uninformed about HIV.

More so than informing youth about the risks of HIV/AIDS, discussed in multiple media and venues
across the country by any number of respected sources, there is a need to alert young people to basic
sexual risks. More than half the group surveyed believes a girl cannot become pregnant the first time
she has sex, and fewer than half understand that pregnancy can occur if a girl is standing during sex.
Four in ten youth do not believe condoms are effective against STIs.

ASRH Attitudes

Exposure to ST media generally is associated with a more balanced perspective on ASRH attitudes,
believing for example that girls in school are less likely to become pregnant, that condom use does not
imply partner mistrust, that buying condoms is a male responsibility, and that girls who carry
condoms are loose. Adolescents, both male and female, exposed to all three STF items are the most
likely to hold positive values toward condoms. However, even those exposed to the most STF
materials maintain some concerns about condom use.

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Straight Talk: Full Report

Gender Attitudes

Gender attitudes are in transition in Uganda. Sizeable minorities of both boys and girls believe that
boys should benefit when family resources are scarce. Nearly half of the boys and a third of the girls
believe men are responsible for the final say about having sex. Half the respondents believe that
women occasionally deserve to be beaten, and nearly 60 percent said that women should tolerate
abuse in order to keep the family together. ST exposure is associated with favorable gender attitudes
among females, but the pattern is not as clear among males.

As mentioned earlier, Straight Talk only recently introduced features that explore gender issues
explicitly. The widespread tolerance of abuse and female inferiority needs to be addressed openly and
dispassionately to change persistent gender stereotypes.

Self Efficacy and Self Confidence

The majority of young people feel happy the way they are, although many lack confidence in their
position in the household or in school. A third of the adolescents feel that their friends are better than
they are, but most feel they are as skilled as others their age. About a third of the respondents doubt
they have a bright future, particularly among those who are out of school or live in rural districts.
More probing data collection is needed in order to determine whether these self-doubts reflect
subjective feelings of inadequacy, or accurate perceptions of skills, intelligence, relative wealth, or
other factors that shape young people’s environment.

Adolescents, particularly girls, who are exposed to two or three STF items, are significantly more
likely to report higher self confidence than those who are not exposed to any item. Thus STF is
improving the self-assuredness of many young women in Uganda, an attribute that is likely to enable
resilience in other aspects of their lives.

Knowledge of STIs

The STF products seem to have been particularly effective on the topic of STIs, this topic, as a higher
proportion of those living in high media intensity districts, and those exposed to higher numbers of
STF materials, are more likely than their counterparts to know about other STIs. Males, urban
residents, and those in school (all associated with higher exposure to ST) are most likely to know that
other diseases besides HIV/AIDS are transmitted through sexual intercourse.

Use of Health Facility Services

About 20 percent of the 15 to 19 year old respondents had visited a health facility for contraceptives,
pregnancy tests, or voluntary counseling and testing for HIV/AIDS; most used public facilities. Those
in urban areas and those with high exposure to STF products were more likely than their counterparts
to visit a facility, probably due to the accessibility of services in urban areas and the emphasis by ST
on encouraging health-seeking behavior.

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Support if Child Sexual Abuse Attempted

Most young people say they have someone to tell if they were pressured to have sex. Living in high
media intensity districts and exposure to more STF materials is associated with higher proportions
reporting someone to tell, indicating that messages about turning to a trusted adult, in most cases
identified by the adolescents as a parent, are being heard and accepted. Girls seem to feel more
confident that they can tell someone about abuse, and those exposed to STF products were more
confident than those not exposed. Fewer young boys report having someone to tell about abuse; they
are also the group least likely to express confidence in telling someone about it. This may suggest an
area that should be addressed; while efforts have focused on girls, there may be a need to turn
attention to the youngest boys.

Sexual Activity Among Adolescents

About a quarter of the respondents reported that they have a boyfriend or girlfriend; most were among
the older youth. Those reporting more exposure to STF materials and those living in high media
density districts are somewhat more likely to report having a boyfriend or girlfriend; the multivariate
analysis found little association among males and a slight association for girls. The association may
also be confounded by residence in urban areas, with its greater opportunities for boys and girls to
meet, mix, and spend time together.

Fifteen percent of boys and 9 percent of girls had ever had sex. As has been demonstrated in other
countries, school attendance appears to exert a protective effect, with three times more out of school
youth reporting sexual activity compared with those in school. The bivariate analysis shows that
greater exposure to the STF program is associated with a small increase in sexual activity, but this is
not borne out statistically in the multivariate analysis; indeed exposure to STF appears to be
associated with a lower likelihood of ever having had sex among males, but the pattern among
females is not statistically significant.

Nearly half the sexually active adolescents commenced their sexual careers out of love, followed by
curiosity. However, nearly one in five sexually active females was ―forced‖ into sex, indicating that
sexual coercion is a real risk for HIV in the study population. It means that the efforts STF is making
to empower females while instilling responsibility among males should be continued and
strengthened. It also suggests that sexual debut among many adolescent females presents a very real
threat for HIV.

Half of the sexually active boys and nearly two-thirds of sexually active girls have had only one
partner. More youth living in high media density districts report having only one lifetime partner,
indicating that they may be responding to safer sex messages to be monogamous if they are sexually
active. Males with greater exposure to STF products were more likely to report no partners in the
prior 12 months, suggesting that they are influenced to resume secondary abstinence. This means that
STF activities have contributed to significant proportions of youth who are now not being exposed to
heterosexual transmission of HIV.

About 30 percent of the adolescents have received gifts for sex during the prior year (nearly equal
proportions of boys and girls). However, boys were four times more likely to report having given a
gift for sex. Twice as many out-of-school youth report giving or receiving a gift or money for sex. It
seems that transactional sexual exchange is an important strategy among those out of school.
Exposure to STF media appears to reduce the acceptability of transactional exchanges.

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While 41 percent of sexually active youth have ―no plans‖ with their most recent partner, more than a
quarter plan to marry theirs, with higher proportions of older youth, those in secondary school, and
those out of school saying this. Given that greater exposure to STF products is associated with higher
percentages reporting planning to marry, particularly among males, it is possible that these youth are
adopting norms of fidelity promoted through STF as well as other sources in Uganda’s comprehensive
HIV/AIDS prevention campaign. Those with less exposure are twice as likely to say they are simply
friends with their partner. Higher exposure to STF products is also associated with current partner
being a student, perhaps in response to STF media advice to avoid ―sugar daddies‖ and ―sugar
mommies.‖ All these factors contribute to reducing HIV risk among Ugandan adolescents.

Condom Use at Last Sex

While STF has considered whether to limit discussion of condom-related topics in its materials, it
appears that exposure to STF products is associated with some increase in condom use, but the
relationship is not statistically significant, largely due to the small sample size limiting statistical
analysis. Half of the girls and 41 percent of boys report having used condoms at their last intercourse.
While two-thirds of the boys report being responsible for using condoms, more than half the girls
report taking the initiative to use them.

Reasons for Never Having Sex

Fear of HIV is the most pronounced reason for never having had sex, but this needs to be considered
in the context that many of these young people have not yet had an opportunity to be sexually active.
Protective messages may have been absorbed and acted upon, but it is also likely that many of these
young people have not yet found themselves in a situation to make the choice to advance or delay
their sexual debut. The sizeable proportion saying they ―are not ready,‖ ―don’t want to,‖ or ―are not
interested‖ underscores the reality that many young people monitor their sexual maturation
responsibly.
While it appears that exposure to more STF products is associated with smaller proportions of youth
saying they are not ready or do not want to have sex, this is partially due to the far larger share of the
total saying that they fear contracting HIV/AIDS. STF seems to have affected young people’s
awareness of the disease and their assessment of personal risk, allowing them to articulate this as a
specific concern shaping their decision to remain abstinent.

HIV Testing

Seven percent of the full sample and 17 percent of the sexually active participants had been tested for
HIV. Urban and older youth were more likely to have been tested (they are also those most likely to
be sexually active, so this is not surprising). Exposure to STF materials was clearly associated with
having been tested (especially among those exposed to all three STF products), and with knowing
whether a partner had been tested. Indeed multivariate analysis shows that respondents exposed to all
three STF items were more than three times as likely to have been tested for HIV themselves.

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References

Grunseit and Kippax. 1993. Effects of Sex Education on Young People's Sexual Behavior. Geneva:
World Health Organization, p. 5–6.

Hosmer, D. W. and S. Lemeshow. 2000. Applied Logistic Regression. New York: John Wiley and
Sons Inc.

Kirungi, W. L. et al. 2006. ―Trends in antenatal HIV prevalence in urban Uganda associated with
uptake of preventive sexual behaviours,‖ Sexually Transmitted Infections 82(Suppl 1): 36–41.

Ministry of Health (MOH) [Uganda] and ORC Macro. 2006. Uganda HIV/AIDS Sero-behavioural
Survey 2004–2005. Calverton, Maryland, USA: Ministry of Health and ORC Macro.

Neema, S. et al. 2006. ―Adolescent sexual and reproductive health in Uganda: results from the 2004
Uganda national survey of adolescents,‖ occasional report no. 25. New York: Guttmacher Institute.

Statistics Department [Uganda] and Macro International Inc. 1996. Uganda Demographic and Health
Survey 1995. Calverton, Maryland, USA: Statistics Department and Macro International Inc.

Uganda Bureau of Statistics (UBOS). 2005. "The 2002 Uganda population and housing census—Main
report", March 2005, Kampala, Uganda.

Uganda Bureau of Statistics (UBOS) and ORC Macro. 2001. Uganda Demographic and Health
Survey 2000–2001. Calverton, Maryland, USA: Uganda Bureau of Statistics and ORC Macro.

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Appendix 1
Sample Design

The community-based survey targeted about 2,100 adolescents ages 10 to 19 years in six districts,
namely Apac, Arua, Ntungamo, Kamuli, Kisoro, and Soroti. These districts were selected to provide a
diverse geographic distribution of STF activities, including sites where activities have not been
implemented as intensely. The sample size was calculated to enable an estimation of several
indicators with 95 percent confidence and 80 percent power. It also accommodates a 15 percent non-
response rate, and a 35 percent cluster effects cushion.9 The calculated sample size is 342 households
per district, translating into a total of 2,052 households in the survey. In these households, 2,052
interviews were to be conducted with adolescents, and 512 with parents.

Sample Frame

In Uganda, there are about 70 administrative districts, and each district is divided into a county, sub-
county, and parish. On average, each of the districts selected for the survey has 4–7 counties, and each
county can have anywhere from 2–10 sub-counties. The population in each sub-county varies, but can
be anywhere from 15,000–50,000 individuals. In each participating district, two counties were for
data collection, and within each county, two sub-counties and two parishes each were selected. Thus a
total of 12 counties, 24 sub-counties, and 48 parishes participated in the survey.

The Uganda Bureau of Statistics (UBOS) has divided each parish into an enumeration area (EA). The
UBOS also has a list of all households in Uganda, and is the basis on which national samples such as
the UDHS sample are drawn. A recent household survey of adolescents conducted by ORC/Macro
and Alan Guttmacher Institute (AGI) also used the UBOS household list. The STF Survey drew from
the same UBOS sample.

2,052 households were selected across the six districts, translating into 342 households per district and
171 households per county. Because the survey did not purport to provide district estimates, the
interviews were distributed evenly across the districts, and no proportionate allocations were
attempted. The sample was drawn in a way to accommodate refusals and not-at-homes. Thus an
additional 20 percent of households per district were listed to provide a back-up where an interview
was not possible.

Selection of Respondents

In each household, one eligible adolescent was identified. If there was more than one eligible
adolescent, a table of random numbers was used to identify the one to be interviewed. Where the
adolescent was a minor (i.e., under 18 years of age), parental consent was sought to interview him/her.
Informed consent of the minor was also sought, even if parental/guardian consent was obtained. When
an interview was declined by either the parent/guardian or by the adolescent, a household from the
back-up sample was identified. As is the standard practice with the UDHS, visiting adolescents were
eligible if they spent the prior night at the household. Also, like the UDHS, households headed by

9
The variables used to calculate the sample size were: a) How to avoid HIV (18 percent); b) Discussion of abstinence (17
percent); c) discussion of condoms (24 percent); d) Any exposure to ST activities (94 percent); and e) Discussion of
condoms (30 percent). The calculation yielded a sample size of 512 per unit (in this case, per district). Using this sample
enables estimation of the other variables within the desired confidence and power.

71
children under the age of 18 were excluded in the sample, because parental consent cannot be
obtained. The study excluded married adolescents.

Efforts were made to interview a male or female adolescent in alternate households, in order to
produce as close to a 50/50 split as possible. In cases in which a back-up household was selected, the
gender of the original respondent sought was maintained. The task assignments were such that same-
sex interviews were conducted; i.e., male interviewers interviewed male respondents and female
interviewers interviewed female respondents.

In 25 percent of the households, interviews of both a parent and an adolescent were conducted. Efforts
were made to interview an equal number of mothers and fathers. A total of 368 mothers and 368
fathers are included in the sample.

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Straight Talk: Full Report

Appendix 2
Variable Definitions

Variable Definition
ST exposure 0 = not exposed to any ST items; 1 = exposed to 1 item; 2 = exposed to 2 items; 3
= exposed to all 3 items assessed

Age Q103
Age in years (continuous variable)

Radio Q301:
Listens 0–3 times versus 4+ times a week

Location Currently residing in an urban (1) or rural (2) area (generated from sampling and
household listing process)

Living arrangements with parents Q1001:


Currently lives with both parents vs. lives with one vs. lives with none

Schooling status Q110:


Currently enrolled vs. currently not enrolled in a school

Knowledge Q600
1. A girl cannot get pregnant the first time she has sex.
2. A girl cannot get pregnant if she has sex standing up.
3. A person who looks healthy can be infected with the AIDS virus
4. It is possible to cure AIDS.
5. The AIDS virus can be passed from a pregnant mother, if she is
infected, to her unborn child.
Correct answer scored 1 point, range of scores: 0–5 points
Dichotomized: 0–3 = low knowledge, 4–5 = high knowledge

Attitudes toward gender Q900:


1. When money is scarce and the family cannot send all children to
school, boys should be sent before girls.
2. It is OK for boys to have sex before getting married.
3. It is OK for girls to have sex before marriage.
4. Girls are generally not as intelligent as boys.
5. A woman should tolerate abuse from her husband in order to keep her
family together.
6. When it comes to sex, it is the man who should have the final word.
7. There are times when women deserve to be beaten by their husbands.
8. A girl who becomes pregnant while in school should be expelled.
9. Boys who have many girlfriends are “powerful.”
10. A schoolboy who makes a schoolgirl pregnant while he is in school
should be expelled.
Desired response scored 1 point; range of points: 0–10 points
Dichotomized: 0–4 = negative attitudes, 5–10 = positive attitudes

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Attitudes toward condoms Q600:
1. Condoms are an effective way of protecting against sexually transmitted
infections if used properly.
2. Girls who carry condoms are loose.
3. Buying a condom is the responsibility of males only.
4. Using a condom is a sign that your partner does not trust you
Desired response scored 1 point; range of points: 0–4 points
Dichotomized: 0–1 = negative attitudes, 2–4 = positive attitudes

Parent-child communication Q1004: Has any of your parents/guardians ever talked to you about issues related
to sexuality, growing up, relationships between boys and girls etc.?
Yes-no response

Self confidence Q1100


1. I am happy the way I am.
2. I don’t feel I am as important to my family as other family members.
3. I feel that most of my friends are better than me.
4. I feel that I can do things as well as most people my age.
5. I do not feel like I have a bright future.
6. FOR GIRLS: I wish I was born as a boy instead of a girl; FOR BOYS: I
wish I was born a girl instead of a boy.
7. I am sure that I can say “no” to sex if I don’t want it.
Desired response scored 1 point, range of points = 0–8
Dichotomized: 0–4 = low self esteem, 5–8 = high self esteem

Awareness of one’s HIV status Q1500: We do not want to know your results but have you been tested for HIV?
Yes-no response

Having a girlfriend or a boyfriend Q1414: Have you ever had a girlfriend (for males)/boyfriend (for females)?
Yes-no response

Sexually experienced Q1415: Have you ever had sex?


Yes-no response

Now practicing secondary virginity Q1421:


Referring just to the past 12 months, how many times have you had sex?
Secondary virgins defined as those who responded “zero times.”

Used a condom at last sex Q1429:


The last time you had sex, was a condom used?
Yes-no response

Seriousness of relationship Q1426:


Thinking again about your last partner, what are your plans with him/her?
Options were: 1 = Plan to marry; 2 = We are dating; 3 = We are just friends; 4 =
We had just met; 5 = We already broke up; 6 = No plans at all; 7 = Don’t know/not
decided
Responses dichotomized as: Serious relationship = Plan to marry or dating;
Casual relationship = all the others.

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Straight Talk: Full Report

Appendix 3
Ugandan Adolescents in Context

The common image of Ugandan adolescents is of teenagers in uniform at a secondary school studying
en route to higher education. This was the audience Straight Talk began addressing by 1993. But in
fact, less than 10 percent of Ugandan adolescents resemble this image. There is a far more
demographically-correct image of Ugandan adolescent, which hinges upon age and gender.

Young Adolescents Ages 10 to 14 Years

At this age both boys and girls are overwhelmingly in school and on the surface their lives are not so
different. School enrollment is about equal, and few of either sex are married (less than 2 percent of
girls and 0.3 percent of boys) (UHSBS 2004–05).

Children of this age of both genders are unlikely to have started having sex. However, contrary to
common perceptions that girls start sex earlier, boys in this age group are twice as sexually active as
girls. In 2004–5 just 8.9 percent of girls ages 15 to 17 years had had sex before the age of 15
compared to 17.2 percent of boys (UHSBS 2004–05). This figure for girls is considerably lower that
that reported by the DHS 2000–01, a sign that girls have increasingly delayed sex. The DHS 2000–01
found that 14 percent of girls had had sex before the age of 15. Of this, 35 percent was marital and 64
percent was premarital.

Since the introduction of universal primary education in 1997, Uganda now has one of the highest
enrollments in Africa for this age group: 93 percent of girls and 98.5 percent of boys aged 10 to 14
years are in school. However, this positive fact conceals problems. Overcrowding, lack of school
feeding programs and a host of other challenges lead children to spend many years repeating classes.
Thirteen is the official age for going to secondary school, but less than 2 percent of adolescents
advance by that age. Most young adolescents are in primary classes meant for seven, eight, and nine
year olds, while older adolescents fill the higher primary classes. This has grave reproductive health
implications, including the age-appropriateness of the sex education that the different classes receive.

Despite the near equal enrollment, there are profound differences in what is expected of girls and boys
and what they achieve. Both have domestic obligations, but boys perform far better academically than
girls, an indication that they have fewer home duties and teachers and parents handle them differently.
Girls are kept close to home, are more socially connected, and receive more counsel from adults,
especially their mothers. Boys are allowed to adventure and wander and often have no close adult, and
in particular no close male figure.

About 75 percent of 10 to 14 year olds have both parents alive, but only half of rural children and a
third of urban children live with both of them. This parenting scenario resembles that in much of
Africa, and is better than in some countries. For young Ugandan adolescents, mothers are more
present than fathers: 62 percent of girls and 65 percent of boys ages 10–14 years live with their
mothers, but only 55 percent of girls and 58 percent of boys with their fathers. Many fathers work
away from home. Single, divorced, or widowed women head about a third of households. Sharing
children among relatives is also common in Uganda.

Parenting status has a strong bearing on sexual debut. In Uganda orphaned and vulnerable girls are 1.5
times as likely to have had sex before the age of 15 as non-OVC girls: 15 percent of orphaned girls

75
and 14 percent of OVC girls start sex before 15 compared to 9 percent of non-OVC girls. OVC boys
are 1.1 times more likely to start sex before the age of 15 than non-OVC boys (UHSBS 2004–05).

Parenting status also has a large impact on whether the child goes to school. Adolescents living with
neither parent are about twice as likely not to be in school as those living with both parents. About 25
percent of young adolescents do not live with either parent in Uganda (DHS 2000–01).

HIV prevalence in this age group for both genders is extremely low; of the little that there is, much is
probably due to vertical transmission from mother to infant.

However, girls who start sex before the age of 15 are more likely to have HIV later in life than those
who start sex later (although the benefit of delaying debut is eventually dampened by more recent
sexual behavior). In contrast, sex in early adolescence does not seem to raise risk of HIV infection in
males. In fact, infection is slightly higher in males who start sex later (see Table 3.1.

Table 3.1 HIV prevalence by age of first sex among women and men ages 15–49 years
who have ever had sex, 2004–5
Age at first sex Percentage HIV-positive Percentage HIV-positive
among women 15–49 among men 15–49
< 15 11.4 4.3
15–17 9.1 6.4
18–19 7.5 6.2
20+ 5.6 6.6

UHSBS 2004–05

Pregnancy in this age group is also unusual but does occur: 2.4 percent of girls gave birth before the
age of 15, according to the DHS 2000–01.

Older Adolescents Ages 15 to 19 Years

In this age group the lives of boys and girls start to rapidly diverge, until at the age of 19 they are
almost living in different universes:
Boys stay in school far longer, rarely marry in adolescence, have many years of premarital sex,
have extremely low rates of HIV prevalence, and put off parenthood into their twenties.
Girls fall out of school precipitously from the age of 16. They also become rapidly more sexually
active, with most of the sex in this age group occurring within marriage (see Table 3.2). By the
age of 18–19 years they are 18 times more likely to have HIV, eight times more likely to be
married and a quarter as likely to be in school as boys the same age.

At ages 15 and 16 years boys are more likely to have had sex than girls of 15 and 16, but at 17, 18,
and 19 girls overtake boys. By age 15, 81 percent of girls are abstaining compared to 76 percent of
boys. By age 16, 70 percent of girls are abstaining, 8 percent are having sex in marriage and 22
percent are having premarital sex. The comparable figures for boys of 16 are 67 percent abstaining,
0.6 percent married, and 32 percent having premarital sex.

This trend of increasing female sexual activity mostly in marriage and increasing male sexual activity
almost entirely outside marriage increases steadily. By age 19, 57 percent of girls are married while
59 percent of boys are having sex outside of marriage.

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Straight Talk: Full Report

The common belief in Uganda has been that girls are ―doing less well‖ than boys on reproductive
health. This originates with the concern that girls overall start sex earlier than boys and also from data
from successive DHS Surveys that show that boys have shifted their sexual debut upwards more than
girls. The DHS of 1995 gave age of first sex for boys as 17.5 years and that of 2000–01 as 18.8. The
figures for girls were 16.1 in 1995 and 16.7 in 2000–01.

However, the UHSBS shows that although boys do continue to start sex later than girls, there have
been more positive trends for girls and more worrying ones for boys:
The median age for first sex among women in the 20–24 age group was 17.1 years compared with
16.6 to 16.7 years for older women: this implies a ―recent increase in age at first sex,‖ says the
UHSBS, p.61.
The percentage of women who had sex by age 15 has decreased from 22 percent among women
now aged 45–49 to 12 percent among women aged 15–19 in 2004–05.
The proportion of girls aged 15–19 years that has never had sex increased from 38 percent in 1995
to 48 percent in 2000–01 to 54 percent in 2004–05.

In contrast, in some respects boys are not doing well at all:


The median age at first sex for boys has fallen from 18.8 in 2000–01 to 18.3 in 2004–05. Reports
that it was much lower in the 1980s seem not to be borne out by the UHSBS which shows that it
has been consistent at 18.3 to 18.5 for the last 20 years.
More boys are having sex by age 15: 11–12 percent among males aged 20–24 up to 16 percent
among boys ages 15–19 in 2004–05.
The proportion of boys who have never had sex shows no convincing trend. It was 53 percent in
1995, 61 percent in 2000–01, and 58 percent in 2004–05.

Boys also have twice as much higher-risk sex (defined in the UHSBS as sex with a non-cohabiting
partner) than girls. In 2004–05, 45 percent of girls ages 15–19 who had had sex in the previous 12
months had higher-risk sex compared to 92.3 percent of their male counterparts. This is largely
because girls are having sex in marriage (see Table 3.4). The median age of marriage for girls is just
under 18, just a few months after the age of first sex. For boys it is 22, almost four years after their
sexual debut.

On a more positive note, sex without a condom with a non-cohabiting partner decreased in both
females and males between 1995 and 2004–5.

77
Table 3.2 Percent distribution of sexual activity of females and males ages 15–19
years
Females
1995 2000 2005
% % %
High risk sex, no condom 9 8 2
High risk sex, used condom 2 8 1
Spousal sex, no condom 43 29 25
Spousal sex, used condom 1 1 9
Secondary abstinence 6 6 8
Primary abstinence 39 48 54
Males
1995 2000 2005
% % %
High risk sex, no condom 18 11 3
High risk sex, used condom 6 11 2
Spousal sex, no condom 7 5 11
Spousal sex, used condom 0 0 9
Secondary abstinence 16 11 17
Primary abstinence 53 61 57

UHSBS 2004–5; Kirungi et al, 2006.

One way to think about older adolescents is to consider reproductive health by gender. For boys,
while much of their behavior is high risk, it has not yet translated into poor health. In contrast, older
adolescent girls already face severe reproductive health problems. The UHSBS 2004–05 found nine
times as much HIV infection in girls of this age than boys: 2.7 percent of girls ages 15–19 are infected
compared to just 0.3 percent of boys.

HIV increases from 1.9 percent in girls ages 15–17, to 3.9 percent in girls aged 18–19, to 5.5 percent
in girls ages 20–22, to 7.7 percent in young women ages 23–24. For boys, HIV prevalence starts at a
much lower figure. Just 0.3 percent of boys ages 15–17 are HIV-positive, 0.2 percent of those ages
18–19, 2.3 percent of those ages 20–22, and 2.5 percent of those ages 23–24 (UHSBS 2004–05).

Uganda’s teenage pregnancy rate is the seventh highest in Africa (DHS 2000–01), down from first in
1995: 31 percent of girls under age 19 are pregnant or have begun childbearing (see Table 3.3). This
has major implications for population growth, fertility rates, poverty, and maternal and infant
mortality. About a fifth of pregnant adolescent girls seek to end their pregnancy by abortion. Unsafe
abortions among adolescents contribute 25 percent of the maternal mortality, which at 800 for
100,000 women per year is one of the highest in the world. Adolescent use of modern contraception
stands at 6.8 percent. (UHSBS 2004–05)

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Straight Talk: Full Report

Table 3.3 Teenage pregnancy and motherhood in Uganda


Age Percent who are Percent who are pregnant Percent who have
mothers with first child begun childbearing
% % %
15 1.9 1.4 3.3
16 9.9 3.0 12.9
17 17.1 6.1 23.2
18 43.1 11.0 54.0
19 54.6 6.6 61.2

DHS 2000–1

All of the above needs to be seen in the context of Uganda’s success in bringing down rates of HIV.
Prevalence has declined by two-thirds, from a high of 18 percent of adults infected in 1992 to about 6
percent in 2000. However, prevalence has not declined further since 2000, and there is a subtle
upward trend in infection in many parts of the country. Adolescent sexuality is a driver of the
epidemic, especially the high incidence of new infections in female adolescents and the male pattern
of multiple partners.

Finally, education has a major impact on knowledge, behavior, and attitudes toward HIV and other
facets of reproductive health. So what is the educational status of 15 to 19 year olds in Uganda?

At 15 boys and girls are equally likely to be in school, but almost always in primary school and not
secondary school where their official age puts them. Furthermore, between ages 17 and 19, girls
switch school for marriage. At age 17 just over half of girls are in school, whereas by 19 well over
half are married and not in school. At age 19 almost half of boys are still in school.

Table 3.4 Percent of girls and boys by school status, sexual activity, and marital
status, by age
Girls Boys
Age In school Have ever Ever In school Have ever Ever
% had sex Married % had sex married
% % % %
15 87 17 2 88 23 .3
16 70 30 8 80 32 .6
17 54 45 18 62 41 2
18 31 66 41 58 55 6
19 12 81 57 46 65 7

National Survey of Adolescents 2004; UHSBS 2004–5

In 2002, of all 15 to 19 year olds females enumerated by the Census, 45 percent were in school, 40
percent had left school, and 15 percent had never attended. Among boys, 59 percent were currently in
school, 32 percent had left school, and 9 percent had never attended.

About 30 percent of boys and girls ages 15–19 have some exposure to secondary school. This is a
great increase above the 12 percent of girls ages 15–19 with some secondary exposure in 1986 (MOH

79
and ORC Macro 2001). But still the highest educational attainment of most 15–19 and 20–24 year
olds remains primary school.

According to the Census (UBOS 2005), of young people aged 20–24 in 2002, the highest education
achieved by most was ―some primary‖ (38 percent). Twelve percent had achieved complete primary,
22 percent some secondary, and just 7 percent completed secondary.

The seriousness of this situation is compounded by the poor quality of primary education. Completing
primary school does not necessarily confer literacy or life skills. Girls who complete primary school
have the same contraceptive prevalence as those with no education.

In Uganda 87 percent of the population is rural with access to land. Thus on leaving school the
majority of boys turn to farming, usually receiving a portion of land from their fathers. They also
often have the physical strength and social mobility to set up small businesses.

In contrast, girls do not receive land but must dig for their parents: few have the social confidence or
financial backing to set up even a small business. Nor can they remain unmarried in their parents’
home for long. Factors pushing them out include parental reluctance to keep providing for them, the
family’s fear that they will bring shame by becoming pregnant while still at home, and the family’s
desire for a bride price. Girls also organize their own exit from the family home by eloping for love or
the desire to acquire their own home and land to till through marriage. Frequently they marry men
with wives: about a third of girls ages 15–19 are in polygamous unions.

In conclusion, the image of a Ugandan female adolescent is not a young single woman in high school
but rather a girl in primary school or just out of primary school on the cusp of early marriage. She
may be fortunate enough to have had some exposure to secondary school, but even girls in this
category are on the verge of marriage and early childbirth. By 18.5 years she is likely to have given
birth to her first child.

The image of a Ugandan male adolescent is of a young single male, also in primary school or just out,
beginning to establish himself economically. He will have several sexual partners before settling
down to marriage in his early twenties.

Both will live in rural areas, be one of many siblings, and likely not live with both parents. For both,
radio will be their lifeline to the outside world. For both, the economic future will be very uncertain.
For boys, it will depend upon what they are able to achieve for themselves. For girls, it will depend
upon the male they marry.

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Straight Talk: Full Report

Figure 3.1 Percent exposed to zero and to three ST items by age

Knows 3 ST media Knows 0 ST media

100

80

60
Percent

40

20

0
10 11 12 13 14 15 16 17 18 19
Age

81
Appendix 4
2005 Straight Talk Evaluation Survey, Uganda
Adolescent Questionnaire, August 2005
Straight Talk Foundation and Population Council/Horizons

IDENTIFICATION

DISTRICT _________________________________________________ ________

COUNTY __________________________________________________ _______ ________

SUB-COUNTY _____________________________________________ _______ ________

PARISH _________________________________________________ ________ _______

VILLAGE (LC) ____________________________________________ ________ _______

HOUSE NUMBER _______ ______ _____ _______ ______

URBAN/RURAL 1=URBAN 2=RURAL

INTERVIEWER VISITS

1 2 FINAL VISIT

DAY
DATE ____ _____/_____ ____/_______ ____ _____/_____ ____/_______
MONTH

INTERVIEWER’S ___________________________ ___________________________ YEAR 2 0 0 5


NAME

RESULTS** __________________ __________________ RESULTS

NEXT VISIT TYPE OF RESPONDENT:


DATE ____ _____/_____ ____/_______ 1=ORIGINAL; 2=REPLACEMENT

TIME __________________ IF INTERVIEW NOT COMPLETED:

1….SELECT ANOTHER HOUSEHOLD


**RESULTS CODES 2….SELECT ANOTHER RESPONDENT
1. COMPLETED FROM SAME HOUSEHOLD
2. PARTIALLY COMPLETED
3. NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT
AT HOME AT TIME OF VISIT INTERVIEW LANGUAGE CODES:
4. ENTIRE HOUSEHOLD ABSENT FOR AN EXTENDED PERIOD OF TIME
5. POSTPONED 1. ATESO
6. PARENT/CARETAKER/GUARDIAN REFUSED 2. LUGANDA
7. ADOLESCENT REFUSED 3. LUGBARA
8. DWELING VACANT, ADDRESS NOT A DWELLING, OR DWELLING 4. LUO
DESRTOYED 5. 4Rs
9. DWELLING NOT FOUND 6. RUFUMBIRA
10. OTHER (SPECIFY) 7. LUSOGA
____________________________________________________ 8. ENGLISH
9. OTHER (SPECIFY)
LANGUAGE OF INTERVIEW ____________________________________________ CODE __________________
______

PARENT INTERVIEWED? 1……YES (QXNR CODE ____________________________)


2…….NO

SUPERVISOR/ FIELD EDITOR KEY-ENTERED (1ST ENTRY) KEY-ENTERED (2ND ENTRY)

NAME ___________________ NAME ___________________ NAME ___________________

DATE ___________________ DATE ___________________ DATE ___________________

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Straight Talk: Full Report

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

SECTION I. RESPONDENT‘S BACKGROUND

101a. CIRCLE CODE FOR MALE 1

SEX OF RESPONDENT FEMALE 2

10–14 1
101b. CIRCLE CODE FOR AGE GROUP
15–19 2

101c RECORD THE TIME


INTERVIEW BEGINS. HOUR

MINUTES

102 In what month and year were you


born?
MONTH

DON’T KNOW MONTH …………………………………….98

YEAR

DON’T KNOW YEAR 9998

103 How old are you?


AGE IN COMPLETED YEARS
COMPARE AND CORRECT 103
IF INCONSISTENT.

104 Have you ever been married?


YES……………………………………….1 (END THE INTERVIEW)
NO…………………..……………………..2

105 First I would like to ask you some URBAN AREA………………………………………………..1


questions about you and your
RURAL AREA………………………………………………..2
family. For most of the time until
you were 10 years old, did you CAN’T TELL…………………………………………………..3
live in an urban or rural area?

106 What is your religion?


CATHOLIC…….……………………………..……………1
PROTESTANT….………………….………..……………2
MUSLIM………..…………………………….……………3
NO RELIGION/NONE.…………………….………..……4 108
SAVED/BORN AGAIN……………………………………5
OTHER (SPECIFY) _____________________________________
107 How many times do you attend
religious services in a month? RARELY OR NEVER…………………………………………………1
1–2 TIMES A MONTH…………………………………………………2
3–4 TIMES A MONTH……………………………………………..….3
MORE THAN 4 TIMES A MONTH……………………………….…4
108 How important is religion to you?
Would you say it is (READ LIST) VERY IMPORTANT………………………………………………….1
SOMEWHAT IMPORTANT…………………………………………2
NOT IMPORTANT AT ALL………………………………………….3

83
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

109 Have you ever attended school? YES 1


NO 2 116

110 Are you currently attending YES 1


school?
NO 2
116

111 During the current school year,


PRIMARY 1
what level and class are you
attending? (RECORD LEVEL SECONDARY 2
BEING ATTENDED, AND
VOCATIONAL 3
CLASS. FOR THOSE IN
UNIVERSITY OR COLLEGE, UNIVERSITY 4
RECORD YEAR OF COLLEGE
COLLEGE………………………………………………………5
OR UNIVERSITY FOR
―CLASS‖) OTHER (SPECIFY) ____________________________

CLASS

112 Is your school a mixed school or MIXED 1


is it only for boys or for girls
ONLY GIRLS 2
alone?
ONLY BOYS 3

113 Are you a day student or a DAY STUDENT 1


boarder at the school?
BOARDER 2

114 What is the highest level of PRIMARY 1


school you think you will
SECONDARY 2
complete?
VOCATIONAL 3
UNIVERSITY 4
COLLEGE………………………………………………………5
OTHER (SPECIFY) ____________________________

NOT SURE/CAN’T TELL 6

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Straight Talk: Full Report

115 How confident are you that you VERY CONFIDENT…………………………………………..1


will be able to achieve your
SOMEWHAT CONFIDENT………………………………….2
educational goals?
NOT CONFIDENT AT ALL…………………………………..3
Bukakafuki bwoli nabwo nti CAN’T TELL…..……………………………………………….4
oidha kusobola okutukiriza
byolubilira mu kusomakwo?
Would you say you are (READ
LIST):

116 CHECK Q109 & Q110 CURRENTLY IN SCHOOL 201

EVER ATTENDED SCHOOL BUT CURRENTLY NOT ATTENDING


117
NEVER ATTENDED SCHOOL
201

117 What is the highest level of PRIMARY 1


education you attained before you
SECONDARY 2
stopped: primary, secondary,
vocational, university……? VOCATIONAL 3
UNIVERSITY 4
COLLEGE………………………………………………………5
OTHER (SPECIFY) ____________________________

118 What was the main reason you COULD NOT PAY SCHOOL FEES 01
stopped attending school? (DO
LACK OF SCHOOL MATERIALS 02
NOT READ RESPONSES.
CIRCLE ONLY ONE COMPLETED 03
RESPONSE)
GOT PREGNANT 04
GOT MARRIED 05
ILLNESS 06
WORK AT HOME 07
NOT INTERESTED 08
NOT A GOOD STUDENT 09
GOT A JOB 10
OTHER 96
(SPECIFY)
DON’T KNOW 98

119 How old were you when you


stopped attending school? AGE
DON’T KNOW 98

85
SECTION II: SOURCES OF INFORMATION

Most Imp. Pref.


201 Young people learn about puberty
Source Source
(body changes in boys and girls
during teenage years), sexual MOTHER…………………………………..1……….……..……...…1
and reproductive health,
FATHER……………………………………2……..……..………..…2
relationships and sexual matters
from many sources. Which one SISTER…………………………………….3……..……..………..…3
person has been your most
BROTHER…………………………………4…………………….….4
important source of such
information? BOYFRIEND/GIRLFRIEND/LOVER…….5………………….……5
OTHER FRIEND……….……………….…6……………………….6
Abantu abato beega
ebigema ku nkyukakyuka AUNT………………………………….……7…………….…………7
y‘emibiri gyaibwe nga bali UNCLE……………………..…………………….………8…………….………………….8
kukula, enkola
GRANDMOTHER/GRANDFATHER….…9………………………..9
y‘ebyokwegaita
muby‘omukwano okuva OTHER RELATIVE……………………….10……………………..10
munsibuko edhiwera. TEACHER…………………………………11……………………...11
Basobola okwega okuva ku
HEALTH WORKER……………………….12……………………..12
bazaire, baana banaibwe,
mukwano egindi, PEER EDUCATOR……………………….13……………………..13
abenganda, abakozi STRAIGHT TALK WORKER…………….14………………….….14
beby‘obulamu, oba abantu
RELIGIOUS LEADER………………….…15……………….…….15
abandi. Muntu ki omulala ati
abaire ow‘omugaso einho MYSELF…………………………………...16……………….…….16
202 mu kukuwa amawulire oti ni NO ONE…………………………………...17……………………..17
gano?
SOMEONE ELSE (SPECIFY)
(DO NOT READ RESPONSES.
CIRCLE ONLY ONE ANSWER) _____________ ____________

From which one person would


you prefer to receive information
on these topics?
Naani gwewandyenze
okufunaku amawulire
agandi ku mitwe gino?
(DO NOT READ RESPONSES.
CIRCLE ONLY ONE ANSWER)

203 Young people also learn about


YOUNG TALK………………………………………………………1
these issues from newspapers
and magazines. What has been STRAIGHT TALK……………………………………………….…..2
your most important source of
such information in terms of
newspaper/magazines? (DO NOT OTHER NEWSPAPERS (SPECIFY) ______________………..3
READ RESPONSES. CIRCLE
ONLY ONE ANSWER) DOES NOT KNOW NAME OF NEWSPAPER………………….4
NO NEWSPAPER.……………………………………..……….…5

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Straight Talk: Full Report

204 Young people also learn about


STRAIGHT TALK…………………………………….……….…1
these issues from radio
programs. What has been your
most important source of such
information in terms of radio OTHER RADIO PROGRAM (specify)…______________….2
programs? (DO NOT READ
RESPONSES. PROBE FOR DOES NOT KNOW NAME OF RADIO PROGRAM………....3
NAME OF RADIO PROGRAM. NO RADIO PROGRAM…………………………………………4
CIRCLE ONLY ONE ANSWER)

205 Of the 3 sources you’ve


PERSON………………………………………………………………1
mentioned above, that is person,
newspaper and radio, which one NEWSPAPER/MAGAZINE………………………………………….2
is the most important overall? Is it
RADIO PROGRAM…………………………………………………..3
the person, newspaper or radio
program? (CIRCLE ONLY ONE DON’T KNOW/CAN’T DECIDE……………………………………..5
ANSWER)
ALL ARE IMPORTANT………………………………………….…..6

206 If you needed information about


SCHOOL……………………………………………………….….…..1
growing up, relationships and
sexual matters, which one place HEALTH FACILITY……………………………………………….….2
would you go to for information?
MY (RESPONDENT’S) HOUSE……………………………………3
(DO NOT READ RESPONSES.
CIRCLE ONLY ONE ANSWER) SOMEONE’S HOUSE……………………………………………….4
CHURCH……………………………………………………………...5
OTHER (SPECIFY) ___________________________________
DON’T KNOW WHERE TO GO…………………………………….6

87
SECTION III: EXPOSURE TO STRAIGHT TALK RADIO

301 How many days a week do you


listen to the radio? (IF ____________ DAYS A WEEK
RESPONDENT DOES NOT
LISTEN TO THE RADIO AT ALL
DURING THE WEEK, RECORD
―0‖)

302 CHECK TO SEE WHETHER


YES………………………………………………………………..1
RESPONDENT HAS LISTENED
TO STRAIGHT TALK RADIO N0………………………………………………………………….2--- Q400
PROGRAM AT Q204 ABOVE. IF
NOT SURE……………………………………………………….3---
SO, CIRCLE ‗YES‖ ON Q302. IF Q400
NOT, ASK:
These days there are many radio
programs for young people. Have
you ever listened to a radio
program called Straight Talk
about young people’s health?
FOR THE OTHER
LANGUAGES, REPLACE
―STRAIGHT TALK‖ WITH:
EINER EITENA IN ATESO
LOK ATYER KAMALENG IN
LUO
TUSHESHURE IN THE 4RS
TWOGERE KAATI IN
LUGANDA
KHUHANIKA LUBUULA IN
LUMASABA
EMBAHA NGOLOFU IN
LUSAMIA
EYO ECEZA TRA RI IN
LUGBARA
ERIKANIA OKWENENE IN
LUKONZO

303 How often do you listen to this


4 TIMES A MONTH..……………………………….…………..1
show in a month? Would you say
(READ OPTIONS) 3 TIMES A MONTH……………………………..………………2
2 TIMES A MONTH……..……………………………………...3
ONCE A MONTH………………………………………………..4
RARELY?………………………………………………..……….5

88
Straight Talk: Full Report

304 Besides (language indicated from


ENGLISH ………………………………………………………1
Q302), in what other language(s)
do you listen to Straight Talk LUO ………………………………………………………….…2
radio programs? (PROBE BY
4Rs……………………………………….……………………..3
ASKING ―ANY OTHER
LANGUAGE‖ 2 TIMES. CIRCLE TESO …………………………………………………………..4
ALL LANGUAGES
LUSAMIA……………………………………………………….5
MENTIONED. DO NOT FORGET
TO RECORD THE LANGUAGE LUMASABA…………………………………………………….6
LISTED IN Q302)
LUGANDA………………………………………………………7
LUKONZO………………………………………………………8
LUGBARA………………………………………………………9
NONE…………………………………………………………..10
OTHER (SPECIFY) ___________________________

SECTION IV & V: EXPOSURE TO STRAIGHT TALK PRINT MATERIALS AND HEALTH FAIRS

400 CHECK TO SEE WHETHER


YES NO
RESPONDENT HAS READ
STRAIGHT TALK/YOUNG TALK STRAIGHT TALK ……………….1…………………………..2
NEWSPAPERS FROM Q203
YOUNG TALK……………………1…………………………..2
ABOVE. IF SO, CIRCLE ‗YES‖
ON Q400 AS APPROPRIATE. IF PARENT TALK ……………..…...1………………….……….2
NOT, ASK:
TEACHER TALK……………..….1………………….………..2
Have you ever read any of the
following newspapers or
magazines? (READ LIST)

FOR THE OTHER


LANGUAGES, REPLACE
―STRAIGHT TALK‖ WITH:
EINER EITENA IN ATESO
LOK ATYER KAMALENG IN
LUO
TUSHESHURE IN
RUNYANKOLE/
RUKIGA
TWOGERE KAATI IN
LUGANDA
EYO ECEZA TRA RI IN
LUGBARA
BAZA BUSIMBA IN
RUNYORO/
RUTORO

401 CHECK Q400


1. READS STRAIGHT TALK NEWSPAPER 402

2. DOES NOT READ STRAIGHT TALK NEWSPAPER 500

402 How many issues of Straight Talk ______________________ ISSUES


do you read in a year? (DO NOT
PROMPT. IF RESPONDENT
CANNOT RECALL, RECORD 77……CANNOT RECAL
ACCORDINGLY).

89
ENGLISH …………………………………………………….…1
403 Besides the (language mentioned
LUO …………………………………………………………..…2
on Q 401), in what other
language do you read Straight RUNYANKOLE-RUKIGA………………………………………3
Talk in? (PROBE BY ASKING
RUNYORO-RUTORO.…………………………………………4
―ANY OTHER LANGUAGE?‖ 2
TIMES. RECORD ALL ATESO ………………………………………………………….5
ANSWERS GIVEN)
LUGBARA………………………………..……………………..6
LUGANDA………………………………………………………7
NONE……………………………………………………………8
OTHER (SPECIFY) ___________________________ 9

404 Think about the last issue of


FROM SCHOOL………………………………………………..01
Straight Talk you read. Where did
you get it from? (RECORD ONLY FROM HOME/PARENTS……………………………………..02
ONE ANSWER. DO NOT
FROM FRIENDS (INCLUDING FAMILY FRIENDS)……….03
PROBE)
FROM OTHER RELATIVES…………………………………..04
FROM A HEALTH FACILITY…..……………………………..05
FROM A CHURCH……………………………………………..06
FROM A COMMUNITY CENTER…………………………….07
FROM A LIBRARY……………………………………………..08
I BUY THE NEWSPAPER MYSELF………………………….09
FROM HEALTH FAIRS………………………………………..10
FROM SOMEWHERE ELSE (SPECIFY)
____________________________________
DON’T KNOW/CAN’T RECALL………………………………..11

405 Would you recommend the YES……………………………………………………………….1


Straight Talk magazine to people
NO………………………………………………………………..2
of your age?

Osobola okusemba akatabo


ka Straight Talk eli abantu
ab‘emyakagyo?

500 CHECK Q400


1. DOES NOT READ YOUNG TALK
504
2. READS YOUNG TA LK
501

90
Straight Talk: Full Report

501 Think about the last issue of FROM SCHOOL………………………………………………..01


Young Talk you read. Where did
FROM HOME/PARENTS……………………………………..02
you get it from? (RECORD ONLY
ONE ANSWER. DO NOT FROM FRIENDS (INCLUDING FAMILY FRIENDS)……….03
PROBE)
FROM OTHER RELATIVES…………………………………..04
FROM A HEALTH FACILITY…..……………………………..05
FROM A CHURCH……………………………………………..06
FROM A COMMUNITY CENTER…………………………….07
FROM A LIBRARY……………………………………………..08
I BUY THE NEWSPAPER MYSELF………………………....09
FROM HEALTH FAIRS………………………………………..10
FROM SOMEWHERE ELSE (SPECIFY)
____________________________________
CAN’T RECALL………………………………………………..11

502 Would you recommend Young YES……………………………………………………………….1


Talk magazine to people your
NO………………………………………………………………..2
age?

Osobola okusemba akatabo


ka Young Talk eli abantu
ab‘emyakagyo?

503 CHECK FOR EXPOSURE TO LISTENS TO STRAIGHT TALK RADIO……………………YES


STRAIGHT TALK MATERIALS OR READS STRAIGHT TALK NEWSPAPER…………….YES
AND CIRCLE AS APPROPRIATE OR READS YOUNG TALK NEWSPAPER………………...YES 504

DOES NOT LISTEN TO STRAIGHT TALK RADIO …………..NO


AND DOES NOT READ STRAIGHT TALK NEWSPAPER…..NO
AND DOES NOT READ YOUNG TALK NEWSPAPER………NO 600

91
504 Thinking of all the Straight Talk ABSTINENCE…………………………………………………..1
activities you mentioned you have
DELAY OF SEX……………………………………….………..2
been exposed to (that is Straight
Talk radio programs, Straight Talk BEING FAITHFUL………………………………………………3
newsletters, Young Talk
DEFILEMENT/CHILD SEXUAL ABUSE……………………..4
newsletters, Straight Talk Health
Fairs) what kind of information did COMMUNICATION WITH PARENTS………………………..5
you get from these materials?
ORPHANS/VULNERABLE CHILDREN………………………6
(PROBE BY ASKING ―WHAT
ELSE‖ 2 TIMES. RECORD ALL CARE FOR PEOPLE WITH HIV………………………………7
ANSWERS MENTIONED.)
PREVENTION OF HIV…………………………………………8
HARMFUL TRADITIONS………………………………………9
WAR AND ABDUCTED CHILDREN…………………………10
AVOIDING PREGNANCY…………………………………….11
GIRLS AND BOYS ARE EQUAL…………………………….12
ART, TREATMENT OF AIDS…………………………………13
VCT/HIV TESTING……………………………………………..14
CONDOM KNOWLEDGE AND USE…………………………15
SEXUALLY TRANSMITTED DISEASES…………………….16
BODY CHANGES……………………….………………………17
STAYING IN SCHOOL…………………………………………18
TALKING WITH PARENTS/GUARDIAN……………………..19
TALKING WITH TEACHERS…………………………………..20
VISITING CLINICS………………………………………………21
NOT EXCHANGE GIFTS/MONEY/FAVORS FOR SEX…....22
ALCOHOL AND DRUGS………………………………………23
OTHER (SPECIFY) _________________________________
OTHER (SPECIFY) _________________________________

505 Have you ever taken any specific


YES……………………………………………………………….1
action as a result of this
exposure? NO………………………………………………………………..2 600

Wali obaireku nikyokolawo


ekyendhawulo, nga kiva mu
biviire mu/ bibwikwirwa mu
bintu bya Straight Talk (nga
empayo dh‘oku Radio;
amawulire ga Straight talk ni
Young Talk)?

92
Straight Talk: Full Report

506 What action did you take? CONTINUED ABSTAINING FROM SEX ………………..……1
STOPPED PREMARITAL SEX…..…………………………….2
Wakolawo ki?
GONE FOR VCT…………………………………………………3
(PROBE BY ASKING ―WHAT VISITED A HEALTH FACILITY FOR STI TREATMENT.……4
ELSE‖ 2 TIMES. RECORD ALL
ANSWERS MENTIONED.) VISITIED HEALTH FACILITY FOR CONTRACEPTIVES…..5
VISITED A HEALTH FACILITY FOR COUNSELING………..6
STAYED FAITHFUL TO MY PARTNER……………………...7
STARTED USING CONDOMS………………………………...8
TALKED TO MY PARENTS……………………….…………...9
TALKED WITH MY FRIEND/S…………………….………….10
TALKED TO ANOTHER ADULT………………….………….11
RECOMMENDED THE SHOW TO SOMEONE….…………12
WROTE TO STRAIGHT TALK…………………….………….13
JOINED A STRAIGHT TALK CLUB……………….…………14
REFUSED TO ACCEPT GIFTS/MONEY/FAVORS
FOR SEX……………………………………………………..15
STOPPED USING ALCOHOL/DRUGS………………………16
OTHER (SPECIFY) ________________________________
OTHER (SPECIFY) ________________________________

93
SECTION VI: REPRODUCTIVE HEALTH & HIV/AIDS KNOWLEDGE
Now I will read some statements
and I would like you to tell me if
they are true, false, or if you do
not know, simply say so TRUE FALSE DON’T KNOW

600 A girl cannot get pregnant the first 1 2 3


time she has sex.

601 A girl cannot get pregnant if she 1 2 3


has sex standing up.

602 A person who looks healthy can 1 2 3


be infected with the AIDS virus.

603 It is possible to cure AIDS. 1 2 3

604 The AIDS virus can be passed 1 2 3


from a pregnant mother, if she is
infected with HIV, to her unborn
child.

Now here are a set of statements.


I will read them and please tell
me whether you agree with the
statement, disagree, or if you do AGREE DISAGREE DON’T KNOW
not know, feel free to say so.

605 Condoms are an effective way of 1 2 3


protecting against sexually
transmitted infection if used
properly.
606 1 2 3
Girls who carry condoms are
607 loose. 1 2 3

Buying a condom is the


responsibility of males only.
AGREE DISAGREE DON’T KNOW

608 1 2 3

Using a condom is a sign that


609 your partner does not trust you. 1 2 3

Girls who stay in school longer


are less likely to have unwanted
pregnancies.

94
Straight Talk: Full Report

SECTION VII: KNOWLEDGE OF SEXUALLY TRANSMITTED DISEASES

ADOLESCENTS 10–14, SKIP TO SECTION IX

YES…………………………………..…………………………..…….1
701 Apart from HIV/AIDS, are there
NO…………………………………….………………………………..2
other diseases that men and 801
women can get by having sexual DON’T KNOW…………………………………………………………3
intercourse?
801

702 Apart from HIV/ADS, what are the DISCHARGE FROM PENIS………………………………….…...1
signs and symptoms of a sexually
PAIN DURING URINATION………………………………….……2
transmitted disease in a male?
ULCERS/SORES IN GENITAL AREA……………………………3
Bubonero ki nabintu ki ITCHING IN GENITAL AREA……………………………………...4
ebiboneka, ebiraga
endwaile edh‘obukaba mu INFERTILITY………………………………………………………...5
musadha? NONE………………………………..……………………….………6
OTHER (SPECIFY) __________________________________7
(PROBE BY ASKING ―WHAT
ELSE‖ 2 TIMES. CIRCLE ALL DON’T KNOW………………………………….……………………8
ANSWERS MENTIONED)
VAGINAL DISCHARGE…………………………………………..1
703 (Apart from HIV/ADS) What are
PAIN DURING URINATION……………………………………..2
the signs and symptoms of a
sexually transmitted disease in a ULCERS/SORES IN GENITAL AREA………………………….3
female?
ITCHING IN GENITAL AREA…………………………………...4
Bubonero ki nabintu ki INFERTILITY………………………………………………………5
ebiboneka, ebiraga NONE………………………………………………………………6
endwaile edh‘obukaba mu
OTHER (SPECIFY) ________________________________7
mukazi?
DON’T KNOW…………………………………………..…………8
(PROBE BY ASKING ―WHAT
ELSE‖ 2 TIMES. CIRCLE ALL
ANSWERS MENTIONED)
704 CHECK Q702 AND Q703. IF RESPONDENT DOES NOT KNOW THE SYMPTOMS
OF STDS FOR ANY GENDER, GO TO Q801
KNOWS SYMPTOMS OF STDS
705
DOES NOT KNOW SYMPTOMS OF STDS

801

705 Have you ever had a sexually


YES……………………………………………………………..….….1
transmitted disease? 801
NO……………………………………………………………………..2

95
SHOP……………………………………………………….…..……..1
706 Where did you seek treatment?
PHARMACY……………………………………………………..……2
GOVERNMENT HOSPITAL/HEALTH CENTER/.CLINIC………..3
YOUTH HEALTH FACILITY………………………………………...4
PRIVATE DOCTOR/NURSE/CLINIC………………………………5
HERBALIST…………………………………………………………..6
DO NOT SEEK TREATMENT……………………………………...7
OTHER (SPECIFY) ________________________________ …8

707 Did the partner who infected you YES……………………………………………………………..……..1


obtain treatment?
NO……………………………………………………………………..2

DON’T KNOW………………………………………………………..3

SECTION VIII: HEALTH SEEKING BEHAVIOR

801 Have you ever visited a health YES .NO


facility or a health provider of any
CONTRACEPTION? 1 .2
kind to receive service or
information on: (READ LIST. PREGNANCY?…………………….. 1…………………….2
IF RESPONDENT HAS VISITED
SEXUALLY TRANSMITTED DISEASE?…..1…………………….2
A HEALTH FACILITY FOR STD
TREATMENT AS INDICATED IN HIV/AIDS INFORMATION…………………..1…………………….2
SECTION VII, ACKNOWLEDGE
VCT……………………………………………1……………………..2
THIS AND ASK ABOUT OTHER
SERVICES AS LISTED ON
Q801)

802 CHECK Q801


1. HAS VISITED A PROVIDER 803

2. HAS NEVER VISITED A PROVIDER 900

803 How many times have you sought


such services or information in ____ _____ TIMES
the last 12 months? (RECORD
―00‖ IF RESPONDENT DID NOT
SEEK ANY CARE IN THE LAST
12 MONTHS)

804 Thinking about your last visit, SHOP……………………………………………………….…..……..1


what kind of facility did you visit?
PHARMACY……………………………………………………..……2
(CIRCLE ONLY ONE ANSWER)
GOVERNMENT HOSPITAL/HEALTH CENTER/.CLINIC………..3
YOUTH HEALTH FACILITY………………………………………...4
PRIVATE DOCTOR/NURSE/CLINIC………………………………5
HERBALIST…………………………………………………………..6
OTHER (SPECIFY) ________________________________ …8

96
Straight Talk: Full Report

805 Did the facility you visited have a YES…………………………………………………………………..1


Straight Talk sign outside?
NO……………………………………………………………………2

CAN’T RECALL…………………………………………………….3

806 Why did you decide to go to that FACILITY CLOSE BY………………………………………………1


particular facility? (PROBE BY
FACILITY FREE/AFFORDABLE………………………………….2
ASKING ―WHAT ELSE?‖ 2
TIMES. CIRCLE ALL FACILITY YOUTH-FRIENDLY……………………………………3
MENTIONED)
FACILITY PROMPTED BY STRAIGHT TALK…………..………4
FACILITY RECOMMENDED BY FAMILY/FRIEND/OTHER…...5
THIS IS WHERE ROUTINELY GO FOR CARE………………...6
KNOWS ABOUT IT………………………………………………..7
DON’T KNOW/CAN’T RECALL REASON……………………….8
OTHER (SPECIFY) _________________________________

807 When you last visited a health


INFORMATION (SPECIFY) _______________________….1
facility, what was your reason for
going? (PROBE BY ASKING CONTRACEPTION………………………………………….…..2
―WHAT OTHER REASON? 2
STD………………………………………………………………..3
TIMES. CIRCLE ALL
MENTIONED) PREGNANCY TEST……………………………………………..4
ANTENATAL OR POSTNATAL CARE………………………..5
VCT………………………………………………………………..6
OTHER (SPECIFY) ________________________________7
OTHER (SPECIFY) ________________________________8

97
SECTION IX: GENDER
I will now read some statements
and tell me whether you agree or
disagree with each one. If you
cannot decide which way, you
can also say that. (READ EACH
STATEMENT AND THEN SAY DON’T KNOW/
―DO YOU AGREE OR AGREE DISAGREE CAN’T DECIDE
DISAGREE?‖)

901 When money is scarce and the 1 2 3


family cannot send all children to
school, boys should be sent
before girls.

902 It is OK for boys to have sex 1 2 3


before getting married

903 It is ok for girls to have sex before 1 2 3


marriage.

Girls are generally not as


904 1 2 3
intelligent as boys.
Okutwalira awalala, abawala
tiibagezigezi nga abalenzi

1 2 3
A woman should tolerate abuse
905
from her husband in order to keep
her family together
1 2 3
When it comes to sex, it is the
906
man who should have the final
word.

1 2 3
There are times when women
907
deserve to be beaten by their
husbands

A girl who becomes pregnant


908 1 2 3
while in school should be
expelled.

Boys who have many girlfriends


909 1 2 3
are “powerful”

A schoolboy who makes a


910 1 2 3
schoolgirl pregnant while he is in
school should be expelled.

911 Do you feel that boys and girls BOTH TREATED THE SAME..……………………………….1
are treated equally at your home
GIRLS FAVORED…………………..………………………….2
or is one group favored?
BOYS FAVORED………………….……………………………3
Owulira mule nga abalenzi
CAN’T DETERMINE……………………………………………4
n‘abawala babisibwa kyenkanyi
mu maka gaimwe or is one THERE ARE NO BOYS/GIRLS IN HOUSEHOLD…………..5
group favored?

98
Straight Talk: Full Report

912 Do you feel that boys and girls BOTH TREATED THE SAME.………………………………..1
are treated equally at your school
GIRLS FAVORED…………………..………………………….2
or is one group favored?
Owulira mule nga abalenzi BOYS FAVORED………………………………………………3
n‘abawala babisibwa kyenkanyi
CAN’T DETERMINE……………………………………………4
kwisomero lyaimwe or is one
group favored? (FOR THOSE NO CAN’T RECALL………………………………………..………..5
LONGER IN SCHOOL, ASK
NEVER ATTENDED SCHOOL………………………………..6
ABOUT THE LAST SCHOOL
THEY ATTENDED)

913 If you needed information about


SCHOOL………………………………………………………………..01
legal rights and protection of
young people, which one place HEALTH FACILITY……………………………………………………02
would you go to for information?
MY (RESPONDENT’S) HOUSE……….…………………………….03
SOMEONE ELSE’S HOUSE…………………………………………04
CHURCH……………….……………………………………………….05
POLICE/LC OR LOCAL ADMINISTRATION ……………………….06
OTHER PLACE (SPECIFY) _______________________________
DON’T KNOW WHERE TO GO………………………………………07

SECTION X: COMMUNICATING WITH PARENTS OR GUARDIANS

1000
FOR ADOLESCENTS MOTHER……………………………………………………..…1

WHERE A PARENT FATHER………………………………………………………...2

IS BEING GRANDPARENT……………………………………………….3

INTERVIEWED: UNCLE…………………………………………………………..4
What is the relationship between AUNT…………………………………………………………….5
you and the [adult being
BROTHER……………………………………………………….6
interviewed]? (CIRCLE ONLY
ONE ANSWER. IF THIS IS AN SISTER…………………………………………………………..7
ADOLESCENT-ONLY
COUSIN………………………………………………………….8
INTERVIEW, CIRCLE 99)
OTHER RELATIVE……………………………………………..9
OTHER GUARDIAN……………………………………………10
OTHER (SPECIFY) _______________________________
ADOLESCENT-ONLY INTERVIEW…………………………..99

99
1001 Who do you currently live with? BOTH PARENTS……………………………………………….1
(CIRCLE ONLY ONE ANSWER.
FATHER ONLY…………………………………………………2
IF RESPONDENT LIVES WITH
OTHER PEOPLE WHO ARE MOTHER ONLY………………………………………………..3
VISITING, DO NOT INCLUDE
GRANDPARENT/S…………………………………………….4
THOSE. THE PURPOSE OF
THIS QUESTION IS TO UNCLE…………………………………………………………..5
DETERMINE WHO IS IN
AUNT…………………………………………………………….6
CHARGE OF THE
ADOLESCENT. BROTHER……………………………………………………….7
SISTER…………………………………………………………..8
IF A COUSIN………………………………………………………….9
PARENT/GUARDIAN OTHER RELATIVE…………………………………………….10
INTERVIEW IS FRIEND (INCLUDING FAMILY FRIEND)……………………11
BEING ALONE…………………………………………………………..12
CONDUCTED, OR IF OTHER (SPECIFY) _______________________________
CONSENT FROM
PARENT/GUARDIAN
WAS OBTAINED,
REPHRASE
ACCORDINGLY)

IF DOES NOT LIVE WITH


FATHER OR WITH MOTHER, FATHER LIVES ELSEWHERE………………………………….1
ASK GENTLY:
FATHER DECEASED………………………………………….…2
1002a
Where is your father? RESPONDENT DOES NOT KNOW…………………………….3

MOTHER LIVES ELSEWHERE…………………………………1


1002b
MOTHER DECEASED……………………………………….…..2
Where is your mother?
RESPONDENT DOES NOT KNOW……………………………3

1003 CHECK 1002a & 1002b 1. IF FATHER ALIVE OR IF THERE IS A MALE GUARDIAN
1004
2. IF MOTHER ALIVE OR IF THERE IS A FEMALE GUARDIAN

3. IF BOTH PARENTS DECEASED AND NO GUARDIAN 1004

1100

100
Straight Talk: Full Report

1004 Has any of your


parents/guardians ever talked to YES………………………………………….1
you about issues related to
sexuality, growing up, NO……………………………………………2 1014
relationships between boys and
girls etc.? NOT SURE………………………………….3 1014
(IF THIS IS A PARENT-CHILD
PAIRED
INTERVIEW, FRAME THE
QUESTIONS IN RELATION TO
THE PARENT/GUARDIAN
BEING INTERVIEWED)

Abazairebo/Abakukuuma
baali bogeireku niiwe ku
nsonga edhigemagana
n‘okwegaita muby‘obukaba,
okukula, enkolagana wagati
w‘abalenzi n‘abawala etc?.

1005 Which issues have they (or PERSONAL HYGIENE………………………..…………….1


parent/guardian being
interviewed) talked to you about? BOY-GIRL RELATIONSHIP………………………………..2
(DO NOT READ LIST, WAIT
FOR RESPONDENT TO BODY CHANGES AS YOUTH GET OLDER……….…….3
ANSWER. PROBE TWICE BY
ASKING ―WHAT ELSE?‖. ABSTINENCE………………………………………………..4
CIRCLE ALL RESPONSES
MENTIONED) SEXUAL BEHAVIOR…………………………………….….5

STDS……………………………………………………….…6

HIV/AIDS………………………………………………………7

CONTRACEPTIVES………………………………………….8

ALCOHOL AND DRUG ABUSE……………………………..9

NOT TO ACCEPT GIFTS FOR SEX………………………..10

OTHER (SPECIFY) _______________________________

OTHER (SPECIFY) _______________________________

How old were you when your


1006 parent/guardian (or
parent/guardian being ____________ YEARS OF AGE
interviewed) talked to you the first
time? (ASK RESPONDENT TO
ESTIMATE, PERHAPS BY CAN’T RECALL………………………….88
USING THE CLASS S/HE WAS
IN WHEN THE PARENT
TALKED TO HIM/HER)

101
1007 How many times have you _________ TIMES
discussed these matters with your
parent/guardian (or MANY TIMES……………………………………..…….77
parent/guardian being
interviewed) in the past 12 CAN’T RECALL/CAN’T TELL………………………….88
months?
Mirundi emeka
gyewakakubaganya ebidhuubo
ku nsonga dhino
(in the past 12 months)?

(IF RESPONDENT CANNOT


STATE EXACTLY, ASK
HIM/HER TO GIVE YOU THEIR
BEST ESTIMATE)

1008 When was the last time you A WEEK AGO OR MORE RECENTLY……….1
discussed these matters with your
ABOUT A MONTH AGO……………………….2
parent/guardian (or
parent/guardian being ABOUT 2–6 MONTHS AGO…………………...3
interviewed)?
ABOUT 7–12 MONTHS AGO………………….4
Wasembayo li okukubaganya
ebilowoozo ku nsonga dhino OVER 12 MONTHS AGO………………………5
n‘omuzairewo/omukuumi wo?
CAN’T RECALL………………………………….6
(or parent/guardian being
interviewed)?

(DO NOT READ RESPONSES,


WAIT FOR THE RESPONDENT
TO ANSWER. IF S/HE CANNOT
REMEMBER EXACTLY, ASK
HIM/HER TO GIVE YOU THEIR
BEST ESTIMATE)

1009 Which parent/guardian did you


PARENT/GUARDIAN BEING INTERVIEWED…….….1
discuss these matters with the
last time you held such a MOTHER OR FEMALE GUARDIAN………………..….2
discussion?
FATHER OR MALE GUARDIAN…………………….….3
BOTH………………………………………………………4
CAN’T RECALL……………………………………….….5

1010 The last time you held a


PARENT/GUARDIAN BEING INTERVIEWED………….1
discussion about these matters,
who started the discussion? MY SELF (I.E. ADOLESCENT)………………………..…2
Omulundi gwewasembayo
PARENT/GUARDIAN…..…………………………….……3
okukubaganya ebilowoozo ku
nsonga dhino, naani NO ONE PERSON/IT JUST HAPPENED………….……4
eyatandika oluwayo luno?
CANT RECALL………………………………………….….5
(DO NOT READ LIST; WAIT
FOR RESPONSE. CIRCLE OTHER (SPECIFY _____________________________
ONLY ONE ANSWER)

102
Straight Talk: Full Report

1011 The last time you held such a HAPPY IT HAD HAPPENED…………………….…………...1
discussion with your
UNHAPPY IT HAD HAPPENED……………………………..2
parent/guardian (or
parent/guardian being COULD NOT JUDGE THE REACTION..……………………3
interviewed) about these matters,
CANNOT REMEMBER………………………………………..4
what was his/her reaction? Would
you say s/he was:
Omulundi gwewasembayo
okwogera
n‘omuzairewo/omukuumi wo
ku nsonga dhino, ye yeebisa
atya?
Would you say s/he was ……..
(READ LIST. CIRCLE ONLY
ONE ANSWER)

1012 When you have talked to your


HELPFUL…………………………………………………………1
parent/guardian (or
parent/guardian being NEITHER HELPFUL NOR UNHELPFUL……………………..2
interviewed) about issues related
UNHELPFUL……………………………………...……………..3
to sexuality, how helpful would
you say these discussions have CAN’T DECIDE………………..………………………………..4
been? Would you say:
Bwewayogeraku
n‘omuzairewo/omukuumiwo
ku nsonga edhigema ku
by‘okwegaita
muby‘obukaba, osobola
okukoba nti emboozi eno
yakuyamba etya? Osobola
okukoba nti yali
(READ LIST. CIRCLE ONLY
ONE ANSWER)

103
1013 How comfortable would you say FR/MALE MTHR/FEM
a you are talking to your FATHER
OR MALE GUARDIAN (or VERY COMFORTABLE……………………..1………………..1
parent/guardian being interviewed
COMFORTABLE……………………….……..2……………….2
if he is a male) about these
matters? Would you say you are: UNCOMFORTABLE………………………….3……………….3

Wandikobye nti owulira


otya mule, nga oli kwogera
ni baabawo oba omuntu
omusadha akukuuma, ku
nsonga dhino?
1013 (READ LIST. CIRCLE ONLY
b ONE ANSWER)

How comfortable would you say


you are talking to your MOTHER
OR FEMALE GUARDIAN (or
parent/guardian being interviewed
if she is a female) about these
matters? Would you say you are:

Wandikobye nti owulira


otya mule nga oli kwogera
ni maamawo oba omuntu
omukazi akukuuma, ku
nsonga dhino:
(READ LIST. CIRCLE ONLY
ONE ANSWER)

1014 CHECK 1004 1. IF NOT TALKED TO PARENT/GUARDIAN


1015
2. IF TALKED TO PARENT/GUARDIAN

1016

1015 Why haven’t you talked to your I AM EMBARRASSED...…………………………………....….…1


parents/guardians (or
I PREFER TO TALK TO SOMEONE ELSE (WHO?)
parent/guardian being interviewed
if he is a male) about these ___________________________________…….……………...2
issues issues? (DO NOT READ
I DO NOT HAVE ENOUGH INFORMATION……………..……..4
LIST. PROBE TWICE
BYASKING ―WHAT ELSE?‖. I AM NOT INTERESTED IN THESE THIINGS………………….5
CIRCLE ALL RESPONSES
I DO NOT SEE PARENT/GUARDIAN OFTEN………………….6
MENTIONED)
PARENT/GUARDIAN NOT INTERESTED………………………7
I AM AFRAID OF PARENT/GUARDIAN/S REACTION…………8
I DO NOT THINK S/HE WILL KNOW THE ANSWERS……..….9
OTHER (SPECIFY) ____________________.___…………….10
OTHER (SPECIFY) ____________________.____________11

104
Straight Talk: Full Report

1016 How confident are you that your


a FATHER OR MALE GUARDIAN
(or parent/guardian being FR/MALE MTHR/FEM
interviewed if he is male) can
answer your questions about
VERY CONFIDENT………………………1………………….1
sexuality issues? Would you say
he is: CONFIDENT……………………………….2…………………2
Bukakafuki bwoli nabwo nti
NOT CONFIDENT AT ALL……………….3………………….3
baabawo oba omukumiwo
omusadha asobola okwiramu DON’T KNOW/CAN’T TELL……………..4…………………..4
ebibuzobyo ebigema ku
nsonga dh‘ebyokwegaita mu
by‘omukwano. (READ LIST.
CIRCLE ONLY ONE ANSWER)
1016
b REPEAT ABOUT
MOTHER/FEMALE GUARDIAN
1017 How knowledgeable would you
a say that your FATHER OR MALE FR/MALE MTHR/FEM
GUARDIAN (or parent/guardian
being interviewed if he is male) is
VERY KNOWLEDGEABLE………………1…………………1
about sexuality issues? Would
you say he is: KNOWLEDGEABLE………………………2…………………2
Osobola okukoba nti bumanhi
NOT KNOWLEDGEABLE AT ALL..……..3…………………3
ki baabawo oba omukuumiwo
omusadha bwali nabwo ku DON’T KNOW/CAN’T TELL……………...4………………….4
nsonga edhigema ku
by‘okwegaita mu
byomukwano?
(READ LIST. CIRCLE ONLY
ONE ANSWER)
1017b
REPEAT ABOUT
MOTHER/FEMALE GUARDIAN

105
SECTION XI: SELF-EFFICACY AND SELF CONFIDENCE

I will now read some statements


on how young people your age
might feel about themselves.
Please tell me whether you agree
or disagree with the statement as
it applies to you. If you cannot
decide or are not sure, feel free to AGREE DISAGREE CAN’T DECIDE
say so as well. (READ EACH
1100 STATEMENT AND ASK: ―DO 1 2 3
YOU AGREE OR DISAGREE?‖)
1101
I am happy the way I am 1 2 3

I don’t feel I am as important to


1102 my family as other family
members.
1 2 3

I feel that most of my friends are


1103 better than me.
Mpulira mule nga mikwano
gyange abasinga, bansinga 1 2 3
okuba obulungi

I feel that I can do things as well


1104 as most people my age.
Mpulira mule nga nsobola
okukola ebintu ebindinga 1 2 3
abantu bemyaka gyange
1105 abandi.

I do not feel like I have a bright


future. 1 2 3
Tiwulira mule nga ndi
1106 n‘ebiseera eby‘omumaiso
ebitangaavu 1 2 3

FOR GIRLS: I wish I was born as


a boy instead of a girl
FOR BOYS: I wish I was born a
girl instead of a boy

I am sure that I can say “NO” to


sex if I don’t want it.

SECTION XII: PUBERTAL DEVELOPMENT


1201 FOR FEMALES: As young YES………………………………………….1
people grow up, they experience
changes in their bodies. Have you NO……………………………………………2 1300
started having your periods?
NOT SURE………………………………….3 1300
FOR MALES: As young people
grow up, they experience
changes in their bodies. Have you
started having wet dreams?

106
Straight Talk: Full Report

1202 How old were you when you first


started having your periods/wet _____________ YEARS
dreams?
DON’T KNOW…………………88

CAN’T RECALL……………….77

1203 Did you know what was YES………………………………………….1


happening to you when you
started having your periods/wet NO……………………………………………2
dreams?

1204 Had anyone ever talked to you YES………………………………………….1


about preparing for your
periods/wet dreams before they NO……………………………………………2
came?
NOT SURE/CANT RECALL……………….3

SECTION XIII: DEFILEMENT AND CHILD SEXUAL ABUSE


1300 Sometimes young people are DO NOT GO OUT AT NIGHT……………………………………..…1
tricked or forced to have sex with
others when they do not want to. DO NOT GO OUT ALONE………………………………………..….2
What are some of the things
young people can do to avoid AVOID DARK OR ISOLATED PLACES…………………………….3
being forced into sex by others?
(PROBE BY ASKING ―WHAT AVOID BEING ALONE W/ SOMEONE YOU DONT TRUST .……4
ELSE?‖ 2 TIMES. CIRCLE ALL
MENTIONED) NOT ACCEPT GIFTS FROM PEOPLE YOU DON’T TRUST…....5

Ebiseera ebindi, abantu ALWAYS MEET YOUR BOY-GIRLFRIEND IN A


abato basendebwa PLACE WHERE THERE ARE PEOPLE………….………………...6
sendebwa oba bakakibwa
BE ASSERTIVE, SAY “NO”…………………………………………. 7
okwegaita muby‘obukaba
n‘abantu abandi nga IF ATTACKED, RUN TO WHERE THERE ARE PEOPLE………...8
tibenda. Bintuki abantu
abato byebayinza okukola, IF ATTACKED, SHOUT LOUDLY……………………………………9
okwewala okukakibwa mu
by‘obukaba n‘abantu FIGHT WITH ALL YOUR MIGHT…………………………………..10
abakulu?
(PROBE BY ASKING ―WHAT THREATEN TO TELL THE PERSON’S WIFE OR HUSBAND….11
ELSE?‖ 2 TIMES. CIRCLE ALL
MENTIONED) OTHER (SPECIFY) __________________________________12

OTHER (SPECIFY) __________________________________13

1301 If someone tries to force you to


YES………………..…………………………………………….1
have sex with him/her, and you
don’t want to have sex, do you NO………………………………………………………………..2------ 1303
have anyone you would you tell?

107
1302 Who would you tell? (PROBE BY
MOTHER……………………………………….………………….1
ASKING ―WHO ELSE‖ 2 TIMES.
CIRCLE ALL MENTIONED) FATHER…………………………………………..……………….2
GUARDIAN...……………………………………..………………3
BOYFRIEND/GIRLFRIEND/LOVER……………………………4
OTHER FRIEND……….…………………………………………5
SPOUSE/HUSBAND/WIFE……………………………………..6
SISTER…………………………………………………………….7
BROTHER…………………………………………………………8
AUNT/UNCLE…………………………………………………….9
GRANDMOTHER/GRANDFATHER………………………….10
OTHER RELATIVE……………………………………………..11
TEACHER………………………………………………………..12
HEALTH WORKER/COUNSELOR……………………………13
PEER EDUCATOR……………………………………………..14
STRAIGHT TALK WORKER…………………………………..15
RELIGIOUS LEADER…………………………………………..16
POLICE…………………………………………………………..17
COMMUNITY LEADER………………………………………...18
SOMEONE ELSE (SPECIFY) _______________________
SOMEONE ELSE (SPECIFY) _______________________

1303 If someone actually forced you to VERY CONFIDENT……………………………………………..……..1


have sex against your will, how
SOMEWHAT CONFIDENT………………………………………..….2
confident are you that you could
tell someone about this? Would NOT CONFIDENT AT ALL……………………………………..……..3
you say you would be: (READ
CAN’T DECIDE/NOT SURE…………………………………….…….4
LIST. CIRCLE ONLY ONE
ANSWER)

108
Straight Talk: Full Report

SECTION XIV: HIV RISK EXPOSURE

Now I’d like you to answer some


questions about some things you
may have done or may have
happened to you in the past 12
months. This information is all
completely private and secret. No
one will know that you are the
one who answered the question.
Please answer the questions
honestly and to the best of your
knowledge.
How many times have you done
any of the following in the past 12
months? (Read statement and
record the respondent‘s
answer. If ―no times‖, record
―0‖. If s/he cannot recall, circle
77.)

1401 Attended discos or village night ______________ TIMES 77…….CANNOT RECALL


dances?

1402 Read pornographic


books/magazines on sexual ______________ TIMES 77…….CANNOT RECALL
relations between men & women?
Wasomaku ebitabo oba
obutabo obugemagana ku
by‘okwemoola
muby‘omukwano wagati
w‘abasadha n‘abakazi?

1403 Kissed with someone of the _______________ TIMES 77…….CANNOT RECALL


opposite sex?

1404 Accepted gift/money/favor FROM


someone of the opposite sex in _______________ TIMES 77…….CANNOT RECALL
exchange for love or affection
Waikirizaku ekirabo/empiya
okuva ku muntu
gw‘otafanaganya naye kikula
nga muwanisaganya
omukwano oba obwenzi?

1405 Given gift/money/favor TO _______________ TIMES 77…….CANNOT RECALL


someone of the opposite sex in
exchange for love or affection

1406 Drank alcohol (including local _______________ TIMES 77…….CANNOT RECALL


brews)

1407 Smoked cigarettes _______________ TIMES 77…….CANNOT RECALL

1408 Smoked bhang, taken other drugs _______________ TIMES 77…….CANNOT RECALL

109
How many times have the
following happened to you in the
past 12 months? (Read
statement and record the
respondent‘s answer. If ―no
times‖, record ―0‖. If s/he
cannot recall, circle 77.)

1409 Someone of the opposite sex _____________ TIMES 77…….CANNOT RECALL


touched you in a way that made
you feel uncomfortable

1410 Someone of the opposite sex ____________ TIMES 77…….CANNOT RECALL


tried to force you to kiss them
even though you did not want to.
Omuntu ow‘ekikula ekindi
yagezaaku okukukaka
okumunuuna ku munwa, waile
nga iwe wali toyenda.

1411 You kissed someone of the _____________ TIMES 77…….CANNOT RECALL


opposite sex even though they
did not want to be kissed by you

1412 Someone tried to force you into _____________ TIMES 77…….CANNOT RECALL
having sex even though you did
not want it
1413
You tried to force someone into _____________ TIMES 77…….CANNOT RECALL
having sex even though they did
not want it

1414 Have you ever had a YES………………..……………………………………………..1


boy/girlfriend?
NO………………………………………………………………..2

1415 Have you ever had sex? YES………………..……………………………………………..1

NO………………………………………………………………..2
1433

1416 How old were you when you had


_____________ YEARS
sex for the first time?
DON’T KNOW……………….88
CAN’T RECALL……………..77

1417 What date did you play sex for


MONTH
the first time? (IF RESPONDENT
CANNOT RECALL, PERSUADE
DON’T KNOW MONTH …………………………………….98
THEM TO DO THEIR BEST)
YEAR

DON’T KNOW YEAR …………………………..9998

110
Straight Talk: Full Report

1418 How old was your first sexual _____________ YEARS


partner?

DON’T KNOW…………………88
CAN’T RECALL……………….77

1419 What made you decide to have TO SHOW LOVE………………………………………………01


sex the first time? (DO NOT
TO GET MY SELF A GIRL/BOY FRIEND…………………..02
READ LIST. CIRCLE ALL
ANSWERS MENTIONED. TO SATISFY CURIOUSITY………………………………….03
PROBE BY ASKING
I WAS FORCED……………………………………………….04
―ANYTHING ELSE?‖ 2 TIMES.)
I WAS RAPED…………………………………………………05
MY PARTNER INSISTED…………………………………….06
MY FRIENDS PRESSURED ME…………………………….07
WE WERE PLANNING TO MARRY…………………………08
I DO NOT KNOW WHY……………………………………….09
OTHER (SPECIFY) ____________________________
OTHER (SPECIFY) ____________________________

1420 How many sex partners have you _____________ PARTNERS


had since you first started playing
sex? “MANY” ……………………66

CAN’T RECALL……………….77

1421 Referring just to the past 12 _______________ TIMES


months, how many times have
you had sex? (IF NO TIMES, IF 0 TIMES 1425
RECORD ―0‖ AND GO TO
Q1423) “MANY”…………………66

CAN’T RECALL……....77

1422 How many partners have you had _____________ PARTNERS


sex in the past 12 months?
“MANY” ……………………66

CAN’T RECALL……………….77

1423 In the past 12 months, have you YES……………….………………………………….1


had sex with someone from
whom you received gifts or NO……………………………………………………2
money in exchange for sex?

1424 In the past 12 months, have you YES……………….………………………………….1


had sex with someone to whom
you gave gifts or money in NO……………………………………………………2
exchange for sex?

111
1425 Thinking about your last sex ______________ YEARS
partner, how old was s/he?
DO NOT KNOW…………88

CAN’T RECALL………….77

1426 Thinking again about your last


WE PLAN TO MARRY………………………………………..1
sex partner, what are your plans
with him/her? (CIRCLE ONE WE ARE DATING …………………………………………….2
REASON ONLY)
WE ARE JUST FRIENDS…………………………………….3
WE HAD JUST MET…………………………………………..4
WE ALREADY BROKE UP…………………………………...5
NO PLAN AT ALL…………………………………………..…5
DON’T KNOW/NOT DECIDED...…………………………….6
OTHER (SPECIFY) _____________________________

1427 What does s/he (your last


STUDENT…………………………………………………….1
partner) do for a living?
EMPLOYED…………………………………………………..2
UNEMPLOYED (I.E. NO JOB)…………….……………….3
ENGAGED IN BUSINESS…………………………………..4
DON’T KNOW/NOT SURE………………………………….5
OTHER (SPECIFY) ____________________________

1428 If you do not want to have sexual


VERY CONFIDENT…………………………………………..1
intercourse, how confident are
you that you could tell your SOMEWHAT CONFIDENT………………………………….2
partner and s/he would not force
NOT CONFIDENT AT ALL…………………………………..3
you? Would you say you are
(READ LIST): CANT DECIDE/NOT SURE………………………………….4

1429 The last time you had sex, was a


YES………………..……………………………………………..1
condom used?
NO………………………………………………………………..2 1431
CAN’T REMEMBER……………………………………………3
1431

1430 The last time a condom was


MYSELF………………………………………………..1
used, who suggested it?
MY PARTNER…………………………………………2
BOTH OF US…………………………………………..3
CANNOT RECALL…………………………………….4

112
Straight Talk: Full Report

1431
CHECK Q1429
USED CONDOM LAST SEX 1500

1432
DID NOT USE CONDOM LAST SEX

1432 IF A CONDOM WAS NOT USED:


TRUSTED MY PARTNER……………………………………01
What was the main reason a
condom was not used? (DO NOT CONDOMS NOT AVAILABLE……………………………….02
READ LIST. CIRCLE ONLY ONE
CONDOMS TOO EXPENSIVE………………………………03
ANSWER)
PARTNER OBJECTED………………………………………04
CONDOMS TOO EMBARRASSING………………………..05
WE USED OTHER CONTRACEPTIVE……………………..06
I DIDN’T THINK IT WAS NECESSARY…………………….07
DID NOT KNOW ABOUT CONDOMS………………………08
I WAS AFRAID TO SUGGEST………………………………09
CONDOMS ARE FOR PROMISCIOUS PEOPLE…………10
I DON'T LIKE THEM…………………………………………..11
I DIDN’T THINK OF IT………………………………………..12
DON’T KNOW WHY WE DID NOT USE……………………13
OTHER (SPECIFY) _______________________________

1433 CHECK WHETHER HAD SEX 1500


1. HAD SEX
OR NOT
2. NOT HAD SEX 1434

1434 (IF NOT HAD SEX) What is your


I DO NOT WANT TO………………………………………………01
main reason for not having sex?
I AM NOT READY….………………………………………………02
Oba tiwegaitangaku mubya I AM NOT INTERESTED….………………………………………03
mukwano, nsonga ki yeene
enkulu ekuletera I WANT TO FINISH EDUCATION..………………………………04
okubiviiraku ilala? RELIGIOUS TEACHINGS……….……………………….……….05
RISK OF PREGNANCY……………………….………….……….06
(CIRCLE ONLY ONE ANSWER)
FEAR CONTRACTING STD/HIV.………………………………...07
FEAR MY PARENTS………………………………………………08
WOULD LIKE TO ABSTAIN TILL MARRIAGE…………………..09
NOBODY HAS ASKED ME…………………………………..……10
OTHER (SPECIFY)__________________________________11

113
SECTION XV: HIV TESTIING

1500 We do not want to know the


YES………………………………………………………………..1
results, but have you ever been
tested for HIV? NO………………………………………………………………….2----- 1502
DON’T KNOW……………………………………………………..3

1501 What date was your last HIV test?


MONTH

DON’T KNOW MONTH …………………………………….98

YEAR

DON’T KNOW YEAR …………………………..9998

1502 CHECK WHETHER HAD SEX 1503


1. HAD SEX
OR NOT

1600
2. NOT HAD SEX

1503 Has your last sex partner ever


YES………………………………………………………………..1
been tested for HIV?
NO………………………………………………………………….2
DON’T KNOW/NOT SURE………………………………………3

1504 RECORD THE TIME


INTERVIEW ENDS. HOUR

MINUTES

SECTION XVI: ENDING


1600 We are now at the end of the questionnaire. Are there any comments you would like to make? (WRITE THE COMMENTS
VERBATIM; DO NOT ABBREVIATE OR INTERPRET. PLEASE THANK THE RESPONDENT AT THE END OF HER/HIS
COMMENTS.)

114

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