Sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda: prevalence, predictors, and implications for sexual and reproductive health programming

Abstract Background Psychoactive substance use has an impact on risky sexual behaviour. Globaly, over 275 million people use psychoactive substances, however evidence on the predictors of sex under the influence of these substatnces is scanty. We investigated the prevalence and predictors of sex under the influence of psychoactive substances among young people aged 18–24 years. Methods A cross-sectional study was conducted among 744 sexually active young psychoactive substance users living in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire preloaded on Kobocollect. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the factors associated with the outcome variable. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. Results About 61.0% (454/744) of the respondents had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04–1.34), being 20–24 years of age (PR: 1.22, 95% CI: 1.04–1.44), being married (PR 1.15, 95% CI: 1.01–1.31) or divorced/separated (PR 1.43, 95% CI: 1.26–1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99–1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79–1.03) and using alcohol (PR 1.43, 95% CI: 1.25–1.69), marijuana (PR 1.16, 95% CI: 1.02–1.31) and khat (PR 1.25, 95% CI: 1.10–1.42) in the last 30 days. Conclusion This study revealed a high prevalence of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. The predictors of sex under the influence of psychoactive substances were being female, being 20–24 years of age, being married or divorced/separated, not living with biological parents or guardians, and using alcohol, marijuana and khat in the last 30 days. There is a need for sexual and reproductive health programs to incorporate risk reduction interventions that aim to reduce sex under the influence of psychoactive substances among the said categories in informal settlements.