Determinants of Gender Inequality In Sexual Debut Among Youth In Uganda: A Decomposition Analysis

Introduction: Teenage pregnancies and sexually transmitted diseases are major public health problems in Uganda. Early sexual debut is one of the main routes for these public health problems. Determinants of gender inequality in sexual debut are crucial for developing gender specific sexual and reproductive health promotion programs that delay sexual debut. Hence the aim of this study was to identify factors that explain gender inequality in sexual debut among Ugandan youth. Methods: : This study used secondary data from a cross sectional Uganda demographic health survey of 2016. Participants were 10,235 sexually experienced youth. Using stata 14, intermediary analysis was done to assess statistical association between explanatory variables and sexual debut in a multiple logistic regression analysis. Oaxaca decomposition was used to decompose factors that explain inequalities in sexual debut between male and female youth. Results: Intermediary results showed Islam, many household members, eastern Uganda and being divorced/widowed were predictors of early sexual debut. While secondary education, higher education, blue collar jobs, being 20 to 24 and 25 to 30 years old were protective factors against early sexual debut. Material, behaviour/cultural, psychosocial, and demographic explanatory factors jointly explained a statistically significant portion of the observed gap in sexual debut between female and male youth. More female were at a disadvantage of early sexual debut as compared to male youth. About 96.37% of this gap was explained by unequal distribution of material, behaviour/cultural, psychosocial, and demographic factors between male and female youth. Relationship to household head (49%), education (16.87%), occupation (8,94%), number of household members (8.57%), frequency of using internet (7.99%) and reading newspaper or magazines (4.39%) made significant contribution to the explanation of sexual debut inequality between male and female youth. Conclusions: Results showed sexual debut inequality between female and male youth that favoured men. Programs designed to address early sexual debut and related health outcomes such as teenage pregnancies, HIV must combat inequities in education, sex education, employment opportunities, access of internet and reading newspaper or magazines across gender. They should also foster household relationships and monitor girls to reduce sexual debut inequality across gender.