Sexual Gender-Based Violence among Adolescent Girls and Young Women during COVID-19 Pandemic, Mid-Eastern Uganda

Background Global studies indicate that sexual gender based violence (SGBV) may increase during pandemics including the COVID-19. The Mid-Eastern region in Uganda was of a concern due to high prevalence of intimate partner sexual violence among adolescent girls and young women (AGYW) (13% in 2016). Due to limited data, we investigated factors associated with SGBV among AGYW during the COVID-19 pandemic in Eastern Uganda, April 2022. Methods We line listed all AGYW 10-24 years who obtained SGBV services at ten high-volume health facilities from March 2020 to December 2021, the main COVID-19 period in Uganda. We conducted a case-control study among these AGYW. A case was ≥1 SGBV episode experienced by an AGYW aged 10-24 years residing in Tororo and Busia Districts. For every randomly-selected case from the health facility line list, we identified two neighbourhood-matched AGYW controls who reported no SGBV. We interviewed 108 and 216 controls on socio-demographics, socio-economics, and SGBV experiences during COVID-19. We conducted logistic regression to obtain adjusted odds ratios and confidence intervals. Results Among 389 SGBV cases, the mean age was 16.4 (SD± 1.6: range 10-24) years, and 350 (90%) were 15-19 years. Among 108 cases interviewed, 79 (73%) reported forced sex. Most (73; 68%) knew the perpetrator. In multivariate analysis, self-reported SGBV before the COVID-19 period [aOR=5.8, 95%CI: 2.8-12] and having older siblings [aOR=1.9, 95%:CI 1.1-3.4] were associated with SGBV during the period. Living with a family that provided all the basic needs was protective [aOR=0.42, 95%: CI 0.23-0.78]. Conclusion Previous SGBV experiences and family dynamics, such as having older siblings, increased the odds of SGBV during the COVID-19 pandemic in Uganda. Conversely, a supportive family environment was protective. Identifying, supporting, and enacting protective interventions for existing SGBV victims and socioeconomically vulnerable AGYW could reduce the burden of SGBV during similar events.