Table 1 shows slightly over five-in-every nine (56%) young women in rural residence had primary education while nearly one half (49.3%) of young women in urban residence had secondary level as their highest educational level. The highest rural-urban differential (26.3%) in highest educational level was at the primary level. Nearly three-in-every five (59.5%) young women in urban residence were aged between 20–24 years. On other hand, about five-in-every ten (54.1%) young women in rural residence were between the ages of 15–19. Majority of the young women in urban (37.44%) and rural (39.2%) residences were Catholics. On the other hand, the lowest proportion of young women in urban (17.8%) and rural (12.1%) residences were Muslims.
Majority of the households in urban (60%) residence were headed by females while most of the households in rural (53.2%) residence were headed by males. Concerning total children ever born, results in both urban (64.3%) and rural (55.8%) residences reveal nearly six in every 10 young women had no child. However, the proportion of young women having at least one child was generally higher in rural compared to urban residence. Results also show majority of young women in both rural (69.3%) and urban (61.9%) residence to have initiated sex between 15–18 years.
Most of the young women in rural (62.0%) and urban (62.5%) residences worked in the informal sector while the formal sector posted the lowest percentage in both rural (6.2%) and urban (7.8%) residence. Results reveal the highest proportion (57.2%) of young women in urban residence having comprehensive knowledge on HIV while majority (52.3%) of young women in rural residence lacked comprehensive knowledge on HIV. With regard to HIV stigma, the highest proportion of young women in both rural (70.7%) and urban (79.2%) areas did not have HIV stigma. However, the proportion of young women who had stigma was higher (29.3%) in rural areas compared to urban areas (20.8%). Majority of the households in urban areas (70.1%) were at the highest level of wealth index while in rural residence (24.4%) majority of the households were in the fourth level of household wealth index.
Table 1
Distribution by women’s characteristics
Characteristic
|
Urban (n = 493)
|
Rural (n = 1,102)
|
Difference (%)
|
Highest educational level
|
|
|
|
No education
|
1.2
|
1.5
|
0.3
|
Primary
|
30.6
|
56.8
|
26.3
|
Secondary
|
49.3
|
34.1
|
-15.2
|
Highest
|
18.9
|
7.5
|
-11.4
|
Age in 5 year groups
|
|
|
|
15–19
|
40.5
|
54.1
|
13.6
|
20–24
|
59.5
|
45.9
|
-13.6
|
Religion
|
|
|
|
Anglican
|
25.3
|
35.5
|
10.3
|
Catholic
|
37.4
|
39.2
|
1.8
|
Muslim
|
17.8
|
12.1
|
-5.7
|
Others
|
19.6
|
13.3
|
-6.3
|
Sex of household head
|
|
|
|
Male
|
40.0
|
53.2
|
13.2
|
Female
|
60.0
|
46.8
|
-13.2
|
Total children ever born
|
|
|
|
No child
|
64.3
|
55.8
|
-8.5
|
1 Child
|
24.8
|
27.9
|
3.1
|
2 Children
|
7.4
|
11.3
|
3.9
|
3 and more children
|
3.6
|
5.0
|
1.5
|
Age at first sex
|
|
|
|
Before 15 years
|
15.4
|
19.2
|
3.9
|
15–18 years
|
61.9
|
69.3
|
7.4
|
19 Years and above
|
22.8
|
12.5
|
-10.2
|
Respondents Occupation
|
|
|
|
Not working
|
29.6
|
31.9
|
2.3
|
Working in formal sector
|
7.8
|
6.2
|
-1.7
|
Working in informal sector
|
62.5
|
62.0
|
-0.6
|
HIV comprehensive knowledge
|
|
|
|
Don’t have HIV comprehensive knowledge
|
42.8
|
52.3
|
9.6
|
Have HIV comprehensive knowledge
|
57.2
|
47.6
|
-9.6
|
HIV stigma
|
|
|
|
Have HIV stigma
|
20.8
|
29.3
|
8.6
|
Don’t have HIV stigma
|
79.2
|
70.7
|
-8.6
|
Household wealth index
Lowest
Second
Middle
Fourth
Highest
|
3.5
4.0
4.4
17.9
70.1
|
16.6
21.8
21.0
24.4
16.1
|
13.1
17.8
16.6
6.5
-54.6
|
Transactional Sex
Transactional sex (TS) was assessed basing on a binary outcome. These was ‘Yes’ for being engaged in transactional sex and ‘No’ for no engagement in transactional sex. Figure 1 presents the distribution of young women who were engaged in transactional by type of place of residence.
Figure 1 Distribution of young women (15–24) by Transactional sex
According to Fig. 1, approximately one-in-every eleven (8.9%, 95%CI: 6.7%-11.8%) young women in urban residence were engaged in TS compared to about four-in-every twenty-five (16.4%, 95%CI: 14.4%-18.7%) young women in rural residence. This result leaves a significant rural-urban difference (7.5%) in TS among young women demonstrated by non-overlapping confidence intervals (p < 0.05). This implies that young women from rural residence are at a higher risk of consequences associated with TS like teenage pregnancy and HIV infection.
Differentials In Transactional Sex
Table 2 presents differences in Transactional sex between young women from rural and urban residence distributed by their characteristics.
Table 2
Difference in Transactional sex between urban and rural young women
Characteristic
|
Urban
(n = 493)
|
χ2
|
p-value
|
Rural (n = 1,102)
|
χ2
|
p-value
|
Difference (%)
|
Highest educational level
|
|
7.368
|
0.061
|
|
12.047
|
0.007
|
|
No education
|
0.0
|
|
|
5.5
|
|
|
5.5
|
Primary
|
12.4
|
|
|
18.0
|
|
|
5.6
|
Secondary
|
8.8
|
|
|
14.6
|
|
|
5.8
|
Highest
|
3.9
|
|
|
6.3
|
|
|
2.4
|
Age in 5 year groups
|
|
5.872
|
0.015
|
|
12.308
|
0.000
|
|
15–19
|
12.5
|
|
|
19.0
|
|
|
6.4
|
20–24
|
6.4
|
|
|
12.0
|
|
|
5.6
|
Religion
|
|
2.523
|
0.471
|
|
4.911
|
0.178
|
|
Anglican
|
9.1
|
|
|
19.2
|
|
|
10.1
|
Catholic
|
6.3
|
|
|
13.5
|
|
|
7.2
|
Muslim
|
13.4
|
|
|
13.6
|
|
|
0.2
|
Others
|
9.3
|
|
|
15.0
|
|
|
5.7
|
Sex of household head
|
|
1.694
|
0.193
|
0.193
|
3.612
|
0.057
|
|
Male
|
13.0
|
|
|
18.2
|
|
|
5.1
|
Female
|
6.1
|
|
|
13.0
|
|
|
6.9
|
Total children ever born
|
|
4.309
|
0.230
|
|
16.880
|
0.001
|
|
No child
|
10.0
|
|
|
20.1
|
|
|
10.1
|
1 Child
|
6.7
|
|
|
9.9
|
|
|
3.2
|
2 Children
|
1.8
|
|
|
12.2
|
|
|
10.4
|
3 and more children
|
19.0
|
|
|
8.0
|
|
|
-11.0
|
Age at first sex
|
|
14.530
|
0.001
|
|
11.468
|
0.003
|
|
Before 15 years
|
18.8
|
|
|
24.7
|
|
|
5.8
|
15–18 years
|
7.3
|
|
|
14.4
|
|
|
7.1
|
19 Years and above
|
6.3
|
|
|
10.1
|
|
|
3.8
|
Respondents Occupation
|
|
2.159
|
0.340
|
|
7.642
|
0.022
|
|
Not working
|
6.9
|
|
|
16.4
|
|
|
9.6
|
Working in formal sector
|
4.1
|
|
|
6.6
|
|
|
2.5
|
Working in informal sector
|
10.4
|
|
|
16.3
|
|
|
5.9
|
HIV comprehensive knowledge
|
|
0.701
|
0.402
|
|
4.224
|
0.040
|
|
Don’t have HIV comprehensive knowledge
|
10.7
|
|
|
18.5
|
|
|
7.8
|
Have HIV comprehensive knowledge
|
7.5
|
|
|
12.8
|
|
|
5.3
|
HIV stigma
|
|
0.312
|
0.576
|
|
6.737
|
0.009
|
|
Have HIV stigma
|
5.5
|
|
|
20.0
|
|
|
14.4
|
Don’t have HIV stigma
|
9.7
|
|
|
14.0
|
|
|
4.3
|
Household wealth index
|
|
5.547
|
0.236
|
|
7.772
|
0.100
|
|
Lowest
|
5
|
|
|
15.0
|
|
|
10.0
|
Second
|
9.1
|
|
|
21.3
|
|
|
12.2
|
Middle
|
13.6
|
|
|
14.4
|
|
|
0.8
|
Fourth
|
15
|
|
|
17.2
|
|
|
2.2
|
Highest
|
7.4
|
|
|
18.8
|
|
|
4.4
|
Bolden indicates P < 0.05 |
Findings from Table 2 demonstrate a general decrease in TS with increasing level of education from primary level onwards for young women in both rural and urban residences. However, the decrease was only statistically significant among young women from rural residence (p < 0.05). Further, across all levels of education, young women from rural residence had the highest proportion of TS compared to urban residence. With regard to the age group, TS significantly decreased with increase in the age group of a young woman for both residences (p < 0.05). In all age groups TS was higher for young women from rural residence compared to urban residence. Pertaining to religion, highest rural-urban difference (10.1%) in TS was among young women in the Anglican denomination while the lowest difference (0.2%) existed among young women in the Muslim denomination. However, the changes in TS with regard to religion were not statistically significant (p > 0.05) for both residences.
In relation to sex of household head, TS in both residences was higher among young women from households headed by men (urban = 13.0%, rural = 18.2%) compared to those headed by females (urban = 6.1%, rural = 13.0%). However, changes in TS with regard to household head were not statistically significant (p > 0.05) for both residences.
With regard to total children ever born, the highest (11.0%) rural-urban differential in TS was among young women with at least three children ever born and lowest (3.2%) among those with one child. Among young women with at least three children, TS was more pronounced in urban areas (19.8%) compared to rural areas (8.0%). However, the changes in TS with regard to total children ever born were only statistically significant among young women in rural residence (p < 0.05). With regard to age at first sex, results reveal a significant downward trend in TS with increase in age at first sex for both residences (p < 0.05). Pertaining to respondent’s occupation, young women working in the formal sector had the lowest proportion of TS for both sub populations (urban = 4.4%, rural = 6.6%). Results further demonstrate the rural-urban gap in TS being highest (9.6%) among young women not working and lowest (2.5%) among those working in the formal sector. However, changes in TS with regard to respondents occupation were only statistically significant among young women in rural residence (p < 0.05). In both rural and urban residence, TS was higher among young women who lacked HIV comprehensive knowledge compared to those who had HIV comprehensive knowledge. However, only findings from rural residence were statistically significant (P < 0.05).
With regards to HIV stigma, results show TS being highest among young women with HIV stigma in rural residence while in urban residence, highest percentage of TS was among young women who lacked HIV stigma. However, the findings were only statistically significant in rural residence. Across all categories of wealth index, TS was insignificantly highest among young women in rural areas compared to urban residence (P > 0.05). However, wealth index was not included in the multivariate decomposition logistic model since it was not statistically significant at bivariate level and would not add much information in explaining the outcome variable in the final model. Therefore, the following variables were taken for further analysis at multivariate level; highest level of education, age in 5 year groups, religion, sex of household head, total children ever born, age at first sex, respondents occupation, HIV comprehensive knowledge and HIV stigma.
Decomposition Of Differences In Transactional Sex
A multivariate decomposition logistic model was used to decompose the rural-urban gap in TS between rural and urban young women attributed to variation in their characteristics/endowments (E) and variation in the effects of the predictors/coefficients (C). Tables 3 and 4 present decomposition results of the rural-urban gap in TS.
Table 3
Summary of decomposition of Transactional sex
Components
|
Coefficient
|
p-value
|
Percent (%)
|
E
|
0.0212
|
0.0120
|
30.7
|
C
|
0.0477
|
0.0100
|
69.3
|
R
|
0.0689
|
0.0000
|
100.0
|
Note: Overall decomposition results of transactional sex; n = 1,595; variations are attributed to differences due to endowments (E) and coefficients (C); R is the total variation. The assessment is based on weighted data. |
Table 4
Decomposition of Transactional sex
Variables
|
Due to difference in characteristics (E)
|
Due to difference in coefficients (C)
|
|
Coefficient
|
p-value
|
percent
|
Coefficient
|
p-value
|
percent
|
Highest educational level
|
|
|
|
|
|
|
No education
|
1.000
|
|
|
1.000
|
|
|
Primary
|
0.033
|
0.304
|
47.68
|
-0.218
|
0.000
|
-316.90
|
Secondary
|
-0.016
|
0.391
|
-23.32
|
-0.346
|
0.000
|
-502.13
|
Highest
|
-0.003
|
0.862
|
-3.96
|
-0.134
|
0.000
|
-195.10
|
Age in 5 year groups
|
|
|
|
|
|
|
15–19
|
1.000
|
|
|
1.000
|
|
|
20–24
|
-0.004
|
0.370
|
-5.11
|
0.028
|
0.166
|
40.89
|
Religion
|
|
|
|
|
|
|
Anglican
|
1.000
|
|
|
1.000
|
|
|
Catholic
|
-0.001
|
0.106
|
-1.15
|
0.002
|
0.828
|
3.54
|
Muslim
|
0.002
|
0.351
|
3.30
|
-0.005
|
0.371
|
-7.96
|
Others
|
0.002
|
0.290
|
3.25
|
-0.001
|
0.847
|
-1.98
|
Sex of household head
|
|
|
|
|
|
|
Male
|
1.000
|
|
|
1.000
|
|
|
Female
|
0.005
|
0.116
|
7.03
|
0.011
|
0.458
|
15.82
|
Total children ever born
|
|
|
|
|
|
|
No child
|
1.000
|
|
|
1.000
|
|
|
1 Child
|
-0.004
|
0.001
|
-5.18
|
-0.006
|
0.426
|
-9.09
|
2 Children
|
-0.004
|
0.037
|
-5.93
|
0.004
|
0.446
|
5.44
|
3 and more children
|
-0.003
|
0.015
|
-4.04
|
-0.004
|
0.093
|
-5.77
|
Age at first sex
|
|
|
|
|
|
|
Before 15 years
|
1.000
|
|
|
1.000
|
|
|
15–18 years
|
-0.007
|
0.003
|
-9.90
|
0.006
|
0.718
|
9.33
|
19 Years and above
|
0.014
|
0.006
|
20.18
|
-0.005
|
0.631
|
-7.86
|
Respondents Occupation
|
|
|
|
|
|
|
Not working
|
1.000
|
|
|
1.000
|
|
|
Working in formal sector
|
0.001
|
0.474
|
1.43
|
-0.002
|
0.704
|
-3.11
|
Working in informal sector
|
0.000
|
0.266
|
-0.21
|
-0.014
|
0.414
|
-20.59
|
HIV comprehensive knowledge
|
|
|
|
|
|
|
Don’t have HIV comprehensive knowledge
|
1.000
|
|
|
1.000
|
|
|
Have HIV comprehensive knowledge
|
0.003
|
0.249
|
3.79
|
0.005
|
0.721
|
7.08
|
HIV stigma
|
|
|
|
|
|
|
Have HIV stigma
|
1.000
|
|
|
1.000
|
|
|
Don’t have HIV stigma
|
0.002
|
0.336
|
2.87
|
-0.058
|
0.013
|
-84.29
|
Constant
|
|
|
|
0.787
|
0.000
|
1142
|
Total
|
0.021
|
0.012
|
30.7
|
0.048
|
0.010
|
69.3
|
Bolden indicates P < 0.05 |
According to the results in Table 3, differences in TS between rural and urban young women were significantly attributed to both differences in the characteristics and variation effects of predictors of the two groups (P < 0.05). Overall, about 30.7% of the gap in TS can be attributed to differences in characteristics while 69.3% of the gap in TS can be attributed to differences in effects of predictors or coefficients between rural and urban young women.
Variation due to difference in characteristics of women
Overall, findings in Table 4 show that variation in characteristics of young women contributed approximately 30.7% to the overall rural-urban differential in TS. In other words, the rural urban gap in TS would reduce by 30.7% in the absence of the variations in the characteristics of young women. Specifically, the rural-urban gap in TS among young women in Uganda was significantly attributed to characteristics of young women namely; total children ever born and age at first sex (p < 0.05). The positive percentages in the results show the proportion in which the overall gap would decrease if the differences in the characteristics of young women in the two groups were to disappear. On the other hand, the negative percentage shows the proportion to which the gap in TS would increase if the differences in the characteristics of women in the two groups were to disappear.
With regard to total children ever born, the difference in characteristics of young women contributed approximately − 15.2% to the overall rural urban gap in TS. Therefore, the overall gap in TS would increase by 15.2% if the variations in total children ever born among young women were to disappear. Specifically, young women who had one child, two children and 3 or more children contributed − 5.18%, -5.93% and − 4.04% respectively to the overall gap in TS compared to young women with no child. Therefore, the overall gap in TS would increase by 5.18%, 5.93% and 4.04% respectively if the above variations in total children ever born were to disappear. With regard to age at first sex, the difference in characteristics of young women contributed approximately 10.3% to the overall rural urban differential in TS. Therefore, the overall gap in TS would decrease by 10.3% if the differences in age at first sex were to disappear. Specifically, young women who initiated sex between 15–18 years and 19 years and above contributed − 9.9% and 20.2% respectively to the overall difference in TS compared to those who begun sex below 15 years of age. Therefore, the overall gap in TS would increase by 9.9% and reduce by 20.2% respectively if the above variations in age at first sex were to disappear
Variation due to difference in effects of predictors (coefficients)
Findings in Table 4 show that variation in the effects of characteristics (coefficients) contributed about 69.3% to the overall difference in TS between rural and urban young women. Specifically, the rural-urban gap in TS among young women in Uganda was significantly attributed to the effects in characteristics of young women namely; highest level of education and HIV stigma (p < 0.05). With regard to highest educational level, the variation in the effects of predictors of young women contributed approximately − 1,014.1% to the overall rural-urban differential in TS. Therefore, the overall gap in TS would increase by 1,014.1% if the differences in the effects of highest education level were to disappear. Specifically, young women who had primary, secondary and highest level of education contributed − 316.90%, -502.13% and − 195.10% respectively to the overall gap in TS compared to young women who had no education. Therefore, the overall gap in TS would increase by 316.90%, 502.13% and 195.10% respectively if the above variations in the effects of highest educational level were to disappear. With regard to HIV stigma, the variation in the effects of young women who didn’t have HIV stigma compared to those who had HIV stigma contributed approximately − 84.3% to the overall gap in TS. Therefore, the overall gap in TS would increase by 84.3% if the differences in the effects of young women who lacked HIV stigma compared to those who had HIV stigma were to disappear.