Coerced first intercourse and reproductive health among adolescent women in Rakai, Uganda.

CONTEXT Although there is increasing recognition of the scope and significance of sexual coercion experienced by adolescent women in developing countries, evidence on its consequences for reproductive health remains limited. METHODS A sample of 575 sexually experienced 15-19-year-old women were interviewed in 2001-2002 as part of the ongoing Rakai surveillance project in rural Uganda. Chi-square tests and logistic regressions were used to investigate associations between coerced first intercourse and selected reproductive health behaviors and outcomes. RESULTS Fourteen percent of young women reported that their first sexual intercourse had been coerced. After the effects of respondents' demographic characteristics were accounted for, young women who reported coerced first intercourse were significantly less likely than those who did not to be currently using modern contraceptives, to have used condoms at last intercourse and to have used them consistently during the preceding six months; they were more likely to report their current or most recent pregnancy as unintended (among ever-pregnant women) and to report one or more genital tract symptoms. CONCLUSIONS Coerced first intercourse is an important social and public health problem that has potentially serious repercussions for young women's reproductive health and well-being. Interventions to improve adolescent women's reproductive health should directly address the issue of sexual coercion.