Coerced sexual debut and lifetime abortion attempts among women in Rakai, Uganda

Objective: To assess whether reported coercion at sexual debut is associated with a greater lifetime risk of attempting an abortion among women in Rakai, Uganda. Methods: Analysis of data from sexually experienced, ever-pregnant women in a longitudinal, population-based, open cohort study in 56 rural communities in Rakai, Uganda (n = 4784). For univariate analysis, the t test was used for continuous variables and the Pearson χ² or Fisher exact tests for categorical variables. Multivariate logistic regression was used to control for potential confounding. Results: Twenty percent of women reported coercion at sexual debut. Compared with women who reported consensual sexual debut, the adjusted odds ratio (OR) of subsequent abortion attempts among coerced women was 1.57 (95% CI, 1.11-2.20). Conclusion: There is a need to protect women from sexual coercion, implement policies for prevention of violence, and provide comprehensive reproductive health care, including prevention of unwanted pregnancy and unsafe abortions.