Access to and use of sexual and reproductive health services among street children and young adults in Kampala, Uganda: Does Migration matter?

Background: While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural migration on the use of SRH services while controlling for confounding and whether there is a difference in the use of SRH services among migrant and non-migrant street children and young adults.Methods: Data were collected among 513 street children and young adults aged 12 - 24 years using face‐to‐face interviews using venue-based time-space sampling (VBTS). Using STATA 16.00, multivariate logistic regression analysis was performed to identify factors associated with SRH services use, with rural-urban migration status as the main predictor. Participants were further classified as new migrants (≤ 2 years of stay in city), established migrants (> 2 years of stay in city), or non-migrants (lifelong native street children) with no rural-urban migration history.Results: Overall, 18.13% of the street children and young adults had ever used contraception/family planning, 58.67% had ever tested for HIV and knew their status while 34.70% had ever been screened for sexually transmitted infections (STIs). Non-migrant street children and young adults were 2.7 times more likely to use SRH services (HIV testing, STI screening and family planning) compared to the migrants (aOR = 2.7, 95%CI 1.23-5.97). Other factors associated with SRH services use among street children and young adults include age (aOR=4.70; 95%CI 2.87 - 7.68), schooling status (aOR = 0.33, 95%CI 0.15-0.76), knowledge of place of care (aOR = 2.71, 95%CI 1.64 - 4.46) and access to SRH information (aOR = 3.23, 95%CI 2.0 - 5.24). Conclusions: Access to and use of SRH services among migrant street children and young adults is low compared to the non-migrant street children and young adults and is independently associated with migration status, age, schooling status, knowledge of place of SRH care and access to SRH information. Our findings call for the need to design and implement multi-dimensional interventions to increase use of SRH services among street children and young adults while taking into consideration their migration patterns.