Exploring the Association between Technology-Facilitated Intimate Partner Violence and Condomless Sex Among Youth in Uganda

Background: Rapid spread of the internet and mobile technologies have facilitated the emergence of a new form of intimate partner violence (IPV: technology-facilitated intimate partner violence [TFIPV]), and human rights and safety concerns. TFIPV is defined as control, harassment, stalking, and abuse of one’s intimate partner using computer-mediated technologies. With the expansion and rapid adoption of mobile technologies, and the high prevalence of IPV in Uganda, there is an urgent need for research that explores IPV enacted online or via technology to inform intervention development. Specifically, there is need for research that furthers our understanding of how TFIPV affects youth’s mental and sexual health. Therefore, the objective of the current study is three-fold: 1) Validate the TFIPV scale in the Uganda setting; 2) Test the direct relationship between TFIPV and condom use among adolescents; and 3) test the intervening role of depressive symptoms in the relationship between TFIPV and condom use.

Methods: Data for this study were drawn from a cross-sectional probability school-based sample of young people (n=421) from four private co-ed schools in central Uganda. TFIPV was collected using a modified six-item conflict tactic scale that embedded language around technology in questions associated with the tactic. The patient health questionnaire (Phq-9) was used to measure depressive symptoms. Condomless sex was assessed using a single item. We conducted confirmatory factor analysis (CFA) to validate the TFIPV and Phq-9 scales in the Ugandan context. We then conducted structural equation modeling to explore the association between TFIPV on youth’s condom use, through the intervening role of depressive symptoms.

Results: Participants’ age ranged from 15 to 20 years (M=18 years, SD=1.73). Most participants were female (59.5%). For the six TFIPV items measured on a 5-point response scale, participants reported high levels of TFIPV perpetration (M= 3.60, SD= 1.89) and TFIPV victimization (M = 3.70, SD= 1.94). The measurement model resulted in a one-factor model for TFIPV and Phq-9. The final structural equation model had acceptable fit indices: χ2/df ratio = 2.16, RMSEA = .045 (90% CI [.037, .053]), CFI = .99, TLI = .99. Results show that TFIPV is directly associated with condomless sex (β = .33, p < .001) and depressive symptoms (β = .24, p < .001). Depressive symptoms were positively associated with condomless sex (β = .16, p < .001). The sobel test showed that TFIPV was indirectly associated with condomless sex, through the intervening effect of depressive symptoms (β = .04, p < .010).

Conclusion and implications: We found a one-factor structure for TFIPV in the Ugandan setting. The finding of a direct link between TFIPV and condomless sex speaks to the need for IPV and sexual health interventions to include components of TFIPV. These interventions should consider screening, counseling, and provision of social support to survivors and perpetrators of TFIPV. As TFIPV emerges as an important research area, there is a need for IPV researchers to always include TFIPV as an integral part of their research. Also, researchers need to expand the conceptualization and measurement of TFIPV.