Prevalence and factors associated with substance use among adolescent girls and young women working in artisanal and small-scale gold mining communities of Uganda: a cross-sectional exploratory study

Artisanal and small-scale gold mining (ASGM) employs many adolescent girls and young women (AGYW) who face distinct vulnerabilities. Work and leisure activities in ASGM often involve substance use. This increases the health, financial, and social burdens of AGYW. This paper examines the prevalence of and factors associated with substance use among AGYW in ASGM in Uganda. This paper uses a cross-sectional survey of 810 females aged 15–24 years who work in the ASGM sector in Central and Eastern Uganda. To assess the prevalence and determinants of substance use, we used frequency distributions, chi-squared tests, and a complementary log-log model at the multivariable level of analysis. Nineteen percent (19%) of the respondents reported substance use (mainly alcohol) as a general habit or regular behavior. The odds of substance use were higher among respondents: who cohabited (AOR 2.07; 95% CI 1.14–3.77), and those who were previously married (AOR 2.20; 95% CI 1.42–3.42) compared with those who had never been married; from Central (AOR 7.13; 95% CI 3.92–13.00) compared to Eastern region; and those who had multiple sexual partners (AOR 2.24; 95% CI 1.51–3.32) compared to those that did not. Other Christians (Born Again and Seventh Day Adventists) had lower odds of substance use compared to Catholics (AOR 0.61; 95% CI 0.40–0.90). Respondents who earned more than $70 a month and those who did not state their earnings had lower odds of substance use (AOR 0.66; 95% 0.46–0.96), and (AOR 0.49; 95% CI 0.24–0.98) respectively, compared to AGYW who earned less than $70 a month. Substance use among AGYW is prevalent and is associated with poverty as well as unstable or stressful sexual or social relationships. This is evidenced by higher odds among low-income earners, those who were previously married and cohabiting respondents, and those with multiple sexual partners. Addressing substance use in the ASGM sector requires multi-sectoral, participatory, preventive, and management approaches, which include robust oversight in the sector, poverty reduction, and addressing psychosocial, family, work, and community-level factors.