Use of Withdrawal (Coitus Interruptus) for Both Pregnancy and HIV Prevention among Young Adults in Rakai, Uganda

Higgins, Jenny A., Laura Gregor, Sanyukta Mathur, Neema Nakyanjo, Fred Nalugoda, and John S. Santelli
Working paper no. 2013-09


Objectives: We used mixed methods to assess use of withdrawal (coitus interruptus) among 15-24 year-olds in a rural Ugandan setting with considerable HIV prevalence.

Methods: We measured withdrawal reporting among 1) sexually active 15-24 year-olds enrolled in a quantitative community survey (n=6722) and 2) in-depth qualitative interview participants systematically selected from the latest round of the community survey (N=60). Respondents were asked about family planning and HIV prevention practices, including a direct question about withdrawal in the in-depth interviews.

Results: Although less than 1% of quantitative survey participants spontaneously named withdrawal as their current method, 48% of qualitative interview respondents reported recent or lifetime use of withdrawal. Withdrawal was often used as an alternative to condoms, when condoms were not available, and/or as a “placeholder” method before obtaining injectable contraception. A few respondents described using withdrawal to reduce HIV risk.