Digital Health Literacy and Its Role in Awareness of and Access to Sexual Health Products and Services Among Displaced Youth in Uganda's Informal Urban Settlements: Community-Based Cross-Sectional Study.
Okumu M, Logie C, et al. • Journal of medical Internet research • 2025
Digital health literacy (DHL) was positively associated with awareness of and access to sexual health products and services among displaced youth in Kampala, Uganda, though gender-based differences existed and overall access to SRH services remained suboptimal despite generally high DHL levels.
Key Findings
Results
Four distinct digital health literacy classes were identified among displaced youth in Kampala's informal urban settlements.
Latent profile analysis of 444 participants identified 4 DHL classes: low (class 1: n=51, 11.5%), moderate (class 2: n=99, 22.2%), high (class 3: n=138, 31%), and very high (class 4: n=157, 35.3%)
The majority of participants (66.3%) fell into the high or very high DHL categories
Participants were displaced youth aged 16-24 years recruited via peer-driven sampling from 5 informal urban settlements in Kampala, Uganda
Total sample size was N=445, with tablet-assisted cross-sectional survey methodology used
Results
Participants with very high DHL were significantly more likely to know where to access key sexual health products and services compared to those with low DHL.
Class 4 (very high DHL) participants were more likely than class 1 (low DHL) to know where to access condom use training (ME=0.23; P<.001)
Class 4 participants were more likely to know where to access external condoms (ME=0.19; P<.001)
Class 4 participants were more likely to know where to access HIV testing (ME=0.23; P<.001)
These associations were identified using adjusted multivariate probit models with marginal effects
Results
Very high DHL was associated with greater actual access to sexual health products and services in the prior 3 months compared to low DHL.
Class 4 respondents reported higher access to condom use training than class 1 respondents (ME=0.13, SE=0.04; P<.001)
Class 4 respondents reported higher access to external condoms than class 1 (ME=0.14; P<.050)
Class 4 respondents reported higher access to HIV testing than class 1 (ME=0.24; P<.050)
Access was measured over a 3-month recall period
Results
Gender-based differences were observed in the relationship between very high DHL and awareness of sexual health services.
Men with very high DHL, compared to those with low DHL, were more likely to know where to access SRH information (ME=0.46; P<.001) and condom use training (ME=0.40; P<.050)
Women with very high DHL were more likely than those with low DHL to know how to access condom use training (ME=0.12, SE=0.06; P<.050), external condoms (ME=0.34; P<.001), and HIV testing (ME=0.22, SE=0.10; P<.050)
The magnitude of the association with SRH information awareness was substantially larger for men (ME=0.46) than for women
Gender-disaggregated multivariate probit models were constructed to identify these differences
Results
Gender-based differences were also found in the relationship between very high DHL and actual access to sexual health services.
Among men, those with very high DHL were more likely to access condom use training than those with low DHL (ME=0.28; P<.010)
Among women, those with very high DHL were less likely to access SRH information than those with low DHL (ME=-0.20; P<.001)
The negative association between high DHL and SRH information access among women suggests structural or social barriers may override digital literacy advantages for women
No statistically significant DHL-access associations were reported for women regarding condom or HIV testing access in the gender-stratified models
Results
Despite generally high DHL levels, awareness of and access to sexual and reproductive health services remained suboptimal among the study population.
The authors characterized DHL as 'generally high' but SRH awareness and access as 'suboptimal' among urban displaced youth in Kampala
Over one-third of participants (35.3%) were in the very high DHL class, yet gaps in SRH access persisted
The study population consisted of displaced youth aged 16-24 living in informal urban settlements, a marginalized and underserved group
Findings suggest DHL alone is insufficient to ensure adequate SRH access, particularly for women
Methods
The study used peer-driven sampling to recruit displaced youth across five informal urban settlements in Kampala, Uganda.
A cross-sectional tablet-assisted survey design was employed
Participants were displaced youth aged 16-24 years (N=445)
Recruitment occurred across 5 informal urban settlements in Kampala
Peer-driven sampling was used to reach this hard-to-reach population
Latent profile analysis was used to identify DHL patterns, and gender-disaggregated multivariate probit models estimated associations with SRH awareness and access
What This Means
This research studied how well displaced young people in Kampala, Uganda understand and use digital health tools, and whether that knowledge helps them find sexual health products and services like condoms, HIV testing, and sexual health information. The researchers surveyed 445 displaced youth aged 16–24 living in informal urban neighborhoods and used statistical analysis to group participants by their level of digital health literacy (DHL). They found four groups ranging from low to very high DHL, with most youth falling into the higher categories — suggesting that displaced youth in this setting are generally capable digital health users.
The study found that youth with very high digital health literacy were more likely to know where to find — and to have recently used — services like HIV testing, condoms, and condom use training, compared to youth with low digital health literacy. However, the benefits were not equal for everyone. Young men with high DHL gained more awareness of where to find sexual health information, while young women with high DHL were more likely to know where to get condoms and HIV testing. Strikingly, women with very high DHL were actually less likely to have accessed sexual health information in the past three months — suggesting that even when women know how to navigate digital health tools, social or structural barriers may still prevent them from getting the services they need.
This research suggests that simply improving digital skills among displaced youth is not enough to close gaps in sexual health access, especially for women. Programs designed to improve sexual health among displaced urban populations need to be tailored to gender differences and account for broader social, cultural, and structural barriers that digital literacy alone cannot overcome. The findings point to the importance of combining digital health tools with gender-responsive, community-grounded approaches to make sexual health services truly accessible to all displaced youth.
Okumu M, Logie C, Koomson I, Nyoni T, Muzei J, Sharma B, et al.. (2025). Digital Health Literacy and Its Role in Awareness of and Access to Sexual Health Products and Services Among Displaced Youth in Uganda's Informal Urban Settlements: Community-Based Cross-Sectional Study.. Journal of medical Internet research. https://doi.org/10.2196/78343