813 respondents were screened during this study of whom 573 (70.5%) were women or girls. The gender ratios displayed in this study probably reflect the manner in which the medical intervention was publicized in the camps- as the intervention mainly addressed women's health concerns. This analysis focused on the women and girls, with most of them (90.2%) displaced from within their mother district of Kitgum. The majority were over the age of 24 years (88.7%), mainly Christian (99.3%), married or ever have been married (82.3%), of no or little formal education (less than 8 years of formal education; 94.9%) and mainly employed as peasant farmers (87.6%).
War related sexual violence and other forms of trauma
Over a quarter (28.6%) of the women and 6.7% of the men reported having suffered at least one form of war related sexual violence (Table ). The most frequently reported forms of war related sexual violence among women included defilement (14.5%), abduction with sex (7.9%), attempted rape (4.9%), forced marriage (4.4%) and heterosexual rape-single episode (4.2%). Among the men the most frequently reported forms of war related sexual violence was homosexual rape (4.2%). Other commonly reported forms of war trauma experiences reported included, death of at least one loved one (67.7%), having suffered at least one physical trauma (52.0%), and having suffered at least one psychological trauma (86.7%).
War related sexual violence among respondents from Kitgum, Northern Uganda (N = 813)
Perpetrators of war related violence among women
The main perpetrators of war trauma in general among women were the rebel Lord's Resistance Army (71.4%) and the government soldiers (23.4%), a similar pattern was also reflected for war related sexual violence where the main perpetrators were the rebel Lord's Resistance Army (80.5%) and the government soldiers (23.2%; Table ),
Perpetrators of war related violence among women from Kitgum, Northern Uganda (N = 573)
Table , a comparison of the sexual violations committed by the rebel Lord's Resistance Army (LRA) and the government soldiers reveals that the main method of sexual trauma in both groups were defilement (LRA- 55.3%; government soldiers- 42.1%), abduction with sex (LRA- 27.3%; government soldiers- 36.8%) and attempted rape (LRA- 15.2%; government soldiers- 18.4%). There were however important differences between the two groups of perpetrators with government soldiers proportionally using more the method of sexual comforting (26.3%) than the LRA (10.6%) and the LRA proportionally using more the method of heterosexual rape- single episode (12.9%) than government soldiers (7.9%).
A comparison of the sexual violations committed by the Lord's Resistance Army and the government soldiers among female respondents
Reproductive health problems and other morbidities
About three quarters (72.4%) of the respondents had 'at least one gynaecological complaint' with the most commonly reported complaints being chronic lower abdominal pain (52.2%), abnormal vaginal bleeding (27.4%), infertility (26.6%), genital sores (25.3%), and swellings in the abdomen (22.5%).
The respondents also had high levels of both psychological and surgical morbidity including alcoholism (18.7%), significant psychological distress (scores ≥6 on the WHO SRQ-20; 69.4%), attempted suicide life-time (15.8%), having at least one surgical complaint (75.6%) and known HIV positive status (4.8%) (although the majority of respondents (82.3%) did not know their HIV status.
Correlates of war related sexual violence among women
Among women, the socio-demographic factors significantly associated with war related sexual violence were, age ≤ 44 years where 35.2% suffered war related sexual violence as compared to 19.3% in the ≥ 45 years age group (OR, 2.28; 95%CI, 1.52-3.40; p = < 0.001), and being Catholic where 32.3% suffered war related sexual violence as compared to 23.5% in the Protestants (OR, 1.55; 95%CI, 1.06-2.28; p = 0.04) (Table ).
Association between war related sexual violence and socio-demographic factors among women in Kitgum, Northern Uganda
Among women, the medical and psychosocial factors significantly associated with war related sexual violence were, suffered war related physical trauma (OR, 1.55; 95%CI, 1.07-2.24; p = 0.02), and having 'at least one gynaecological complaint' (OR, 2.86; 95%CI, 1.75-4.67; p = < 0.001) (Table ).
Relationship between war related sexual violence and psychosocial factors among women in Kitgum, Northern Uganda
The specific gynaecological complaints associated with war related sexual violence included infertility (OR, 2.16; 95%CI, 1.44-3.24; p = < 0.001), chronic lower abdominal pain (OR, 1.98; 95%CI, 1.35-2.91; p = < 0.001), abnormal vaginal bleeding (OR, 1.86; 95%CI, 1.24-2.79; p = 0.002) and sexual dysfunction (OR, 2.09; 95%CI, 1.27-3.45; p = 0.003) (Table ).
Relationship between reproductive health complaints to war related sexual violence among women in Kitgum, Northern Uganda
The logistic regression model computed showed that 2 domains of factors were independently associated with war related sexual violence, that is the predisposing factors-age of less than or equal to 44 years (AOR, 1.96; 95%CI, 1.23-3.13; p = 0.004) and being Catholic (AOR, 1.65; 95%CI, 1.07-2.54; p = 0.03) and the medical consequences of war related sexual violence-suffering from a gynaecological problem (AOR, 2.36; 95%CI, 1.39-4.00; p = 0.002) (Table ).
Logistical regression model for factors associated with war related sexual violence in female respondents