Profiling the Plight of Adolescent Girls and Young Women: Risks and Pathways for Intervention in Rural Uganda

Background Adolescent girls and young women (AGYW) in rural Uganda face a range of socio-economic, educational, and behavioral challenges that heighten their vulnerability to adverse health and social outcomes. Understanding their baseline risk profiles is essential for designing effective, targeted interventions. Methods This study utilized a retrospective, cross-sectional design to analyze secondary data from 124,258 AGYW across four districts in Uganda. K-means cluster analysis was employed to categorize participants into High-Risk and Low-Risk groups based on socio-economic, educational, and behavioral indicators. Bivariate analysis was used to validate the distinctiveness of these clusters, and logistic regression identified predictors of high-risk behaviors, including transactional sex, school dropout, and experiences of violence. Results The analysis revealed that 24.7% of AGYW were classified into the High-Risk group, with the majority (92%) being aged 20–25 years, compared to 9–14 years in the Low-Risk group. High-risk AGYW were significantly more likely to engage in transactional sex, drop out of school, and experience violence. Education emerged as a protective factor, with school enrollment increasing the likelihood of Low-Risk classification by 108 times (AOR = 108.154, p < 0.001). Economic desperation, particularly transactional sex, was a strong predictor of being classified as High-Risk (AOR = 1599.966, p < 0.001). Additionally, experiences of violence and substance use further compounded the vulnerabilities of this group. Conclusion Adolescent girls and young women in rural Uganda, particularly those aged 20–25, face significant vulnerabilities due to poverty, violence, and limited access to education. Integrated interventions focusing on education, economic empowerment, and violence prevention are critical for reducing these risks, fostering resilience, and promoting sustainable change for AGYW. Addressing these challenges through targeted strategies will improve their well-being and contribute to long-term development outcomes.