Key Social Norms Take-aways Young people in Karamoja navigate contradictory, gendered social norms that simultaneously restrict premarital sexuality while encouraging early marriage and, in some circumstances, legitimizing sexual violence as a pathway to marriage. Social sanctions, stigma, and misconceptions also discourage modern contraceptive and condom use. However, the study identifies potentially protective norms around child spacing and men’s responsibility for preventing closely spaced pregnancies, which could provide an entry point for shifting reproductive norms. The authors argue that interventions should work with youth, parents, elders, and other community leaders to reconcile contradictory expectations, challenge harmful norms, and build on existing supportive practices.

Objectives To explore how social norms influence young people’s attitudes, perceptions, and behaviors related to sexuality and contraceptive use in Karamoja, Uganda.

Methods This cross-sectional qualitative study used 12 focus group discussions with 80 participants, including youth aged 15–24 and community members aged 25 and older; eight in-depth interviews with youth aged 15–24; and eight key informant interviews with parents and community leaders. Participants were purposively selected across Moroto, Napak, and Nabilatuk districts, and data were thematically analyzed using Dedoose. Guided by Social Norms Theory, the study examined descriptive norms (what people commonly do) and injunctive norms (what people believe they ought to do). Focus groups explored collective expectations and group dynamics, while interviews examined personal experiences, community expectations, and sanctions related to sexuality and contraceptive use.

Results Premarital sex was strongly discouraged and sanctioned, especially for girls, yet early and forced marriage and “engagement sex” involving rape were socially legitimized. Norms varied by gender, education, and rural versus urban context and were described as shifting over time. Modern contraception was stigmatized as addictive, immoral, or associated with prostitution, while condom use conflicted with expectations around fertility, masculinity, trust, and marriage and could result in social penalties. Fertility enhanced women’s respect and marital value, creating pressure to bear children soon after marriage. At the same time, traditional postpartum abstinence supported child spacing, and men could be socially expected to help prevent closely spaced pregnancies.

Conclusions Contradictory norms, gendered power relations, stigma, sanctions, and contraceptive misconceptions constrain young people’s agency and healthy reproductive choices. The authors recommend culturally sensitive, gender-responsive, co-created approaches involving youth and influential community reference groups to harmonize messages, dismantle harmful norms, and promote informed contraceptive and sexual health choices.