Uptake of sickle cell screening among sexually active unmarried young adults in Gulu City, northern Uganda: a community-based cross-sectional study

Abstract Sickle cell disease (SCD) is a major public health challenge in Uganda, where up to 20% of the population in northern regions carry the sickle cell trait (SCT). We conducted a community-based cross-sectional study among 321 sexually active unmarried young adults aged 15–35 years in Pece-Laroo Division, Gulu City, to determine the prevalence and predictors of sickle cell screening uptake. Participants were enrolled through stratified random sampling and data collected using a pre-tested interviewer-administered questionnaire; modified Poisson regression with robust standard errors was used for analysis. The median age was 21 years [IQR: 18–24]. Overall, 85 participants (26.5%) had ever undergone sickle cell screening. Favorable knowledge-scale scores were recorded for 176 (54.8%) and positive attitude-scale scores for 178 (55.5%) participants. Tertiary education was the sole independent predictor of screening uptake (adjusted prevalence ratio 2.89; 95% CI 1.98–4.21; p < 0.001). The most commonly cited barrier was lack of awareness of where to access screening services (52.1%). Despite critically low uptake, 78.0% of unscreened participants intended to be screened in the future. Structural barriers rather than individual awareness alone constrain health-seeking behavior. Youth-targeted education campaigns, integration of screening into community health services, and stigma reduction are urgently needed.