From 'Group Talk' to 'Individual Action': A Grounded Theory of the Social Process Linking Peer Influence, Alcohol Use, and Risky Sexual Behaviours among Secondary School Adolescent Students in Greater Mbarara, Uganda

Résumé

Background: Risky sexual behaviours (RSBs) among Ugandan adolescents pose a significant threat to educational attainment, yet school-based interventions, often grounded in a knowledge-deficit model, demonstrate limited efficacy. While peer influence and alcohol use are well-established predictors, the underlying social processes connecting them remain opaque, creating a critical gap for educational policy and practice. Objective: This study sought to move beyond prediction to explanation by uncovering the core social process that links peer influence, alcohol use, and RSBs among school-going adolescents in Greater Mbarara, Uganda. Methodology: A constructivist grounded theory design was employed. Data were collected through 6 focus group discussions (n=30) and 12 in-depth interviews with a purposively selected sub-sample of adolescents (N=42) aged 15-19 from six secondary schools. Concurrent data collection and analysis, using the constant comparative method and theoretical sampling, facilitated the development of a substantive theory. Findings: The analysis uncovered a core social process termed The Cycle of Gendered Performance. This theory reveals that RSBs are not merely individual choices but the outcome of a recursive cycle where adolescents perform culturally mandated gender roles. The cycle begins with Scripting, as peers co-construct narratives of male conquest and female desirability. This leads to Liquid Enabling, where alcohol is strategically consumed—as "Liquid Courage" for boys to overcome inhibition and a "Social Excuse" for girls to preserve reputation. Finally, in Performative Action, these pressures culminate in RSB. The cycle is perpetuated as these experiences become new "war stories" and excuses that feed back into the peer group's normative fabric. Conclusion and Implications: The study generates a novel theoretical framework that explains RSBs as a socially sustained cycle of gendered performance, not merely individual risk-taking. For educational stakeholders in East Africa, these findings necessitate a paradigm shift from information-based interventions to those that directly target the social process. This includes integrating gender-transformative education, building peer resistance skills, and contextualising substance abuse education to disrupt this cycle and foster school environments that truly support adolescent well-being and academic success.