European Society for Paediatric Gastroenterology, Hepatology and Nutrition/North American Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines for treatment of functional consti

The COVID-19 pandemic and associated mitigation measures have had far-reaching impacts on the health and economic well-being of populations globally (). In response to the growing number of COVID-19 cases internationally, the Ugandan government began to proactively implement mitigation measures prior to the country’s first documented COVID-19 case on March 22, 2020. These measures included the suspension of public gatherings and a 14-day mandatory quarantine for travellers entering the country. On March 30, 2020, the government implemented its most restrictive “lockdown” policies including country-wide curfews, stay-at-home-orders, restricted local travel, and the closure of schools (). A timeline showing Uganda’s COVID-19 restrictions and key events is presented in . Uganda’s first lockdown ended in mid-May 2020 and a second lockdown was implemented in response to a surge of COVID-19 cases in June 2021. Both lockdowns resulted in a sharp contraction of economic activity which disproportionately impacted different economic sectors. Employment rates during the first lockdown were at 71% compared to 87% in March 2020 and work stoppages were concentrated in the commerce and personal services sectors (). During the second lockdown, employment was at 81% with more than half of the work stoppages occurring in the agricultural sector. Following Uganda’s second lockdown, food insecurity increased dramatically, with more than half of households nationally reporting moderate or severe food insecurity (). Uganda also closed schools at all levels of education from February 2020 to January 2022, the longest school closure of any country in the world. COVID-19 mitigation measures likely impacted sexual risk behaviours but this area has been underexplored. In particular, transactional sex relationships, or relationships dependent on the implicit exchange of favours, money, and/or material goods for sex, (; ) may have been affected. Transactional sex relationships are distinct from commercial sex work in that material exchange is not formally negotiated and transactional sex partners may not identify as sex workers or clients. These relationships encompass a spectrum of formality (e.g. one-night stand, casual partnership, girlfriend) but do not include marital relationships, which are part of a formally recognised social institution and subject to different social and economic expectations. The vast majority of research on transactional sex in sub-Saharan Africa has focused on relationships between men and women and the gendered power imbalances which play out in these relationships and which are associated gender-based violence, inconsistent condom use, alcohol use and HIV transmission, among other risks.