Background: Globally, adolescents form a substantial proportion of the most vulnerable population in refugee situations, accounting for about 23% of the population of displaced populations in low income countries. Sexual and reproductive health is an essential component of primary health care. Yet, not every adolescent is able to access sexual and reproductive health services due to capacity challenges.

Methods: Using quantitative data from 356 adolescents and qualitative data (17 in-depth interviews and nine key informant interviews), we examine adolescent’s sexual behaviour in Bidibidi settlement – the largest refugee setting in Uganda using a binary logistic regression model.

Results: Results indicate that age, sex, school status and knowledge of getting pregnant were explanatory determinants of sexual behaviour among adolescent refugees in Bidibidi.

Conclusions: The results suggest the need to promote sexual and reproductive health education, contraceptive counselling, keeping adolescents in school, life skills development to improve sexual and reproductive health of adolescent refugees living in low-income countries such as Uganda. Social work has a vital role in giving these adolescent refugees epistemic justice by determining the structural determinants of vulnerability and the political, legal and economic structures that render them vulnerable globally.