Sexual autonomy and self-reported sexually transmitted infections among women in sexual unions

Abstract

Background Sexually transmitted infections (STIs) are major public health challenges worldwide. Despite the importance of sexual autonomy in the prevention and control of sexual and reproductive health disorders such as STIs, there are limited studies on the possible relationship between women’s sexual autonomy and self-reported STIs, especially in sub-Saharan Africa (SSA). This study, therefore, examined the association between sexual autonomy and self-reported STIs among women in sexual unions in SSA. Methods Data from the Demographic and Health Survey (DHS) of 31 countries in SSA conducted between 2010 and 2019 were analysed. A total of 234,310 women in sexual unions were included in the study. Data were analysed using binary logistic regression models and the results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs) at 95% confidence interval (CI). Results The prevalence of self-reported STIs among women in sexual unions in SSA was 5.8%. Approximately 83.0% of the women surveyed had sexual autonomy. Women who had no sexual autonomy were less likely to have self-reported STIs (cOR=0.52, CI: 0.46-0.54), compared to those who had sexual autonomy. Additionally, higher odds of self-reported STIs were found among women aged 25-29, compared to those aged 15-19 (aOR= 1.21, CI: 1.09-1.35); those who reside in urban areas, compared to those who reside in rural areas (aOR= 1.51, CI: 1.37-1.66) and those who were cohabiting, compared to those who were married (aOR= 1.65, CI: 1.52-1.79). On the other hand, lower odds of self-reported STIs were found among women who were exposed to newspapers (aOR= 0.89, CI: 0.82-0.95), those whose partners had primary education (aOR= 0.84, CI: 0.78-0.91), those who were not exposed to radio (aOR= 0.84, CI: 0.79-0.89), and working women (aOR= 0.86, CI: 0.80-0.93). Conclusions Findings from this study suggest that sexual autonomy is a significant predictor of self-reported STIs among women in sexual unions in SSA. Thus, instituting policies and programs that empower women and improve their levels of sexual autonomy may result in increased self-reporting of symptoms associated with STIs which subsequently help in minimising STI-related complications. Also, policies aimed at enhancing women’s sexual autonomy may reduce the burden of STIs in SSA, especially among women in sexual unions.

Gynecological morbidity and treatment-seeking among older adult (aged 45–59) women in India

“…Women with autonomy in household decision making are more likely to report GM, while their disadvantaged counterparts may either ignore or perceive GM as natural corresponding to their age and hence not report it [ 10 ]. An earlier study also reveals that sexual autonomy is a significant predictor of self-reported sexually transmitted infections (STI) [ 30 ]. Religious and cultural beliefs were barriers to accessing SRH services and information among Muslims [ 31 ].…”

Prevalence and determinants of unmet need for contraception among women in low and high-priority segments for family planning demand generation in Nigeria

“…This will not only reduce the level of unintended pregnancies [ 29 , 31 ], but it will also minimize unsafe abortion [ 30 ], and promote women’s sexual autonomy [ 60 ], which further enhances women’s reproductive health. It is particularly important for the national family planning programmers to give special consideration to the plight of women living with disabilities.…”

“…This finding may be reasoned in two ways. Firstly, the determinants that cut across and in accordance with existing findings are religion [ 38 ], desired family size [ 36 , 42 ], place of residence [ 28 , 41 ], geographic region [ 37 , 48 ], community justification of gender-based violence [ 47 ], and lack of sexual autonomy, which further exposes women to adverse sexual health outcomes [ 60 ]. This finding implies that some cross-cutting strategies, either at the individual or community level, targeting selected socio-demographic characteristics, may work effectively to reduce the unmet need for contraception among groups of women.…”

“…At the household level, three variables, namely, the sex of the household head (male or female), household wealth quintile (poorest, poorer, middle, richer, or richest), and sexual autonomy (yes, if a woman can refuse partner sex, ask a partner to use a condom or no, if otherwise). This variable was included because it elevates women’s exposure to unintended pregnancies and other adverse sexual health outcomes, such as infection with sexually transmitted diseases [ 60 ]. At the community level, the selected variables are type of place of residence (urban or rural), geographic region (Northern or Southern), community literacy level, community justification of gender-based violence, community economic prosperity, and proportion ever used contraception in the community.…”

Educational interventions to improve women’s preventive behavior of sexually transmitted infections (STIs): study protocol for a randomized controlled trial

“…Women are biologically more vulnerable to such STIs than men, and they are more likely to experience problems as a result [9]. Women who engage in sexual activity are at risk for STIs [10,11].…”