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Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda.
BMC Public Health. 2016 05 26; 16:440.BP

Abstract

BACKGROUND

Sexually transmitted infections (STIs) are a major reproductive and public health concern, especially in the era of HIV/AIDS. This study examined the relationship between sexual empowerment and STI status of women in union (married or cohabiting) in Uganda, controlling for sexual behaviour, partner factors, and women's background characteristics.

METHODS

The study, based on data from the 2011 Uganda Demographic and Health Survey (UDHS), analysed 1307 weighted cases of women age 15-49 in union and selected for the domestic violence module. Chi-squared tests and multivariate logistic regressions were used to examine the predicators of STI status. The main explanatory variables included sexual empowerment, involvement in decision making on own health, experience of any sexual violence, condom use during last sex with most recent partner, number of lifetime partners and partner control behaviours. Sexual empowerment was measured with three indicators: a woman's reported ability to refuse sex, ability to ask her partner to use a condom, and opinion regarding whether a woman is justified to refuse sex with her husband if he is unfaithful.

RESULTS

Results show that 28 % of women in union reported STIs in the last 12 months. Sexual violence and number of lifetime partners were the strongest predictors of reporting STIs. Women's sexual empowerment was a significant predictor of their STI status, but, surprisingly, the odds of reporting STIs were greater among women who were sexually empowered. Reporting of STIs was negatively associated with a woman's participation in decision-making with respect to her own health, and was positively associated with experience of sexual violence, partner's controlling behaviour, and having more than one life partner.

CONCLUSIONS

Our findings suggest that, with respect to STIs, sexual empowerment as measured in the study does not protect women who have sexually violent and controlling partners. Interventions promoting sexual health must effectively address negative masculine attitudes and roles that perpetuate unhealthy sexual behaviours and gender relations within marriage. It is also important to promote marital fidelity and better communication within union and to encourage women to take charge of their health jointly with their partners.

Authors+Show Affiliations

Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda.Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda.Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda. kkwagala@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27229928

Citation

Nankinga, Olivia, et al. "Gender Relations, Sexual Behaviour, and Risk of Contracting Sexually Transmitted Infections Among Women in Union in Uganda." BMC Public Health, vol. 16, 2016, p. 440.
Nankinga O, Misinde C, Kwagala B. Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda. BMC Public Health. 2016;16:440.
Nankinga, O., Misinde, C., & Kwagala, B. (2016). Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda. BMC Public Health, 16, 440. https://doi.org/10.1186/s12889-016-3103-0
Nankinga O, Misinde C, Kwagala B. Gender Relations, Sexual Behaviour, and Risk of Contracting Sexually Transmitted Infections Among Women in Union in Uganda. BMC Public Health. 2016 05 26;16:440. PubMed PMID: 27229928.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda. AU - Nankinga,Olivia, AU - Misinde,Cyprian, AU - Kwagala,Betty, Y1 - 2016/05/26/ PY - 2015/08/22/received PY - 2016/05/13/accepted PY - 2016/5/28/entrez PY - 2016/5/28/pubmed PY - 2017/8/31/medline KW - Partner behaviours KW - STIs KW - Sexual empowerment KW - Uganda SP - 440 EP - 440 JF - BMC public health JO - BMC Public Health VL - 16 N2 - BACKGROUND: Sexually transmitted infections (STIs) are a major reproductive and public health concern, especially in the era of HIV/AIDS. This study examined the relationship between sexual empowerment and STI status of women in union (married or cohabiting) in Uganda, controlling for sexual behaviour, partner factors, and women's background characteristics. METHODS: The study, based on data from the 2011 Uganda Demographic and Health Survey (UDHS), analysed 1307 weighted cases of women age 15-49 in union and selected for the domestic violence module. Chi-squared tests and multivariate logistic regressions were used to examine the predicators of STI status. The main explanatory variables included sexual empowerment, involvement in decision making on own health, experience of any sexual violence, condom use during last sex with most recent partner, number of lifetime partners and partner control behaviours. Sexual empowerment was measured with three indicators: a woman's reported ability to refuse sex, ability to ask her partner to use a condom, and opinion regarding whether a woman is justified to refuse sex with her husband if he is unfaithful. RESULTS: Results show that 28 % of women in union reported STIs in the last 12 months. Sexual violence and number of lifetime partners were the strongest predictors of reporting STIs. Women's sexual empowerment was a significant predictor of their STI status, but, surprisingly, the odds of reporting STIs were greater among women who were sexually empowered. Reporting of STIs was negatively associated with a woman's participation in decision-making with respect to her own health, and was positively associated with experience of sexual violence, partner's controlling behaviour, and having more than one life partner. CONCLUSIONS: Our findings suggest that, with respect to STIs, sexual empowerment as measured in the study does not protect women who have sexually violent and controlling partners. Interventions promoting sexual health must effectively address negative masculine attitudes and roles that perpetuate unhealthy sexual behaviours and gender relations within marriage. It is also important to promote marital fidelity and better communication within union and to encourage women to take charge of their health jointly with their partners. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/27229928/Gender_relations_sexual_behaviour_and_risk_of_contracting_sexually_transmitted_infections_among_women_in_union_in_Uganda_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3103-0 DB - PRIME DP - Unbound Medicine ER -