Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda
Identifieur interne : 003801 ( Ncbi/Merge ); précédent : 003800; suivant : 003802Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda
Auteurs : Olivia Nankinga [Ouganda] ; Cyprian Misinde [Ouganda] ; Betty Kwagala [Ouganda]Source :
- BMC Public Health [ 1471-2458 ] ; 2016.
Abstract
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.
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 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.
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.
The online version of this article (doi:10.1186/s12889-016-3103-0) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12889-016-3103-0
PubMed: 27229928
PubMed Central: 4881206
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wicri:level="1"><nlm:aff id="Aff1">Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kwagala, Betty" sort="Kwagala, Betty" uniqKey="Kwagala B" first="Betty" last="Kwagala">Betty Kwagala</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Population Studies, School of Statistics and Planning, College of Business and Management, 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type="main">Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda</title><author><name sortKey="Nankinga, Olivia" sort="Nankinga, Olivia" uniqKey="Nankinga O" first="Olivia" last="Nankinga">Olivia Nankinga</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Misinde, Cyprian" sort="Misinde, Cyprian" uniqKey="Misinde C" first="Cyprian" last="Misinde">Cyprian Misinde</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kwagala, Betty" sort="Kwagala, Betty" uniqKey="Kwagala B" first="Betty" last="Kwagala">Betty Kwagala</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12889-016-3103-0) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Garcia Moreno, C" uniqKey="Garcia Moreno C">C Garcia-Moreno</name></author><author><name sortKey="Jansen, Ha" uniqKey="Jansen H">HA Jansen</name></author><author><name sortKey="Ellsberg, M" uniqKey="Ellsberg M">M Ellsberg</name></author><author><name sortKey="Heise, L" uniqKey="Heise L">L Heise</name></author><author><name sortKey="Watts, Ch" uniqKey="Watts C">CH 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sortKey="Maharaj, P" uniqKey="Maharaj P">P Maharaj</name></author><author><name sortKey="Cleland, J" uniqKey="Cleland J">J Cleland</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Rahman, Mm" uniqKey="Rahman M">MM Rahman</name></author><author><name sortKey="Mostofa, Mg" uniqKey="Mostofa M">MG Mostofa</name></author><author><name sortKey="Hoque, Ma" uniqKey="Hoque M">MA Hoque</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Story, Wt" uniqKey="Story W">WT Story</name></author><author><name sortKey="Burgard, Sa" uniqKey="Burgard S">SA Burgard</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Public Health</journal-id><journal-id journal-id-type="iso-abbrev">BMC Public Health</journal-id><journal-title-group><journal-title>BMC Public Health</journal-title></journal-title-group><issn pub-type="epub">1471-2458</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27229928</article-id><article-id pub-id-type="pmc">4881206</article-id><article-id pub-id-type="publisher-id">3103</article-id><article-id pub-id-type="doi">10.1186/s12889-016-3103-0</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nankinga</surname><given-names>Olivia</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Misinde</surname><given-names>Cyprian</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Kwagala</surname><given-names>Betty</given-names></name><address><email>kkwagala@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><aff id="Aff1">Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda</aff></contrib-group><pub-date pub-type="epub"><day>26</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>26</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>16</volume><elocation-id>440</elocation-id><history><date date-type="received"><day>22</day><month>8</month><year>2015</year></date><date date-type="accepted"><day>13</day><month>5</month><year>2016</year></date></history><permissions><copyright-statement>© Nankinga et al. 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12889-016-3103-0) contains supplementary material, which is available to authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Sexual empowerment</kwd><kwd>Partner behaviours</kwd><kwd>STIs</kwd><kwd>Uganda</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/100000200</institution-id><institution>United States Agency for International Development (US)</institution></institution-wrap></funding-source><award-id>#GPO–C–00–08–00008–00</award-id></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Ouganda</li></country></list><tree><country name="Ouganda"><noRegion><name sortKey="Nankinga, Olivia" sort="Nankinga, Olivia" uniqKey="Nankinga O" first="Olivia" last="Nankinga">Olivia Nankinga</name></noRegion><name sortKey="Kwagala, Betty" sort="Kwagala, Betty" uniqKey="Kwagala B" first="Betty" last="Kwagala">Betty Kwagala</name><name sortKey="Misinde, Cyprian" sort="Misinde, Cyprian" uniqKey="Misinde C" first="Cyprian" last="Misinde">Cyprian Misinde</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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