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 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 1,307 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. 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.