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
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.
Gender Relations, Sexual Behaviour, and Risk of Contracting Sexually Transmitted Infections among Women in Union in Uganda (PDF, 574K)