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

Collins Adu; Aliu Mohammed; Eugene Budu; James Boadu Frimpong; Justice Kanor Tetteh; Bright Opoku Ahinkorah; Abdul-Aziz Seidu

doi:10.1186/s13690-022-00796-4

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

Arch Public Health. 2022 Jan 26;80(1):40. doi: 10.1186/s13690-022-00796-4.

Authors

Collins Adu¹, Aliu Mohammed², Eugene Budu³, James Boadu Frimpong², Justice Kanor Tetteh³, Bright Opoku Ahinkorah⁴, Abdul-Aziz Seidu^{5

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Affiliations

¹ Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. collinsadu80@yahoo.com.
² Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.
³ Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
⁴ School of public health Faculty of Health, University of Technology Sydney, Sydney, Australia.
⁵ Department of Estate Management, Faculty of Built and Natural Environment, Takoradi Technical University, Takoradi, Ghana.
⁶ Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.
⁷ College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.

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.

Keywords: Public health; STIs; Sexual autonomy; Sub-Saharan Africa; Women.