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Can married or cohabiting women negotiate protective sex? Findings from Demographic and Health Surveys of two West African countries

Published online by Cambridge University Press:  12 December 2019

Bamikale Feyisetan
Affiliation:
Office of Population and Reproductive Health, United States Agency for International Development, Washington, DC, USA
Kola A. Oyediran*
Affiliation:
MEASURE Evaluation Project, International Division, John Snow Inc., Arlington, VA, USA
*
*Corresponding author. Email: kboyediran@gmail.com

Abstract

Can married or cohabitating women in patriarchal societies, who are often disproportionately affected by STI/HIV infections, negotiate protective sex when perceived necessary by refusing sex or asking for condom use during sex? Protective sex negotiation was examined through measures of power relations related to whether or not a woman has a say in sexual activities within marriage. The study hypothesis was that women who are more able to refuse sex or ask for condom use before sexual intercourse will be more able to discuss and reach agreement with their spouses on protective sex practices when needed. The study used data from DHS surveys conducted in Cote d’Ivoire and Nigeria in 2012 and 2013 respectively. Multivariate logistic regression models were used to predict women’s ability to negotiate protective sex in Cote d’Ivoire and Nigeria. The findings show that moderately high percentages of women in both countries reported the ability to negotiate protective sex, with a higher percentage reporting the ability to refuse sex compared with the ability to ask partners to use a condom. The logistic regression results showed that, in the two countries, women’s ability to refuse sex or ask their partners to use a condom, varied by gender- and power-mediating factors, women’s characteristics and behavioural factors. The study draws attention to the need to intensify efforts to promote more-egalitarian relationships between partners through culturally appropriate interventions.

Type
Research Article
Copyright
© Cambridge University Press 2019

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References

Adebayo, SB, Olukolade, RI, Idogho, O, Anyanti, J and Ankomah, A (2013) Marital status and HIV prevalence in Nigeria: implications for effective prevention programmes for women. Advances in Infectious Diseases 3(3), 210218.CrossRefGoogle Scholar
Bowleg, L, Lucas, KJ and Tschann, JM (2004) ‘The ball was always in his court’: an exploratory analysis of relationship scripts, sexual scripts, and condom use among African American women. Psychology of Women Quarterly 28, 7082.CrossRefGoogle Scholar
Bui, TC, Markham, CM, Tran, LTH, Beasley, RP and Ross, MW (2013) Condom negotiation and use among female sex workers in Phnom Penh, Cambodia. AIDS and Behavior 17(2), 612622.CrossRefGoogle ScholarPubMed
Connell, RW (1987) Gender & Power: Society, the Person and Sexual Politics. Allen & Unwin, Sydney; Polity Press, Cambridge; Stanford University Press, Stanford.Google Scholar
Desgrées du Loû, A (2005) Le couple face au VIH/sida en Afrique sub-saharienne: information du partenaire, sexualité et procréation. Population 60(3), 179198.CrossRefGoogle Scholar
Do, M and Fu, H (2011) Is women’s self-efficacy in negotiating sexual decision making associated with condom use in marital relationships in Vietnam? Studies in Family Planning 42, 273282.CrossRefGoogle ScholarPubMed
Feyisetan, BJ (2000) Spousal communication and contraceptive use among the Yoruba of Nigeria. Population Research and Policy Review 19, 29.CrossRefGoogle Scholar
Gagnon, JH and Simon, W (eds) (2005) Sexual Conduct: The Social Sources of Human Sexuality. Aldine, Piscataway, NJ.Google Scholar
Gielen, AC, Faden, RR, Campo, PO, Kass, N and Anderson, J (1994) Women’s protective sexual behaviors: a test of the health belief model. AIDS Education and Prevention 6(1), 111.Google ScholarPubMed
Gupta, GR (2002) How men’s power over women fuels the HIV epidemic: it limits women’s ability to control sexual interactions. British Medical Journal 324, 183184.CrossRefGoogle Scholar
Guthrie, BL, de Bruyn, G and Farquhar, C (2007) HIV-1-discordant couples in sub-Saharan Africa: explanations and implications for high rates of discordancy. Current HIV Research 5(4), 416–129.Google ScholarPubMed
Hindin, MJ (2003) Understanding women’s attitudes towards wife beating in Zimbabwe. Bulletin of the World Health Organization 81(7), 501508.Google ScholarPubMed
Jesmin, SS and Cready, CM (2016) Community influences on married women’s safer sex negotiation attitudes in bangladesh: a multilevel analysis. Archives of Sexual Behavior 45(2), 383393.CrossRefGoogle ScholarPubMed
Kies, C (1987) Family planning in KwaZulu: transition from traditional to contemporary practices. Southern African Journal of Demography 1(1), 16.Google ScholarPubMed
Kharsany, AB and Karim, QA (2016) HIV Infection and AIDS in sub-Saharan Africa: current status, challenges and opportunities. Open AIDS journal 10, 3448.CrossRefGoogle ScholarPubMed
Krige, EJ (1936) The Social System of the Zulus. Shuter and Shooter, Pietermaritzburg.Google Scholar
Lear, D (1995) Sexual communication in the age of AIDS: the construction of risk and trust among young adults. Social Science & Medicine 41(9), 13111323.CrossRefGoogle ScholarPubMed
Lear, D (1996) ‘You’re gonna be naked anyway’: college students negotiating safer sex. Qualitative Health Research 6(1), 112134.CrossRefGoogle Scholar
LeFranc, E, Wyatt, GE, Chambers, C, Eldemire, D, Bain, B and Ricketts, H (1996) Working women’s sexual risk taking in Jamaica. Social Science & Medicine 42(10), 14111417.CrossRefGoogle Scholar
Masters, NT, Casey, E, Wells, EA and Morrison, DM (2012) Sexual scripts among young heterosexually active men and women: continuity and change. Journal of Sex Research 50, 409420.CrossRefGoogle ScholarPubMed
Nweze, JA, Eke, IE and Nweze, EI (2017) HIV/AIDS in sub-Saharan Africa: current status, challenges and prospects. Asian Pacific Journal of Tropical Disease 7(4), 239256.Google Scholar
Onipede, W and Isiugo-Abanihe, UC (2008) Understanding sexual negotiation between marital partners: a study of ogu families in southwestern Nigeria. African Population Studies 23(2), 155171.Google Scholar
Ostrach, B and Singer, M (2012) At special risk: biopolitical vulnerability and HIV/STI syndemics among women. Health Sociology Review 21, 258271.CrossRefGoogle Scholar
Oyediran, KA and Feyisetan, B (2017) Prevalence and contextual determinants of intimate partner violence in Nigeria. African Population Studies 31 (1) (Supplement), 34643477.CrossRefGoogle Scholar
Oyediran, KA and Isiugo-Abanihe, UC (2002) Husband–wife communication and couple’s fertility desires among the Yoruba of Nigeria. African Population Studies 17(2), 6180.Google Scholar
Oyediran, KA and Isiugo-Abanihe, UC (2005) Perceptions of Nigerian women on domestic violence: evidence from 2003 Nigeria Demographic and Health Survey. African Journal of Reproductive Health 9(2), 3853.Google ScholarPubMed
Oyediran, K, Isiugo-Abanihe, UC, Feyisetan, BJ and Ishola, GP (2010) Prevalence of and factors associated with extramarital sex among Nigerian men. American Journal of Men’s Health 4(2), 124134.Google ScholarPubMed
Oyediran, KA, Odutolu, O and Atobatele, AO (2011) Intergenerational sexual relationship in Nigeria: implications for negotiating safe sexual practices, social and psychological aspects of HIV/AIDS and their ramifications. In Letamo, G (ed.) Social and Psychological Aspects of HIV/AIDS and their Ramifications. In Tech Open Access Publisher, ISBN: 978-953-307-640-9.Google Scholar
Pivnick, A (1993) HIV infection and the meaning of condoms. Culture, Medicine and Psychiatry 17, 431453.CrossRefGoogle ScholarPubMed
Popoola, BI (2009) Sex-negotiation strategies and safer-sex practices among married women in South-western Nigeria. Sexual Relationship Therapy 24, 261270.CrossRefGoogle Scholar
Pulerwitz, J, Gortmaker, SL and DeJong, W (2000) Measuring sexual relationship power in HIV/STD research. Sex Roles 42(7/8), 637660.CrossRefGoogle Scholar
Quinn, TC and Overbaugh, J (2005) HIV/AIDS in women: an expanding epidemic. Science 308, 15821583.CrossRefGoogle ScholarPubMed
Rani, M, Bonu, S and Diop-Sidibe, N (2004) An empirical investigation of attitudes towards wife-beating among men and women in seven sub-Saharan African countries. African Journal of Reproductive Health 8(3), 116136.CrossRefGoogle ScholarPubMed
Riley, NE (1997) Gender, power and population change. Population Bulletin 52(1), 148.Google ScholarPubMed
Santhya, KG, Haberland, N, Ram, F, Sinha, RK and Mohanty, SK (2007) Consent and coercion: examining unwanted sex among married young women in India. International Family Planning Perspectives 33, 124132.CrossRefGoogle ScholarPubMed
Sibthorpe, B (1992) The social construction of sexual relationships as a determinant of HIV risk perception and condom use among injection drug users. Medical Anthropology Quarterly 6(3), 255270.CrossRefGoogle Scholar
Sobo, EJ (1993) Inner-city women and AIDS: the psychosocial benefits of unsafe sex. Culture, Medicine, and Psychiatry 17, 455485 CrossRefGoogle Scholar
Sobo, EJ (1994) Attitudes toward HIV testing among impoverished inner-city African-American women. Medical Anthropology 16, 1738.CrossRefGoogle ScholarPubMed
Tenkorang, EY (2012) Negotiating safer sex among married women in Ghana. Archives of Sexual Behavior 41(6), 13531362.CrossRefGoogle ScholarPubMed
Ulin, P (1992) African women and AIDS: negotiating behavioral change. Social Science & Medicine 34(1), 6373.CrossRefGoogle ScholarPubMed
Ung, M, Boateng, GO, Armah, FA, Amoyaw, JA, Luginaah, I and Kuuire, V (2014) Negotiation for safer sex among married women in Cambodia: the role of women’s autonomy. Journal of Biosocial Science 46(1), 90106.CrossRefGoogle ScholarPubMed
Van der Vliet, V (1974) Growing up in traditional society. In Hammond-Tooke, WD (ed.) The Bantu-Speaking Peoples of Southern Africa. Routledge and Kegan Paul, London, pp. 211245.Google Scholar
Yujiro, S, Alice, P, Sedziafa, SV, Roger, A and Isaac, L (2017) Women’s household decision-making autonomy and safer sex negotiation in Nigeria: an analysis of the Nigeria Demographic and Health Survey. AIDS Care 30(2), 240245.Google Scholar