Department of Sociology, Memorial University of Newfoundland, St. John's, NL, A1C 5S7, Canada.
Arch Sex Behav. 2012 Dec;41(6):1353-62. doi: 10.1007/s10508-012-9960-4. Epub 2012 May 3.
Recent evidence across sub-Saharan Africa shows married women face heightened risks of contracting HIV compared to the never-married. Vulnerability of married women to HIV infection is linked to a number of factors including their inability to negotiate safer sex, inter alia, asking their husbands to use condoms or refusing sexual intercourse even in high risk situations. This study examined what influences married women's ability to say they can ask their sexual partners to use condoms or refuse sexual intercourse. Demographic and Health Survey data from 2,950 married women were analyzed using complementary log-log models. Married women in Ghana were more likely to say they can ask their husbands to use condoms when they know condoms can protect against HIV transmission and had been tested for their HIV serostatus. Also, women who know sexual abstinence can protect against HIV transmission were more likely to say they can refuse sex. Wealthier and highly educated women were more likely to say they can refuse to have sex with their husbands or ask them to use condoms, compared to poorer and less educated women. It is recommended that policy makers promote specific knowledge related to HIV prevention (condom use, HIV testing), while improving the social and economic circumstances of married women in Ghana.
最近在撒哈拉以南非洲的证据表明，已婚妇女感染艾滋病毒的风险比未婚妇女高。已婚妇女感染艾滋病毒的脆弱性与许多因素有关，包括她们无法协商安全性行为，例如要求丈夫使用避孕套或拒绝在高风险情况下进行性行为。本研究考察了哪些因素影响已婚妇女要求性伴侣使用避孕套或拒绝性行为的能力。使用互补对数-对数模型分析了来自 2950 名已婚妇女的人口与健康调查数据。当加纳的已婚妇女知道避孕套可以预防艾滋病毒传播并接受过艾滋病毒血清学检测时，她们更有可能表示可以要求丈夫使用避孕套。此外，知道禁欲可以预防艾滋病毒传播的妇女更有可能表示可以拒绝性行为。与贫穷和受教育程度较低的妇女相比，较富裕和受教育程度较高的妇女更有可能表示可以拒绝与丈夫发生性关系或要求他们使用避孕套。建议政策制定者促进与艾滋病毒预防（避孕套使用、艾滋病毒检测）相关的具体知识，同时改善加纳已婚妇女的社会和经济状况。
