Ahinkorah Bright Opoku, Hagan John Elvis, Seidu Abdul-Aziz, Budu Eugene, Armah-Ansah Ebenezer Kwesi, Adu Collins, Ameyaw Edward Kwabena, Yaya Sanni
School of Public Health, Faculty of Health, University of Technology Sydney, Australia.
Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana.
J Biosoc Sci. 2021 Mar 19:1-16. doi: 10.1017/S0021932021000109.
Female genital mutilation (FGM) is very pervasive in Africa, with significant regional variations in the prevalence of this traditional practice. This study examined the linkages between FGM and multiple sexual partnership in Mali and Sierra Leone - two African countries with a high prevalence of FGM. Data were from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys, and the study sample comprised 4750 women from Mali and 16,614 from Sierra Leone. Multilevel logistic regression was used for the data analysis, with reported adjusted odds ratios (aOR) and associated 95% confidence intervals. In Mali, women who had not undergone FGM were less likely to have multiple sexual partners (aOR=0.60, CI=0.38-0.96) compared with those who had undergone FGM. In Sierra Leone, women who had undergone FGM (aOR=1.15, CI=1.02-1.30) were more likely to have multiple sexual partners compared with those who had not undergone FGM. Age, level of education, wealth quintile, sex of household head, community socioeconomic status, mass media exposure, and community literacy level were found to be associated with the likelihood of multiple sexual partnership among women in Mali and Sierra Leone. Comprehensive, age-group-based risk-reduction strategies, such as abstinence education and decision-making skills (assertiveness) training, are needed to reduce girls' and young women's engagement in multiple sexual partnerships. Policy interventions, such as anti-FGM legislation and initiatives like the 'Schooling for the Female Child' initiative aimed at reducing social inequality among girls and women, might help decrease FGM and the likelihood of health-compromising behaviours like multiple sexual partnership.
女性生殖器切割在非洲非常普遍，这种传统习俗的流行率在不同地区存在显著差异。本研究调查了在马里和塞拉利昂这两个女性生殖器切割流行率较高的非洲国家中，女性生殖器切割与多个性伴侣之间的联系。数据来自2018年马里和2013年塞拉利昂的人口与健康调查，研究样本包括来自马里的4750名女性和来自塞拉利昂的16614名女性。数据分析采用多水平逻辑回归，报告调整后的优势比（aOR）及相关的95%置信区间。在马里，未接受女性生殖器切割的女性相比接受过该手术的女性，拥有多个性伴侣的可能性更低（aOR = 0.60，CI = 0.38 - 0.96）。在塞拉利昂，接受过女性生殖器切割的女性（aOR = 1.15，CI = 1.02 - 1.30）相比未接受过该手术的女性，更有可能拥有多个性伴侣。研究发现，年龄、教育水平、财富五分位数、户主性别、社区社会经济地位、接触大众媒体的情况以及社区识字水平与马里和塞拉利昂女性拥有多个性伴侣的可能性相关。需要采取全面的、基于年龄组的风险降低策略，如禁欲教育和决策技能（自信）培训，以减少女孩和年轻女性参与多个性伴侣关系的情况。政策干预措施，如反女性生殖器切割立法以及旨在减少女孩和妇女之间社会不平等的“女童教育”倡议等举措，可能有助于减少女性生殖器切割以及像多个性伴侣关系这种危害健康行为的可能性。
