Department of Geography and Environment, Western University, 1151 Richmond St, London, ON, N6A 5C2, Canada.
Mzuzu University, Mzuzu, Malawi.
BMC Infect Dis. 2023 Nov 22;23(1):817. doi: 10.1186/s12879-023-08826-4.
Research indicates that women in polygamous relationships may be exposed to unique sexual and reproductive health challenges. However, there are very few studies that examine whether polygamy is associated with safe sex negotiation among married women in sub-Saharan Africa, including Cameroon.
Using the 2018 Cameroon Demographic and Health Survey, we apply logistic regression analysis to compare two indicators of safe sex negotiation (i.e., the ability to ask for condom use and refuse sex against their partner) between polygamous (n = 1,628) and monogamous (n = 5,686) women aged 15-49 years old.
We find that 67% and 50% of married women can ask for condom use and refuse sex against their partner, respectively. Multivariate analysis further reveals that women in polygamous relationships are less likely to report they can ask for condom use (OR = 0.71, p < 0.001) and refuse sex (OR = 0.64, p < 0.001) in comparison to their monogamous counterparts.
Our analysis found that in Cameroon, women in polygamous relationships, Muslim women, married women with inadequate HIV knowledge, those who had never been tested for HIV and women with lower socioeconomic status are less likely to negotiate for safe sex. Based on these findings, we discuss several implications for policymakers, including the establishment of a comprehensive family planning educational program and the deployment of community health workers to disseminate educational initiatives pertaining to safe sex negotiation to community members.
研究表明，处于多配偶关系中的女性可能面临独特的性健康和生殖健康挑战。然而，很少有研究探讨多配偶制是否与撒哈拉以南非洲（包括喀麦隆）已婚女性的安全性行为协商有关。
我们利用 2018 年喀麦隆人口与健康调查数据，通过逻辑回归分析比较了多配偶制（n=1628）和一夫一妻制（n=5686）15-49 岁已婚女性中两项安全性行为协商指标（即要求使用安全套的能力和拒绝与伴侣发生性行为的能力）。
我们发现，分别有 67%和 50%的已婚女性可以要求使用安全套和拒绝与伴侣发生性行为。多变量分析进一步表明，与一夫一妻制女性相比，多配偶制女性报告能够要求使用安全套（OR=0.71，p<0.001）和拒绝性行为（OR=0.64，p<0.001）的可能性较低。
我们的分析发现，在喀麦隆，处于多配偶关系中的女性、穆斯林女性、艾滋病毒知识不足的已婚女性、从未接受过艾滋病毒检测的女性以及社会经济地位较低的女性，更不可能协商安全性行为。基于这些发现，我们讨论了对政策制定者的一些启示，包括建立全面的计划生育教育计划以及部署社区卫生工作者向社区成员传播安全性行为协商方面的教育倡议。
