撒哈拉以南非洲育龄妇女的性暴力与多种高危生育行为之间的关联。
Association between sexual violence and multiple high-risk fertility behaviours among women of reproductive age in sub-Saharan Africa.
机构信息
Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Department of Medical Laboratory Science, University of Cape Coast, Cape Coast, Ghana.
出版信息
BMC Public Health. 2024 Feb 12;24(1):432. doi: 10.1186/s12889-023-17444-3.
BACKGROUND
Intimate partner violence has adverse outcomes on the sexual and reproductive health of women. In this study, we examined the association between sexual violence and multiple high-risk fertility behaviours (MHRFB) among women in sub-Saharan Africa (SSA).
METHODS
We conducted a cross-sectional analysis of data pooled from the most recent Demographic and Health Surveys of 20 countries in SSA. We included countries with most recent datasets conducted from 2015 to 2021 and had data on all variables included in the study. A weighted sample of 88,011 was included in the study. We used a multilevel binary logistic regression to examine the association between sexual violence and MHRFB, controlling for other covariates. The regression results were presented using adjusted odds ratio (aOR) with 95% confidence interval (CI). Statistical significance was set at p < 0.05.
RESULTS
The overall prevalence of MHRFB was 22.53% (95% CI: 22.26-22.81), which ranged from 9.94% in South Africa to 30.38% in Chad. For sexual violence, the pooled prevalence was 7.02% (95% CI: 6.86-7.19). Burundi (20.58%) and the Gambia (2.88%) reported the highest and lowest proportions, respectively. Women who experienced sexual violence were more likely to engage in MHRFB compared to those who did not experience sexual violence [aOR = 1.11, 95% CI: 1.02, 1.21].
CONCLUSION
There is a positive association between sexual violence and the risk of MHRFB. Our findings underscore a need for sub-Saharan African countries to strengthen their efforts to reduce the occurrence of sexual violence in intimate partner relationships. To augment efforts and accelerate social change, sub-Saharan African countries can introduce pro-poor policies and interventions to improve the wealth status of women. Also, empowering women through the encouragement of attaining higher education would be a useful step in lowering the risk of MHRFB in SSA.
背景
亲密伴侣暴力对妇女的性健康和生殖健康有不良影响。在这项研究中，我们研究了性暴力与撒哈拉以南非洲（SSA）妇女多种高危生育行为（MHRFB）之间的关联。
方法
我们对来自 SSA 20 个国家最近的人口与健康调查中汇集的数据进行了横断面分析。我们纳入了最近在 2015 年至 2021 年期间进行且包含研究中所有变量数据的国家。研究纳入了一个加权样本量为 88011 人的样本。我们使用多水平二元逻辑回归来检查性暴力与 MHRFB 之间的关联，同时控制了其他协变量。回归结果以调整后的优势比（aOR）和 95%置信区间（CI）表示。设定统计学显著性水平为 p<0.05。
结果
MHRFB 的总体流行率为 22.53%（95%CI：22.26-22.81），范围从南非的 9.94%到乍得的 30.38%。性暴力的总流行率为 7.02%（95%CI：6.86-7.19）。布隆迪（20.58%）和冈比亚（2.88%）分别报告了最高和最低的比例。与未经历性暴力的女性相比，经历过性暴力的女性更有可能从事 MHRFB[aOR=1.11，95%CI：1.02，1.21]。
结论
性暴力与 MHRFB 风险之间存在正相关。我们的研究结果强调，撒哈拉以南非洲国家需要加强努力，减少亲密伴侣关系中性暴力的发生。为了加强努力并加速社会变革，撒哈拉以南非洲国家可以引入扶贫政策和干预措施，以提高妇女的财富地位。此外，通过鼓励获得更高教育来增强妇女的权能，将是降低 SSA 中 MHRFB 风险的有用步骤。
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