Department of Medicine, Adama General Hospital and Medical College, Adama, Ethiopia.
Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
BMC Public Health. 2024 Sep 29;24(1):2662. doi: 10.1186/s12889-024-20132-5.
Sexual violence is a violation of women's rights, resulting in significant physical and psychological challenges and adverse reproductive health outcomes. Addressing these issues demands urgent public health interventions and support systems to mitigate the profound impact on individuals and societies. Thus, this study aimed to assess sexual violence against ever-married reproductive-age women in East Africa.
Data retrieved from the recent Demographic and Health Survey (DHS) of East African countries was used, and a weighted sample of 40,740 ever-married reproductive-age women was included. To identify factors associated with sexual violence, multilevel mixed-effects models utilizing robust Poisson regression were applied. Akaike's and Bayesian information criteria, as well as deviance, were utilized to compare the models. In the multivariable regression model, adjusted prevalence ratios (APR) with 95% confidence intervals (CI) were used to estimate the strength of association, with statistical significance set at a p-value < 0.05.
The pooled proportion of sexual violence among ever-married reproductive-age women in East Africa was 13.05% (95% CI: 12.74-13.36). The multivariable multilevel robust Poisson regression revealed that age at first cohabitation/marriage, having a primary educational level, being employed, residing in a female-headed household, having a husband/partner who drinks alcohol, and living in rural areas were positively associated with sexual violence. On the contrary, having secondary and higher educational levels and living in communities with a high proportion of uneducated women were negatively associated with sexual violence.
Empowering girls and women through education reduces their vulnerability. Effective programs should prioritize workplace safety, financial independence, and robust legal protections against harassment and abuse. Raising awareness about the impact of alcohol abuse on relationships and the heightened risk of sexual violence is crucial. Moreover, enhancing access to support services and community networks, especially in rural areas, is essential for preventing and responding to sexual violence.
性暴力侵犯了妇女的权利，导致了严重的身体和心理挑战以及不良的生殖健康后果。解决这些问题需要紧急的公共卫生干预和支持系统，以减轻其对个人和社会的深远影响。因此，本研究旨在评估东非已婚育龄妇女遭受的性暴力。
本研究使用了来自东非国家最近的人口与健康调查（DHS）的数据，并纳入了一个经过加权的 40740 名已婚育龄妇女的样本。为了确定与性暴力相关的因素，我们采用了多级混合效应模型，使用稳健泊松回归进行分析。我们还使用了 Akaike 和贝叶斯信息准则以及离差来比较模型。在多变量回归模型中，我们使用调整后的患病率比（APR）及其 95%置信区间（CI）来估计关联强度，统计显著性设置为 p 值<0.05。
东非已婚育龄妇女中遭受性暴力的比例为 13.05%（95%CI：12.74-13.36）。多变量多级稳健泊松回归显示，首次同居/结婚年龄、接受小学教育、就业、居住在女性为户主的家庭、丈夫/伴侣饮酒以及居住在农村地区与性暴力呈正相关。相反，接受中等和高等教育以及居住在女性受教育程度较低的社区与性暴力呈负相关。
通过教育增强女孩和妇女的权能可以降低她们的脆弱性。有效的计划应优先考虑工作场所安全、经济独立以及针对骚扰和虐待的强有力法律保护。提高对酒精滥用对人际关系的影响以及性暴力风险增加的认识至关重要。此外，增加获得支持服务和社区网络的机会，特别是在农村地区，对于预防和应对性暴力至关重要。
