Predictors of safer sex negotiation among women of reproductive ages (15-49) in Uganda

Abstract

Background: Safer sex strategies represent a principle objective of global HIV prevention interventions that address sexual transmission of HIV. Women's ability to negotiate the conditions and timing of sex with their partners is key to the control of several reproductive health outcomes. I examined predictors of safe sex negotiation among women of reproductive ages (15-49) in Uganda. Methods: The study, based on data from the 2016 Uganda Demographic and Health Survey (UDHS), analyzed 18,170 weighted cases of women aged 15–49. Both descriptive and multilevel binary logistic regressions were used to analyze the data. Chi-squared tests and multivariate logistic regressions were used to examine the predictors of SSN status. The main explanatory variables included age, Partner's age, education, occupation, religion, region, wealth index, media exposure, alcohol consumption, and residence. Results: The overall prevalence of safe sex negotiation among women in Uganda was 55%. Age, partner’s age, education, wealth status, region, and knowledge about HIV and occupation were found to be the predictors of SSN among women of reproductive ages in Uganda. Women in the age group 30-34 were more likely to negotiate for safe sex [OR=1.349, CI=1.019-1.787, p=0.037] compared with the 15–19 reference age group. Also, women whose partners were in the age group 30-49 and 50 and above were less likely to negotiate for safe sex [OR=0.771, CI=0.657-0.905, p=0.001] and [OR=6.999, CI=0.552-0.886, p=0.003] respectively. Women who had attained primary, secondary, or higher education were more likely to negotiate for safe sex [OR=1.604, CI=1.376-1.869, p=0.000] [OR=2.161, CI=1.738-2.686, p=0.000] and [OR=3.995, CI=2.661-5.999, p=0.000] respectively compared with those who had no education. Compared with the poorest quintile, women who were in the middle and rich wealth quintile were all more likely to negotiate for safer sex [OR=1.287, CI=1.110-1.493, p=0.001] and [OR =1.279, CI=1.006-1.626, p=0.044] respectively. Conclusion: The study ascertained that the prevalence of women negotiating safer sex is high. Given that I found both sociodemographic and sexual behavioral predict SSN, there is a need to adopt a holistic approach to the diagnosis and management of Sexual behaviors among women in Uganda. Keywords: Safe sex negotiation, public health; Uganda; women