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Abstract：
BACKGROUND: Though women in sub-Saharan Africa have increased risk of intimate sexual violence, research on the association between sexual autonomy and intimate partner violence among this population has not received the requisite attention. Consequently, we investigated if sexual autonomy is a protective factor against intimate partner violence among women in sub-Saharan Africa.
METHODS: Secondary data analysis was conducted based on the Demographic and Health Surveys (DHSs) of 27 sub-Saharan African countries from 2008 to 2021. A total of 104,523 married or cohabitating women were included in the study. We applied a multilevel Poisson regression model with robust variance to identify associated factors. Variables with a p-value<0.2 in the bi-variable multilevel Poisson regression analysis were considered for the multivariable analysis. The Adjusted Prevalence Ratio (APR) with its 95% confidence interval (CI) was reported, and variables with a p-value <0.05 were included in the multivariable analysis.
RESULTS: The prevalence of intimate partner violence and sexual autonomy among women in SSA were 32.96% [95% CI: 32.68%, 33.25%] and 88.79% [95% CI: 88.59%, 88.97%], respectively. Women in Sierra Leone had the highest prevalence of IPV (52.71%) while Comoros had the lowest prevalence of IPV (8.09%). The prevalence of sexual autonomy was highest in Namibia (99.22%) and lowest in Mali (61.83%). The MOR value in the null model was 1.26. We found that women who had sexual autonomy are 1.28 times [APR = 1.28, 95% CI: 1.17, 1.40] more likely to experience IPV than women who had no sexual autonomy.
CONCLUSIONS: This study has demonstrated that sexual autonomy is significantly associated with intimate partner violence, however, it does not necessarily act as a protective factor. The study suggests the need for more education on intimate partner violence targeting women\'s partners. This can help secure the commitment of the perpetrators to rather become proponents of anti-intimate partner violence and further offer women the necessary support for them to attain their full fundamental rights in all spheres of life.
METHODS: Secondary data analysis was conducted based on the Demographic and Health Surveys (DHSs) of 27 sub-Saharan African countries from 2008 to 2021. A total of 104,523 married or cohabitating women were included in the study. We applied a multilevel Poisson regression model with robust variance to identify associated factors. Variables with a p-value<0.2 in the bi-variable multilevel Poisson regression analysis were considered for the multivariable analysis. The Adjusted Prevalence Ratio (APR) with its 95% confidence interval (CI) was reported, and variables with a p-value <0.05 were included in the multivariable analysis.
RESULTS: The prevalence of intimate partner violence and sexual autonomy among women in SSA were 32.96% [95% CI: 32.68%, 33.25%] and 88.79% [95% CI: 88.59%, 88.97%], respectively. Women in Sierra Leone had the highest prevalence of IPV (52.71%) while Comoros had the lowest prevalence of IPV (8.09%). The prevalence of sexual autonomy was highest in Namibia (99.22%) and lowest in Mali (61.83%). The MOR value in the null model was 1.26. We found that women who had sexual autonomy are 1.28 times [APR = 1.28, 95% CI: 1.17, 1.40] more likely to experience IPV than women who had no sexual autonomy.
CONCLUSIONS: This study has demonstrated that sexual autonomy is significantly associated with intimate partner violence, however, it does not necessarily act as a protective factor. The study suggests the need for more education on intimate partner violence targeting women\'s partners. This can help secure the commitment of the perpetrators to rather become proponents of anti-intimate partner violence and further offer women the necessary support for them to attain their full fundamental rights in all spheres of life.
摘要：
背景：尽管撒哈拉以南非洲的妇女遭受亲密性暴力的风险增加，关于该人群中性自主性与亲密伴侣暴力之间关系的研究尚未得到必要的关注。因此,我们调查了撒哈拉以南非洲地区女性的性自主性是否是防止亲密伴侣暴力的保护因素.
方法：次要数据分析是根据2008年至2021年对27个撒哈拉以南非洲国家的人口与健康调查（DHRS）进行的。共有104,523名已婚或同居妇女被纳入研究。我们应用具有稳健方差的多水平泊松回归模型来识别相关因素。双变量多水平泊松回归分析中p值<0.2的变量被考虑用于多变量分析。报告了调整后的患病率比率(APR)及其95%置信区间(CI)，和p值<0.05的变量包括在多变量分析中。
结果：SSA女性中亲密伴侣暴力和性自主性的患病率为32.96％[95％CI：32.68％，33.25%]和88.79%[95%CI：88.59%，88.97%]，分别。塞拉利昂妇女的IPV患病率最高（52.71％），而科摩罗的IPV患病率最低（8.09％）。性自主权的患病率在纳米比亚最高（99.22％），在马里最低（61.83％）。空模型中的MOR值为1.26。我们发现，具有性自主性的女性经历IPV的可能性是没有性自主性的女性的1.28倍[APR=1.28，95％CI：1.17，1.40]。
结论：这项研究表明，性自主性与亲密伴侣暴力显著相关，然而,它不一定是保护因素。该研究表明，有必要对针对女性伴侣的亲密伴侣暴力进行更多的教育。这可以帮助确保肇事者承诺成为反对亲密伴侣暴力的支持者，并进一步为妇女提供必要的支持，使她们在生活的所有领域获得充分的基本权利。
方法：次要数据分析是根据2008年至2021年对27个撒哈拉以南非洲国家的人口与健康调查（DHRS）进行的。共有104,523名已婚或同居妇女被纳入研究。我们应用具有稳健方差的多水平泊松回归模型来识别相关因素。双变量多水平泊松回归分析中p值<0.2的变量被考虑用于多变量分析。报告了调整后的患病率比率(APR)及其95%置信区间(CI)，和p值<0.05的变量包括在多变量分析中。
结果：SSA女性中亲密伴侣暴力和性自主性的患病率为32.96％[95％CI：32.68％，33.25%]和88.79%[95%CI：88.59%，88.97%]，分别。塞拉利昂妇女的IPV患病率最高（52.71％），而科摩罗的IPV患病率最低（8.09％）。性自主权的患病率在纳米比亚最高（99.22％），在马里最低（61.83％）。空模型中的MOR值为1.26。我们发现，具有性自主性的女性经历IPV的可能性是没有性自主性的女性的1.28倍[APR=1.28，95％CI：1.17，1.40]。
结论：这项研究表明，性自主性与亲密伴侣暴力显著相关，然而,它不一定是保护因素。该研究表明，有必要对针对女性伴侣的亲密伴侣暴力进行更多的教育。这可以帮助确保肇事者承诺成为反对亲密伴侣暴力的支持者，并进一步为妇女提供必要的支持，使她们在生活的所有领域获得充分的基本权利。
