Background In India, sexually transmitted infections (STIs) and HIV, take an enormous toll on women’s sexual/reproductive health, yet preventive programmes are lacking as married women’s risks are frequently underestimated. Husbands continue to be the greatest source of STIs including HIV to their wives. Being able to negotiate safe sex is critical to the prevention of HIV/AIDS and other STIs. Therefore, the present study has mainly focused to analyze the women’s attitudes toward safer-sex negotiation if husband has a STI and associated risk of STI/HIV among married women in India.
Methods National Family Health Survey (NFHS-4, 2015–16) collected information from a nationally representative sample of 121,118 women age 15–49 years has been analyzed by using descriptive and multivariate techniques. Women were asked that a wife is justified in refusing to have sexual intercourse with her husband if he has a STI.
Results Overall 78% of women agree that a wife is justified in refusing to have sex with her husband if he has a STI. A higher proportion of women who were agreed that a wife is justified to negotiate sex were from 25–29 years of age, residing in urban area, those who were higher educated and belongs to highest wealth quintile. Results revealed that the likelihood of a woman holding this belief increased with her autonomy, as measured by participation in household decision making and rejection of wife beating (p<0.001). Women who were away from home for one or more month were significantly less likely to agree. Other significant predictors were knowledge/awareness of STIs (OR-1.13 p < 0.01). Those women who agreed towards negotiating sex were significantly less likely to have a STI.
Conclusion Our findings suggest that sexual health education programmes may be more effective if they include strategies to address social norms and cultural practices that limit women’s autonomy in society.
Disclosure No significant relationships.
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