Schierl T, Tanaka LF, Klug SJ, Winkler AS, Stelzle D. The Association of Women's Empowerment with HIV-Related Indicators: A Pooled Analysis of Demographic and Health Surveys in Sub-Saharan Africa.
J Epidemiol Glob Health 2023;
13:816-824. [PMID:
37751144 PMCID:
PMC10686950 DOI:
10.1007/s44197-023-00153-w]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 09/05/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND
Women's empowerment is an important factor for HIV prevention, but the association with HIV-related indicators has never been quantified. In this study, we examined the association between women's empowerment and selected HIV-related indicators.
METHODS
We used the latest Demographic and Health Surveys that included HIV testing among other biomarkers of 31 countries in sub-Saharan Africa. Empowerment was measured by the Survey-based Women's EmPowERment (SWPER) index and was compared to the HIV-related indicators: HIV status, HIV testing (ever and in the past 12 months), condom use at last high-risk sex, the ability to ask the partner to use a condom, and the ability to refuse sex.
RESULTS
208,947 women were included in the analysis, of whom 100,924 (48%) were considered highly empowered and 21,933 (10%) as lowly empowered. There was no association between empowerment and HIV status (OR = 1.12, 95% confidence interval [CI] 0.98-1.28). Highly empowered women were more likely to have ever been tested for HIV (OR = 1.67, 95% CI 1.60-1.74) but less likely to have been tested for HIV in the past 12 months (OR = 0.92, 95%CI 0.88-0.96). Highly empowered women were more commonly able to ask the partner to use a condom (OR = 1.69, 95% CI 1.63-1.75) and to refuse sex (OR = 1.78, 95%CI 1.72-1.85).
CONCLUSIONS
Women's empowerment does not seem to be linked to HIV status, but it is strongly associated with a woman's ability to make decisions about their sexual behavior. Empowering women and young girls has the potential to contribute toward achieving the United Nations' goal of ending AIDS by 2030.
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