Mass Media Exposure and Safer Sex Negotiation among Women in Sexual Unions in Sub-Saharan Africa: Analysis of Demographic and Health Survey Data

Abstract

(1) Background: Improving sexual autonomy among women in sexual unions comes with various benefits, including the reduction of sexually transmitted and blood-borne infections. We examined the relationship between mass media exposure and safer sex negotiation among women in sub-Saharan Africa (SSA). (2) Methods: The study involved a cross-sectional analysis of Demographic and Health Survey (DHS) data of 29 sub-Saharan African countries. A total of 224,647 women aged 15–49 were included in our analyses. We examined the association between mass media exposure and safer sex negotiation using binary logistic regression analysis. The results are presented using a crude odds ratio (cOR) and adjusted odds ratio (aOR), with their respective confidence intervals (CIs). Statistical significance was set at p < 0.05. (3) Results: The overall prevalence of safer sex negotiation among women in sexual unions in SSA was 71.6% (71.4–71.8). Women exposed to mass media had higher odds of negotiating for safer sex compared with those who had no exposure (aOR = 1.94; 95% CI = 1.86–2.02), and this persisted after controlling for covariates (maternal age, wealth index, maternal educational level, partner’s age, partner’s educational level, sex of household head, religion, place of residence, and marital status) (aOR = 1.40; 95% CI = 1.35–1.46). The disaggregated results showed higher odds of safer sex negotiation among women exposed to mass media in all the individual countries, except Ghana, Comoros, Rwanda, and Namibia. (4) Conclusions: The findings could inform policies (e.g., transformative mass media educational seminars) and interventions (e.g., face-to-face counselling; small group sensitization sessions) in SSA on the crucial role of mass media in increasing safer sex practice among women in sexual unions. To accelerate progress towards the achievement of the Sustainable Development Goal five’s targets on empowering all women and safeguarding their reproductive rights, the study recommends that countries such as Ghana, Comoros, Rwanda, and Namibia need to intensify their efforts (e.g., regular sensitization campaigns) in increasing safer sex negotiation among women to counter power imbalances in sexual behaviour.

Factors that determine women’s autonomy to make decisions about sexual and reproductive health and rights in Nepal: A cross-sectional study

“…Similar to our findings, the studies conducted in lower and middle-income countries of Sub-Saharan Africa and India identified that media exposure is highly associated with a higher level of women's empowerment [24][25][26]. The evidence shows women's exposure to mass PLOS GLOBAL PUBLIC HEALTH PLOS GLOBAL PUBLIC HEALTH media improves access to information which empowers them to take part in the decision-making process by changing social norms, behaviours, and practices [26]. The media positively influence a person's will, assets, knowledge, and power relation within the family and society to make them more independent in their action [27].…”

“…However the basic education of women, husband's education, religion, size of household, and place of residence in terms of urban vs rural do not have any significant association with women's autonomy. Similar to our findings, the studies conducted in lower and middle-income countries of Sub-Saharan Africa and India identified that media exposure is highly associated with a higher level of women's empowerment [24][25][26]. The evidence shows women's exposure to mass PLOS GLOBAL PUBLIC HEALTH PLOS GLOBAL PUBLIC HEALTH media improves access to information which empowers them to take part in the decision-making process by changing social norms, behaviours, and practices [26].…”

Multi-level predictors of sexual autonomy among married women in Nigeria

“…Two, women’s individual characteristics are important factors that either deter or enhance sexual autonomy. As shown in the study, and in line with findings in existing studies, individual characteristics such as maternal education [ 26 , 42 ], media exposure [ 40 , 43 ], nature of first marriage [ 7 , 40 ], and employment [ 40 ] play significant roles as levers of sexual and reproductive autonomy. This finding gives credence to many existing strategies on improving women’s characteristics particularly women’s education and economic status.…”

Determinants of Open Defecation among Rural Women in Ghana: Analysis of 2003, 2008 and 2014 Demographic and Health Surveys

“…This result suggests that the Ghanaian government should deploy the media to spread awareness of poor sanitation and hygiene behaviours, such as open defecation. This may raise rural women's knowledge of the harmful health implications of open defecation and the need to stop engaging in this hazardous behaviour [46].…”