Predictors of Extra-Marital Partnerships among Women Married to Fishermen along Lake Victoria in Kisumu County, Kenya

Abstract

BackgroundThe vulnerability of women to HIV infection makes establishing predictors of women's involvement in extra-marital partnerships critical. We investigated the predictors of extra-marital partnerships among women married to fishermen.MethodsThe current analyses are part of a mixed methods cross-sectional survey of 1090 gender-matched interviews with 545 couples and 12 focus group discussions (FGDs) with 59 couples. Using a proportional to size simple random sample of fishermen as our index participants, we asked them to enrol in the study with their spouses. The consenting couples were interviewed simultaneously in separate private rooms. In addition to socio-economic and demographic data, we collected information on sexual behaviour including extra-marital sexual partnerships. We analysed these data using descriptive statistics and multivariate logistic regression. For FGDs, couples willing to participate were invited, consented and separated for simultaneous FGDs by gender-matched moderators. The resultant audiofiles were transcribed verbatim and translated into English for coding and thematic content analysis using NVivo 9.ResultsThe prevalence of extra-marital partnerships among women was 6.2% within a reference time of six months. Factors that were independently associated with increased likelihood of extra-marital partnerships were domestic violence (aOR, 1.45; 95% CI 1.09–1.92), women reporting being denied a preferred sex position (aOR, 3.34; 95% CI 1.26–8.84) and spouse longer erect penis (aOR, 1.34; 95% CI 1.00–1.78). Conversely, women's age – more than 24years (aOR, 0.33; 95% CI 0.14–0.78) and women's increased sexual satisfaction (aOR, 0.92; 95% CI 0.87–0.96) were associated with reduced likelihood of extra-marital partnerships.ConclusionDomestic violence, denial of a preferred sex positions, longer erect penis, younger age and increased sexual satisfaction were the main predictors of women's involvement in extra-marital partnerships. Integration of sex education, counselling and life skills training in couple HIV prevention programs might help in risk reduction.

Population mobility associated with higher risk sexual behaviour in eastern African communities participating in a Universal Testing and Treatment trial

“…The findings presented here also confirm our prior research documenting high levels of mobility and HIV risk in communities on the shores of Lake Victoria: fishermen follow the fish over great distances, and female fish traders, who buy, process, transport and retail the fish in local markets, are also highly mobile [38,39]. Moreover, a lakeside transactional sexual economy known as "sex-for-fish", or "jaboya", contributes to the continued spread of HIV in these communities [38,40] and those effects are likely to be amplified through women's mobility necessary to access fish and to sell in local and distant markets.…”

Linking gender, extramarital affairs, and HIV: a mixed methods study on contextual determinants of extramarital affairs in rural Tanzania

“…In Zambia, a good relationship quality was found to prevent married men and women from unsafe sex practices [ 43 ]. In Kenya, sexual satisfaction was found to be protective against extramarital partnerships among married women [ 44 ].…”

A Qualitative Study of Substance use during Pregnancy: Implications for Reproductive Healthcare in Western Kenya

“…Our results also echo other research on alcohol use throughout women’s reproductive lives as driven by socioeconomic factors such as poverty, stress, mental health issues, and violence 39 . In western Kenya, gendered inequalities are rooted in women’s limited access to steady employment, education, and healthcare, which increase their exposure to various forms of gender-based and structural violence 4, 23–24,32 . In our larger survey with people who inject drugs, women were more likely than men to be HIV positive, have lower levels of education, and be the primary caregivers of all or most of their children 2,36 , findings which provided the impetus for us to undertake the qualitative interviews documented in this article.…”

“…Western Kenya is a culturally rich and complex region where political, economic, and social factors converge to create gendered health disparities. Factors such as early initiation into sexual activity, alcohol use, and experiences of sexual violence among adolescents 31 , concurrent sexual relationships 32 , and engagement in both formal and informal sex work 33 place women at high risk for unintended pregnancies and HIV. HIV positive women also suffer from gender-based violence and prevalent but undertreated mental health issues 34 .…”