Women’s Economic Contribution, Relationship Status and Risky Sexual Behaviours: A Cross-Sectional Analysis from a Microfinance-Plus Programme in Rural South Africa

Abstract

In sub-Saharan Africa, women bear a disproportionate burden of HIV/AIDS while also facing economic and gender inequalities. To explore the association of women’s economic contribution and relationship status with risky sexual behaviour, this study analysed cross-sectional data from 626 women aged 22 to 84 in rural South Africa. All women were enrolled in a microfinance plus gender training programme (Intervention with Microfinance for AIDS and Gender Equity (IMAGE)). We used univariable and multivariable logistic regression to explore the associations of relationship status and women’s household income contribution with inconsistent condom use, multiple sexual partners and transactional sex, respectively. We found that married, older women had the highest odds of inconsistent condom use, while those contributing all the household income had higher odds of multiple sexual partnerships, but lower odds of transactional sex compared to those with no contribution. Income contribution and relationship status have a nuanced relationship with sexual risk behaviours. Thus, economic strengthening interventions should target relevant vulnerable women while also addressing the broader social and economic drivers of risky sexual behaviour.

Risky sexual behaviors and associated factors among adult patients on antiretroviral treatment at Mankweng Hospital in Limpopo Province, South Africa

“…These findings concur with the results of a study conducted by Molla and Gelagay, which posits that married participants are more likely to engage in risky sexual behavior as compared to unmarried participants (29). Multivariate logistic regression showed that married participants were 2.60 times more likely to practice risky sexual behavior, a finding which is in agreement with research done by Tolmay et al (31), who reported that married participants had the highest odds of inconsistence use of condoms as compared to those who are not married. The study found that low sexual decision-making capacity, relationship instability worry, and infidelity accusation fear were the main causes of inconsistent condom use in married women (31).…”

“…Multivariate logistic regression showed that married participants were 2.60 times more likely to practice risky sexual behavior, a finding which is in agreement with research done by Tolmay et al (31), who reported that married participants had the highest odds of inconsistence use of condoms as compared to those who are not married. The study found that low sexual decision-making capacity, relationship instability worry, and infidelity accusation fear were the main causes of inconsistent condom use in married women (31). Furthermore, Madiba and Ngwenya, cited that most men have indicated that they cannot pay lobola and still use a condom (32).…”

“…Furthermore, Madiba and Ngwenya, cited that most men have indicated that they cannot pay lobola and still use a condom (32). In patriarchal societies, refusing unprotected sex or suggesting condom use is viewed as a threat to a husband's authority or an indication of unfaithfulness, and may be confronted with physical abuse by the husband (31). In addition, a study by Tadesse and Gelagay (18), attributed the high prevalence of risky sexual behavior in married women to the need to have children, while some participants see no use of condoms since they are already infected with HIV.…”

Aetiology of genital ulcer disease and associated factors among Mthatha public clinic attendees

“…27,28 High rate of unprotected sex among the heterosexual and homosexual population is driven by several factors, among which there is fear of being considered unfaithful in the relationship and money and gifts in exchange for sex. 29 The syndromic STI management approach is beneficial, but it limits the opportunities for diagnosing asymptomatic STIs. 9,30 Syndromic STI management is the diagnosis of STIs based on symptoms and signs, which subsequently leads to their treatment, with point-of-care therapies to treat the majority of microbes that produce specific syndromes without confirmation with the laboratory tests.…”

“… 27 , 28 High rate of unprotected sex among the heterosexual and homosexual population is driven by several factors, among which there is fear of being considered unfaithful in the relationship and money and gifts in exchange for sex. 29 …”