Increased responsibility could lead to decreased sexual activity among women

"A very consistent pattern was observed across all six countries we surveyed—as the number of decisions in which a women had the final say increased, the mean and median time since most recent sex also increased by three- to 100-fold," said Michelle Hindin, PhD, MHS, lead author of the study and an associate professor at the Bloomberg School's Department of Population, Family and Reproductive Health. "The more decisions a woman reported making on her own, as compared to joint decision making, the less likely she was to have sex and the longer it was since she last had sexual intercourse."

Researchers analyzed nationally representative data from the Demographic and Health Surveys in Ghana, Malawi, Mali, Rwanda, Uganda, and Zimbabwe that asked survey participants to indicate the day, week, month and year they last had sexual intercourse. Survey participants were also asked to indicate the person in the household who typically had the final say on the following decisions: respondent's health care, large household purchases, household purchases for daily needs and the respondent visiting family and friends. Researchers also examined socio-demographic and relationship factors such as age, wealth, parity, husband's residence, and marital duration and found that most standard socio-demographic variables were not consistently associated with the timing of most recent sexual intercourse.

The majority of women participating in the survey reported sexual intercourse within the last month. Patterns of decision-making power varied by country, with husbands having the final say on more decisions in Malawi and Mali more than in other countries. Ghanaian and Rwandan women reported having the final say in more decisions than women in the other countries, whereas Zimbabwean women reported the most joint decision making. For men, making autonomous decisions was not related to the timing of most recent sex.

"Understanding how women's position in the household influences their sexual activity may be an essential piece in protecting the sexual rights of women and helping them to achieve a sexual life that is both safe and pleasurable," said Carie Muntifering, co-author of the study and student at the Bloomberg School. "The findings from this analysis contribute to our understanding of the frequency of sexual activity in sub-Saharan Africa and its relationship to household decision making. Additional studies are needed to further explore the strong association between women's decision-making power and recent sexual activity that was found in our analyses."

Provided by Johns Hopkins University Bloomberg School of Public Health