Prevalence of Forced Sex and Associated Factors among Women and Men in Kisumu, Kenya

Maureen K. Adudans, Michele Montandon, Zachary Kwena, Elizabeth A. Bukusi, Craig R. Cohen

Abstract

Sexual violence is a well-recognized global health problem, albeit with limited population-based data available from sub-Saharan Africa. We sought to measure the prevalence of forced sex in Kisumu, Kenya, and identify its associated factors. The data were drawn from a population-based cross-sectional survey. A two-stage sampling design was used:  40 clusters within Kisumu municipality were enumerated and households within each cluster selected by systematic random sampling. Demographic and sexual histories, including questions on forced sex, were collected privately using a structured questionnaire. The prevalence of forced sex was 13% (women) and 4.5% (men).  After adjusting for age and cluster, forced sex among women was associated with transactional sex (OR 2.33; 95%CI 1.38-3.95), having more than two lifetime partners (OR 1.9; 95%CI 1.20-3.30), having postprimary education (OR 1.49; 95%CI 1.04-2.14) and a high economic status (OR 1.87; 95%CI 1.2-2.9). No factors were significantly associated with forced sex among the male respondents. Intimate partners were the most common perpetrators of forced sex among both women (50%) and men (62.1%). Forced sex prevention programs need to target the identified associated factors, and educate the public on the high rate of forced sex perpetrated by intimate partners (Afr J Reprod Health 2011; 15[4]:

87-97).

 

Résumé

Prévalence du sexe forcé et facteurs qui y sont liés chez les femmes et les hommes à Kisumu, Kenya. La violence sexuelle est un problème de santé qui est bien reconnu partout dans le monde, bien que les données basées sur la population et disponible de l’Afrique subsaharienne soient limitées.  Nous avons cherché à mesurer la prévalence du sexe forcé à Kisumu, Kenya et à identifier ses facteurs associés.  Nous avons recueilli les données à partir d’une enquête transversale basée sur la population.  Nous nous sommes servis d’un modèle d’échantillon à deux étapes : Nous avons énuméré 40 petits groupes au sein de la municipalité de Kisumu et les ménages au sein de chaque groupe choisi au hasard à partir d’un échantillon systématique.  Des histoires démographiques et sexuelles y compris des questions sur le sexe forcé, ont été recueillies en privé à l’aide d’un questionnaire structuré.  La prévalence du sexe forcé était 13%(femmes) et 4,5% (hommes).  Après avoir ajusté selon  l’âge et le groupe, le sexe forcé chez les femmes a été lié au sexe transactionnel (OR2,33 ; 95%CI 1,38-3,95% CI 1,20-3,30), ayant plus de deux partenaires de toute une vie(OR 1,9 ; 95% CI 1,20-3,30), ayant reçu une éducation post primaire (OR 1,49 ; 95%CI 1,04214) et une haute situation économique (OR1, 87 ; 95%CI 1,2-2,9).  Il n’y avait pas de facteur qui a été significativement lié au sexe forcé chez les interviewés mâles.  Des partenaires intimes  étaient les auteurs les plus communs du sexe forcé parmi les femmes (50%) et les hommes (62,1%).  Les programmes destinés à la prévention du sexe forcé doivent viser les facteurs qui y sont liés et qui ont été identifiés et il faut sensibiliser le public à l’égard du taux élevé du sexe forcé qui est perpétré par des partenaires intimes (Afr J Reprod Health 2011; 15[4]: 87-97).

 

  Keywords: Forced sex, Intimate partner violence, Sexual violence, Kenya

Full Text:

PDF

References

World Health Organization. World report on violence and health: Geneva: World Health Organization, 2002.

Jewkes R, Dunkle K, Koss MP, Levin JB, Nduna M, Jama N, et al. Rape perpetration by young, rural South African men: Prevalence, patterns and risk factors. Soc Sci Med 2006;63(11):2949-61.

Glover EK, Bannerman A, Pence BW, Heidi Jones RM, Weiss E, Nerquaye-Tetteh J. Sexual health experiences of adolescents in three Ghanian towns. International Family Planning Perspectives 2003;29(1):32-40.

van der Straten A, King R, Grinstead O, Vittinghoff E, Serufilira A, Allen S. Sexual coercion, physical violence, and HIV infection among women in steady relationships in Kigali, Rwanda. AIDS and Behavior 1995;2(1):61-73.

Matasha E, Ntembelea T, Mayaudi P, Saidi W, Todd J, Mujaya B, et al. Sexual and reproductive health among primary and secondary school pupils in Mwanza, Tanzania: need for intervention. AIDS Care 1998;10(5):571-82.

Youri P. Female adolescent health and sexuality in Kenyan secondary schools: a survey report. African Medical Research Foundation, Nairobi, Kenya 1994.

Erulkar AS. The experience of sexual coercion among young people in Kenya. International Family Planning Perspectives 2004;30(4):182-89.

Tjaden P, Thoennes N. Extent, nature and consequences of rape victimization: Findings from the National Violence Against Women Survey. Washington, DC: National

Institute of Justice, 2006.

Ishoy T, Ishoy PL, Olsen LR. [Street prostitution and drug addiction]. Ugeskr Laeger 2005;167(39):3692-6.

Mekonnen Y, Sanders E, Messele T, Wolday D, Dorigo-Zestma W, Schaap A, et al. Prevalence and incidence of, and risk factors for, HIV-1 infection among factory workers in Ethiopia, 1997-2001. J Health Popul Nutr 2005;23(4):35868.

Foster A, Jolliffe D, Over AM. Huber correction for two-stage least squares estimates. Stata Technical Bulletin 1996;5(29):24-25.

Williams RL. A note on robust variance estimator fot clustercorrelated data. Biometrics 2000;56:645-46.

Fawzi MCS, Lambert W, Singler JM, Tanagho Y, Le´andre F, Nevil P, et al. Factors associated with forced sex among women accessing health services in rural Haiti: implications for the prevention of HIV infection and other sexually transmitted diseases. Soc Sci Med

;60(2005):679-89.

Jewkes R, Abrahams N. The epidemiology of rape and sexual coercion in South Africa: an overview. Soc Sci Med 2002;55:1231-44.

Schuler SR, Hashemi SM, Riley AP, Akhter S. Credit Programs, Patriarchy and Men's Violence against Women in Rural Bangladesh. Soc Sci Med 1996;43(12):1729-42.

Watts C, Keogh E, Ndlovu M, Kwaramba R. Withholding of Sex and Forced Sex: Dimensions of Violence against Zimbabwean Women. Reproductive Health Matters 1998;6(12):57-65.

Jewkes R, Levin J, Penn-Kekana L. Risk factors for domestic violence: findings from a South African cross-sectional study. Soc Sci Med 2002;55(9):1603-17.

WHO. WHO multi-country study on women’s health and domestic violence against Women: summary report of

initial results on

prevalence, health outcomes and women’s responses. Geneva: World Health Organization, 2005.

Hindina MJ, Adair LS. Who’s at risk? Factors associated with intimate partner violence in the Philippines. Soc Sci Med 2002;55:1385-99.

Karamagi CA, Tumwine JK, Tylleskar T, Heggenhougen K. Intimate partner violence against women in eastern Uganda: implications for HIV prevention. BMC Public Health 2006;6:284.

Kalichman S, Simbayi L. Sexual assault history and risks for sexually transmitted infections among women in an African township in Capetown, South Africa. AIDS Care 2004;16(6):681-89.

Zierler S, Feingold L, Laufer D, Velentgas P, Kantrowitz-Gordon I, Mayer K. Adult survivors of childhood sexual abuse and subsequent risk of HIV Infection. Am J Public Health 1991;81(5):572-75.

Upchurch D, Kusunoki Y. Associations between forced sex, sexual and protective practices, and sexually transmitted diseases among a national sample of adolescent girls. Women Health 2003;14(3):75-84.

Molitor F, Ruiz J, Klausner J, McFarland W. History of Forced Sex in Association With Drug Use and Sexual HIV Risk Behaviors, Infection With STDs, and Diagnostic Medical Care J Interpers Violence 2000;15(3):262-78.

Yamaguchi K, Kandel DB. The influence of spouses' behavior and marital dissolution on marijuana use: Causation or selection. Journal of Marriage and the Family 1997;59(1):22-36.

Testa M, VanZile-Tamsen C, Livingston JA. Prospective prediction of women's sexual victimization by intimate and nonintimate male perpetrators. J Consult Clin Psychol 2007;75(1):52-60.

El-Bassel N, Gilbert L, Wu E, Go H, Hill J. Relationship between drug abuse and intimate partner violence: A longitudinal study among women receiving methadone Am J Public Health 2005;95(3):465-70.

Liebschutz J, Savetsky JB, Saitz R, Horton NJ, Lloyd-Travaglini C, Samet JH. The relationship between sexual and physical abuse and substance abuse consequences. Journal of Substance Abuse Treatment 2002;22:121-28.

Zierler S, Witbeck B, Mayer K. Sexual violence against women living with or at risk for HIV infection. Am J Prev Med 1996;12(5):304-10.

Kalichman SC, Williams EA, Cherry C, Belcher L, Nachimson D. Sexual coercion, domestic violence, and negotiating condom use among low-income African American women. J Womens Health 1998;7(3):371-78.

Sable M, Danis F, Mauzy D, Gallagher S. Barriers to reporting sexual assault for women and men: perspectives of college students. J Am Coll Health 2006;55(3):157-62.

Plummer ML, Wight D, Ross DA, Balira R, Anemona A, Todd J, et al. Asking semi-literate adolescents about sexual behaviour: the validity of assisted self-completion questionnaire (ASCQ) data in rural Tanzania. Tropical Medicine and International Health 2004;9(6):737-54.

Catania JA, McDermott LJ, Pollack LM. Questionnaire response bias and face-to-face interview sample bias in sexuality research. Journal of sex research 1986;22:52-72.

Refbacks

  • There are currently no refbacks.