Regional Prevalence, Patterns and Correlates of Sexual Coercion Among Women in Sub-Saharan Africa: A Multi-Country Population-Based Study

Objective: This study investigates the prevalence, perpetrators, and factors associated with forced sexual acts. Methods: Pooled secondary data from the most recent Demographic and Health Survey (DHS) in 22 sub-Saharan African countries was used in this study. The individual woman components of the questionnaire involving 148,720 women of reproductive age (15-49years) were analyzed. Percentages and graphs were used to present distribution of study variables. Multivariable logistic regression was used to examine factors associated with sexual coercion. Results: Forced sexual acts were prominent in Rwanda (15.7%), Gabon (12.3%) and Democratic Republic of Congo (10.9%). The lowest mean age at first forced sexual acts was recorded in Gabon (14.1years), Comoros and Mali (14.9years each), whereas the maximum was recorded in Namibia (25.9years). Results from adjusted logistic regression models identified that factors such as high women decision making power, large spousal age difference, rural residence, Islamic religious beliefs and listening to radio were significantly associated with reduction in the odds of forced sexual acts. Conversely, high-risk partner's behavior, older age at start of first marriage, early age at sexual debut, most disadvantaged community, education, and the use of newspapers were significantly associated with higher odds of forced sexual acts. Conclusion: Based on the findings of this study, policies should be reinforced to handle perpetrators of sexual violence especially non-intimate partners. Population-based preventive measures of sexual coercion are essential to complement justice system responses. Our findings also showed the importance of building gender equity as part of sexual violence prevention approach.