BMC public health · 2025
Spatial distribution of informal sexual relationships among reproductive age women in Ethiopia: spatial and multilevel analysis from Ethiopian Demographic and Health Survey.
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Dinagde Dagne Deresa, Marami Shambel Negese, Feyisa Gizu Tola
Аннотация
BACKGROUND: Globally, more than 1 million new sexually transmitted diseases (STIs) are acquired every day, posing a serious threat to world health as a result of informal sexual activities such as multi-partner sexual practices and premarital sexual initiation. Exposure to informal settings increases the risk of unprotected sexual practices, sexually transmitted infections such as HIV/AIDS, unwanted pregnancies, unsafe abortions, and can adversely affect the social and economic status of adults. Hence, identifying geographical areas at risk for informal sexual relationships in Ethiopia is very important.
METHODS: A community-based cross-sectional survey using a two-stage stratified sample technique was carried out between January 18 and June 27, 2016. A total of 15,683 reproductive age women participated in the analysis, which used information from the 2016 EDHS. The distribution of informal sexual relationships was assessed using the spatial autocorrelation statistic (Global Moran's I) to see if it was randomly distributed, clustered, or dispersed. The correlation between informal sexual relationships and explanatory variables was found using a multilevel logistic regression model, and statistical significance was established at p < 0.05 and 95% CI.
RESULTS: Overall, 51.14% of reproductive age women had informal sexual relationships. In certain areas of Ethiopia, regions like Amhara (14.1%) and Tigray (11.4%) experienced high levels of informal sexual relationships, while Dire Dawa (6.3%), Harari (5.3%), and Addis Ababa (7.7%) were considered lower-risk areas. The spatial distribution of these interactions showed clustering patterns. The highest hotspot areas of informal sexual relationships were observed in central part of Ethiopia. The being under 25 (AOR = 4.02, 95CI: 3.90-5.26), being agrarian (AOR = 1.17, 95CI: 1.04-1.32) and pastoralist region (AOR = 1.34, 1.20-1.52), living in rural areas (AOR = 1.24, 95 CI: 1.09-1.41), not using internet (AOR = 1.14, 95 CI: 1.01-1.37), unemployment (AOR = 0.88, 0.75, 90) and poor household (AOR = 1.22, 1.11, 1.38) were statistically significant.
CONCLUSION: According to this study, half of reproductive age women fall into informal sexual relationships in Ethiopia. As a result, it is crucial to focus on the areas that are most affected.
METHODS: A community-based cross-sectional survey using a two-stage stratified sample technique was carried out between January 18 and June 27, 2016. A total of 15,683 reproductive age women participated in the analysis, which used information from the 2016 EDHS. The distribution of informal sexual relationships was assessed using the spatial autocorrelation statistic (Global Moran's I) to see if it was randomly distributed, clustered, or dispersed. The correlation between informal sexual relationships and explanatory variables was found using a multilevel logistic regression model, and statistical significance was established at p < 0.05 and 95% CI.
RESULTS: Overall, 51.14% of reproductive age women had informal sexual relationships. In certain areas of Ethiopia, regions like Amhara (14.1%) and Tigray (11.4%) experienced high levels of informal sexual relationships, while Dire Dawa (6.3%), Harari (5.3%), and Addis Ababa (7.7%) were considered lower-risk areas. The spatial distribution of these interactions showed clustering patterns. The highest hotspot areas of informal sexual relationships were observed in central part of Ethiopia. The being under 25 (AOR = 4.02, 95CI: 3.90-5.26), being agrarian (AOR = 1.17, 95CI: 1.04-1.32) and pastoralist region (AOR = 1.34, 1.20-1.52), living in rural areas (AOR = 1.24, 95 CI: 1.09-1.41), not using internet (AOR = 1.14, 95 CI: 1.01-1.37), unemployment (AOR = 0.88, 0.75, 90) and poor household (AOR = 1.22, 1.11, 1.38) were statistically significant.
CONCLUSION: According to this study, half of reproductive age women fall into informal sexual relationships in Ethiopia. As a result, it is crucial to focus on the areas that are most affected.