Ugandan women’s autonomy key to safer sex, researchers say

Ugandan women’s ability to negotiate the conditions and timing of sex, such as refusing sex and asking for condom use with their partners, is key to preventing several reproductive health outcomes, say experts from the Brown School at Washington University in St. Louis.

“The cultural norms that sanction unequal power dynamics in relationships; unjustly acknowledge male sexual freedom over female autonomy; restrict women’s mobility; and reinforce female submission to their partners’ sexual needs; exacerbate this vulnerability,” wrote the authors of a correspondence in the Aug. 10 issue of the journal The Lancet.

Sub-Saharan Africa represents nearly 30% of all new HIV infections globally. Uganda stands out as one of the countries with the highest burden of young people living with HIV, with young women having the highest rates of HIV.

This disproportionate burden on young women partly stems from entrenched gender norms that are shaped by the patriarchal system in Uganda, which typically privileges men and enforces rigid gender roles and expectations, the authors wrote.

Authors of the correspondence are Josephine Nabayinda, a research associate at the Brown School’s International Center for Child Health and Development (ICHAD); Samuel Kizito, MD, a faculty associate at ICHAD; Anita Nagawa, a research assistant at ICHAD Uganda; and Fred Ssewamala, the William E. Gordon Distinguished Professor at the Brown School.