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Women's Autonomy and Timing of Most Recent Sexual Intercourse in Sub-Saharan Africa: A Multi-Country Analysis

Since the 1994 Cairo International Conference on Population and Development, there has been increasing interest in promoting women's empowerment, particularly for sexual and reproductive health. Women's ability to negotiate the timing of intercourse with an intimate partner has not been extensively studied. This study explored the relationships between married women's autonomy and the time since most recent sexual intercourse in Ghana, Malawi, Mali, Rwanda, Uganda, and Zimbabwe using the Demographic and Health Surveys. Significant variation both within and between countries in the timing of most recent sex was found. A strong relationship between women's decision-making autonomy and time since last sexual intercourse in all six settings, even after controlling for factors such as the husband living elsewhere, age, marital duration, and other sociodemographic variables, was found. Men's decision-making autonomy was not associated with the time since last intercourse. 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.