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2018 ; 13
(7
): e0199733
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How empowered are girls/young women in their sexual relationships? Relationship
power, HIV risk, and partner violence in Kenya
#MMPMID30024908
Pulerwitz J
; Mathur S
; Woznica D
PLoS One
2018[]; 13
(7
): e0199733
PMID30024908
show ga
BACKGROUND: Gendered power dynamics within couple relationships can constrain
women from achieving positive sexual and reproductive health outcomes. But little
is known about relationship power among adolescents, and tools to measure it are
rarely validated among adolescents. We tested the Sexual Relationship Power Scale
(SRPS) among adolescent girls and young women (AGYW) and examined associations
with select health outcomes. METHODS: A 16-item adaptation of the SRPS was
administered to AGYW aged 15-24 in Kenya (n = 1,101). Confirmatory factor
analysis (CFA) and theta coefficients assessed scale performance for three age
bands: 15-17, 18-20, and 21-24 years old. Relationship power levels were examined
and multivariate logistic regressions assessed the relationship between power,
and partner violence and HIV risk outcomes. RESULTS: CFAs confirmed a one factor
structure for each subgroup, and thetas for final 15-item scales were robust
(>.82). Most respondents reported limited power in their sexual relationships,
however older respondents consistently reported lower levels of power.
Relationship power was strongly associated with several outcomes, even when
controlling for socioeconomic status and schooling. For example, AGYW who
reported more relationship power were 12, 6, and 7 times less likely (ages 21-24,
18-20, and 15-17, respectively) to experience sexual violence (p<0.001).
Significant relationships were also found in multivariate analyses for physical
partner violence (all three age bands), using a condom at last sex
(18-20-year-olds), and increased knowledge of partner's HIV status
(21-24-year-olds). CONCLUSIONS: The SRPS is a good measure of relationship power
for several age bands within AGYW, and power is experienced differently by older
and younger AGYW. Low relationship power was a consistent predictor of partner
violence, as well as an important predictor of HIV risk. Interventions seeking to
address HIV and violence should also explicitly address relationship power and
utilize validated tools (like the SRPS) to evaluate impacts.
|*Power, Psychological
[MESH]
|Adolescent
[MESH]
|Female
[MESH]
|HIV Infections/*epidemiology
[MESH]
|Humans
[MESH]
|Intimate Partner Violence/psychology/*statistics & numerical data
[MESH]
|Kenya
[MESH]
|Sexual Behavior/*psychology/statistics & numerical data
[MESH]