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Gendered power dynamics and threats to sexual and reproductive autonomy among adolescent girls and young adult women: A cross-sectional survey in three urban settings

Author

Listed:
  • Michele R Decker
  • Shannon N Wood
  • Meagan E Byrne
  • Nathalie Yao-N’dry
  • Mary Thiongo
  • Peter Gichangi
  • Funmilola M. OlaOlorun
  • Alain K Koffi
  • Scott Radloff
  • Saifuddin Ahmed
  • Amy O. Tsui

Abstract

Background: Gendered economic and social systems can enable relational power disparities for adolescent girls and young women (AGYW), and undercut autonomy to negotiate sex and contraceptive use. Less is known about their accumulation and interplay. This study characterizes relationship power imbalances (age disparity, intimate partner violence [IPV], partner-related fear, transactional sex, and transactional partnerships), and evaluates associations with modern contraceptive use, and sexual/reproductive autonomy threats (condom removal/“stealthing”, reproductive coercion, ability to refuse sex, and contraceptive confidence). Methods: Cross-sectional surveys were conducted with unmarried, currently-partnered AGYW aged 15–24 recruited via respondent-driven sampling in Abidjan, Côte d’Ivoire (n = 555; 2018–19), Nairobi, Kenya (n = 332; 2019), and Lagos, Nigeria (n = 179; 2020). Descriptive statistics, Venn diagrams, and multivariate regression models characterized relationship power imbalances, and associations with reproductive autonomy threats and contraceptive use. Findings: Relationship power imbalances were complex and concurrent. In current partnerships, partner-related fears were common (50.4%Nairobi; 54.5%Abidjan; 55.7%Lagos) and physical IPV varied (14.5%Nairobi; 22.1%Abidjan; 9.6%Lagos). IPV was associated with reproductive coercion in Nairobi and Abidjan. Age disparate relationships undermined confidence in contraception in Nairobi. In Nairobi and Lagos, transactional sex outside the relationship was associated with condom stealthing. Interpretation: AGYW face simultaneous gendered power differentials, against the backdrop of gendered social and economic systems. Power imbalances were linked with coercive sexual/reproductive health experiences which are often underrecognized yet represent a potent link between gendered social systems and poor health. Pregnancy prevention efforts for AGYW must address reproductive autonomy threats, and the relational power imbalances and broader gendered systems that enable them.

Suggested Citation

  • Michele R Decker & Shannon N Wood & Meagan E Byrne & Nathalie Yao-N’dry & Mary Thiongo & Peter Gichangi & Funmilola M. OlaOlorun & Alain K Koffi & Scott Radloff & Saifuddin Ahmed & Amy O. Tsui, 2021. "Gendered power dynamics and threats to sexual and reproductive autonomy among adolescent girls and young adult women: A cross-sectional survey in three urban settings," PLOS ONE, Public Library of Science, vol. 16(11), pages 1-16, November.
    • Handle: RePEc:plo:pone00:0257009
    DOI: 10.1371/journal.pone.0257009
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    References listed on IDEAS

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    1. Parfait M. Eloundou-Enyegue & C. Shannon Stokes, 2004. "Teen Fertility and Gender Inequality in Education," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 11(11), pages 305-334.
    2. Kate McQueston & Rachel Silverman & Amanda Glassman, 2012. "Adolescent Fertility in Low- and Middle-Income Countries: Effects and Solutions," Working Papers id:4975, eSocialSciences.
    3. Amanda Glassman, Kate McQueston, and Rachel Silverman, 2012. "Adolescent Fertility in Low- and Middle-Income Countries: Effects and Solutions - Working Paper 295," Working Papers 295, Center for Global Development.
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