In India, Men's Sexual Behavior Puts Their Wives' Reproductive Health at Risk
Ball, H., International Family Planning Perspectives
More than one in four women aged 18-45 in Goa, India, had a reproductive tract infection at the time of a 2001-2003 study of the prevalence and determinants of such infections. (1) Although STIs were present in relatively few women (4%), endogenous infections, such as bacterial vaginosis and candidiasis, were common (25%). Being older than 25 at marriage and using condoms or oral contraceptives had a protective effect against bacterial vaginosis, while having a verbally, physically or sexually abusive husband and being concerned about one's husband's habits (such as alcohol consumption) were associated with an increased risk. A low level of social integration, concern about a husband's extramarital relationships (an indicator of sexual risk), never having been pregnant and having been sterilized were associated with having an STI.
The data come from a population-based sample of women aged 18-50, who were randomly selected from a database of health department records and who resided in the north Goa district, spoke one of the study languages, did not have cognitive impairment and were not pregnant. Of the 3,000 eligible women contacted, 2,494 (83%) consented to participate. The majority of the respondents (75%) were Hindu, 14% were unable to read or write, 68% were homemakers and 36% lived in homes with no toilet facility. Some 33% of women's households were in debt, and 5% of women reported having gone hungry in the three months prior to the study. Data collection involved two stages: a semistructured interview to obtain information regarding participants' social and demographic characteristics, experiences with gender disadvantage, and sexual and reproductive health risk factors; and a gynecological examination to determine the presence of endogenous infections (bacterial vaginosis and candidiasis) and STIs (trichomoniasis and gonorrheal or chlamydial infections).
Overall, 28% of women had a reproductive tract infection; 4% of women had at least one STI, and 25% had an endogenous infection. Bacterial vaginosis, found among 18% of participants, was the most common reproductive tract infection.
The univariate analysis indicated that risk factors for STIs and bacterial vaginosis included being older, being married, having less education, having a small household, lacking a toilet in the home and being in debt (p<0.1). Having candidiasis was associated with being younger, being non-Muslim, having fewer than three children and not having tap water in the house.
In a multivariate analysis, having an STI was associated with being married (odds ratio, 2.3), being illiterate (1.8), having fewer than three children in the household (2. …