Factors associated with sexual behaviour among women aged 15-49 in South African low-income communities

Abstract

South Africa faces disproportionately high rates of sexually transmitted diseases (STDs), especially in low-income communities. Understanding how demographic, socioeconomic, and knowledge-based factors influence sexual behavior is critical for targeted public health interventions. Therefore, this study examined the relationships between socioeconomic status (SES), education, ethnicity, marital status, STD awareness, and sexual behavior among women aged 15 – 49 in low-income South African communities. Methods and Materials: We conducted a cross-sectional study utilizing data from the South Africa Demographic and Health Survey 2016 (SADHS 2016). Key variables included sexual behavior (safe versus risky), SES, education, place of residence, ethnicity, marital status, and awareness of STDs. Bivariate and multivariable analyses were used to assess associations between sexual behavior and the aforementioned variables. Results: Among 8,513 respondents, 22.3% (95% CI: 21.1–23.5) engaged in risky sexual behavior. Higher SES was associated with increased odds of risky behavior, as were White, Coloured, and Indian/Asian ethnicities compared to Black Africans. Conversely, higher education levels, being married or cohabiting, and STD awareness (having heard of AIDS) significantly reduced risky sexual behavior. Urban residence had no significant effect. These findings highlight the influence of socioeconomic and educational factors on sexual health outcomes. Conclusion: Sexual behavior may be influenced by a number of factors, and behavioral patterns vary across groups. Public health strategies and intersectional approaches to sexual health should be considered to enhance education and STD awareness to reduce risky behaviors and improve sexual health outcomes in different population groups.