Prevalence and factors associated with extra-spousal partnerships among currently married individuals in Rakai, Uganda: A Cross-sectional study.

Joseph KB Matovu; Arnold Tigaiza

doi:10.51168/sjhrafrica.v6i6.1795

Authors

Joseph KB Matovu Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
Arnold Tigaiza Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1795

Keywords:

Extra-spousal partnerships, Married individuals, Rakai, Uganda

Abstract

Introduction

While extra-marital relations have been associated with increased risk for HIV infection in previous studies, extant literature on the prevalence and factors associated with these sexual relationships remains largely limited. We assessed the prevalence and factors associated with extra-spousal partnerships among currently married individuals.

Methods

This secondary analysis uses data from a large cross-sectional study conducted among married individuals aged 15-49 years in Rakai, Uganda. We used a generic definition of marriage to include all individuals who considered themselves as “married” irrespective of category. Extra-spousal sexual partnerships were defined as concurrent sexual relationships between a married individual and another person (of the opposite sex) with whom they were not currently married. We determined the prevalence of extra-spousal partnerships and used a modified Poisson regression model to assess factors independently associated (at P<0.05) with extra-spousal partnerships, after adjusting for potential confounders. We used STATA (version 14.0) for data analysis.

Results

Of 2,103 currently married individuals, 51.5% (n=1,084) were females; 66.1% (n=1,391) were in their first marriage ever, while 83.3% (n=1,751) had been married for five or more (5+) years. Thirteen per cent (n=282) reported extra-spousal partnerships; 4.5% (n=49) among females and 22.9% (n=233) among males. Being HIV-positive, being in the third or higher marital order marriage, engagement in housework (among women), and being male were significantly associated with engaging in extra-spousal partnerships. Being 35 years or older was protective against engaging in extra-spousal partnerships.

Conclusion

One in ten currently married individuals engaged in extra-spousal partnerships. Extra-spousal partnerships were more common among men, individuals living with HIV, those with a higher number of previous marriages, and women engaged in housework than their counterparts.

Recommendations

Targeted HIV prevention interventions, including those that focus on men and previously married individuals, are urgently needed to protect married individuals from the risk of extra-spousal partnerships.

Author Biographies

Joseph KB Matovu, Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda

Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda

Dr Matovu is a Social and Behavioral Epidemiologist with >25 years of experience in the design and implementation of social, behavioural, and epidemiologic research. He is a researcher, author, and peer reviewer with >130 papers published to date. He is an Associate Professor at Busitema University Faculty of Health Sciences (Mbale, Uganda) and a Senior Research Associate at Makerere University School of Public Health in Kampala, Uganda. Dr Matovu’s research interests include evaluation of social network-based interventions, implementation science, and impact evaluation. Dr Matovu is passionate about the integration of social and behavioural sciences into epidemiological research. He has 4,892 Google Scholar citations, an h-index of 41, and an i10-index of 81. This paper uses data from a cluster-randomized, demand-creation intervention for couples’ HIV counseling and testing among married or cohabiting individuals in Rakai district that Dr Matovu implemented as part of his doctoral studies at Makerere University. This is the fourth paper to be published out of this work.

Arnold Tigaiza, Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda

Arnold Tigaiza is a PhD Fellow at Makerere University School of Public Health. He holds a Bachelor’s degree in Environmental Health Sciences and a Master’s degree in Public Health. His broader academic interests include migration, health systems, and social determinants of health in low-resource settings. He is passionate about using evidence to inform policy and improve service delivery for marginalized communities. His PhD research focuses on the mental health impacts of climate change-induced youth migration in secondary cities of Uganda. He is particularly interested in understanding the differences or similarities in how common depression is among youth who migrate to cities as a result of climate shocks, youths who do not migrate despite climate shocks, and youths who are born and raised in the cities where the migrant youth move to. He is also studying how ecological stressors and mobility patterns affect depression and help-seeking behaviors among young people.

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