CoChat
Sign Up
Cited by 54Intimate Partner and Family ViolenceHIV/AIDS Research and InterventionsMarriage and Sexual Relationships

Proximate context of gender-unequal norms and women's HIV risk in sub-Saharan Africa

Open access
Tsai, Alexander C., Subramanian, S.V.·2012·AIDS
DOI 10.1097/qad.0b013e32834e1ccbPMC PMC4565190
Open this paper in CoChat — free account

Abstract

OBJECTIVE: To determine whether the proximate context of gender-unequal norms about violence against women undermines women's ability to negotiate condom use in sexual relationships. DESIGN: Secondary analysis of cross-sectional data pooled from 22 Demographic and Health Surveys conducted in sub-Saharan Africa. METHODS: Each of the 22 surveys employed a multistage stratified design with probabilistic sampling and was designed to be nationally representative of reproductive-age women. The outcome was self-reported condom use at last sexual intercourse. The primary explanatory variable of interest was a scale consisting of five questions about whether the respondent agreed with the appropriateness of wife beating under five different scenarios. To measure the proximate context of norms about violence against women, this scale was aggregated to the level of the primary sampling unit. We fit logistic regression models with cluster-correlated robust standard errors and adjustment for country-level fixed effects and sociodemographic characteristics. RESULTS: Our analysis sample included data from 198,806 sexually active women living in 22 sub-Saharan African countries. The wife-beating scale was internally consistent (Cronbach's α = 0.84), and factor analysis confirmed the presence of a single factor. Condom use was associated with gender-unequal contextual norms about violence against women (adjusted odds ratio = 0.88; 95% confidence interval, 0.85-0.92; P < 0.001). The estimated association was robust to adjustment for sociodemographic characteristics and several sensitivity analyses. CONCLUSIONS: The proximate context of gender-unequal norms about violence against women is associated with lack of condom use among women in sub-Saharan Africa.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/qad.0b013e32834e1ccb

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • These risk factors may be most likely to raise the risk of violence where women are structurally disadvantaged relative to men in land ownership and access to production, or where violence against women is normative.

    “These risk factors might be most likely to elevate the risk of violence in settings where women are structurally disadvantaged, either by law or by tradition, relative to men in terms of land ownership and access to other factors of production,33 or in settings where violence against women is normative.34, 35”

    From Co-occurring epidemics, syndemics, and population health (2017) · cites this paper as [34]

    The citation to this paper is attached to the clause about settings where violence against women is normative, not the land-ownership clause. The Methods measure norms about wife-beating, and the Results and Discussion relate those norms to condom use, but no passage assesses whether the cited risk factors raise the risk of violence more in such settings. Searched for violence risk and structural disadvantage. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

  • Violence is independently associated with HIV risk.

    “which is itself independently associated with HIV risk [23,24]”

    From Syndemics and Health Disparities: A Methodological Note (2016) · cites this paper as [23]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Tsai, A. C., & Subramanian, S. V.
Affiliations
Harvard University (US)
Corresponding author
Tsai, Alexander C.
ORCID
Venue
AIDS
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-01-28
Volume
26
Issue
3
Pages
381-386
ISSN
0269-9370 (ISSN-L)
DOI
10.1097/qad.0b013e32834e1ccb
PMC
PMC4565190
OpenAlex
W1996694280
Cited by
54
References
39
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 5 · 2016: 3 · 2015: 9 · 2014: 5 · 2013: 7 · 2012: 4
FWCI
5.27
Type
journal article
Language
en
Open access
Locations
  • AIDS (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Robert Wood Johnson Foundation
  • National Institutes of Health (5k25hl081275-05)
  • National Heart, Lung, and Blood Institute (K25 HL081275))
Topics
  • Social Sciences › Health › Intimate Partner and Family Violence
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › Sociology and Political Science › Marriage and Sexual Relationships
Keywords
violence against women, wife beating, condom use, HIV risk, sexual negotiation, women's sexual health, sub-Saharan Africa, sexual and reproductive health
MeSH terms
Adult, Cross-Sectional Studies, Factor Analysis, Statistical, Female, Humans, Interpersonal Relations, Male, Surveys and Questionnaires, Sexual Behavior, Spouse Abuse, HIV Infections, Logistic Models, Odds Ratio, Condoms, Africa South of the Sahara, Risk Assessment

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review