Exploring the Intersections of Gender Dynamics,Sexual Behaviour,and the Hazard of Reporting Sexually Transmitted Infections among Women in Pakistan: An Intersectional Feminist Perspective Utilizing PDHS (2017–18) Data
Restricted accessResearch articleFirst published online April, 2025
Exploring the Intersections of Gender Dynamics,Sexual Behaviour,and the Hazard of Reporting Sexually Transmitted Infections among Women in Pakistan: An Intersectional Feminist Perspective Utilizing PDHS (2017–18) Data
This study examined the factors influencing women's susceptibility to sexually transmitted infections (STIs) in Pakistan from an intersectional feminist perspective. The research analyzed sexual behavior, spouse-related dynamics, patriarchal structure, and socioeconomic and demographic factors to understand the complex realities faced by women in this societal context using the 2017–2018 Pakistan Demographic and Health Survey. In applying intersectional feminist perspectives, statistical analyses, including chi-squared tests and multivariate logistic regressions, were employed to explore the factors influencing reported STI levels. The findings revealed that 35.8 percent of women reported experiencing STIs within the past year. Contrary to expectations, women who exhibited sexual empowerment were prone to report STIs, highlighting the impact of power dynamics and gender norms on women's sexual health. In addition, there was a negative correlation between women's participation in decision making regarding contraceptive use and the reporting of STIs, suggesting that women's autonomy in reproductive choices does not necessarily lead to improved sexual health outcomes. To effectively combat this issue, this article presents an integrated approach that challenges negative masculine attitudes, promotes healthy sexual behaviors, and emphasizes communication and shared responsibility for sexual health within marital relationships. Interventions should prioritize fostering marital fidelity, enhancing communication between partners, and empowering women to make conversant decisions about contraception.
KhanRBilalASiddiquiSH. Knowledge about HIV and discriminatory attitudes toward people living with HIV in Pakistan. Pak J Public Health. 2019;9(1):37–41. https://pjph.org/pjph/article/view/237.
5.
CrenshawK. Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics. Univ Chicago Legal Forum. 1989;1989(1):139–167.
6.
StanglALAtkinsKLeddyAM, et al.What do we know about interventions to reduce intersectional stigma and discrimination in the context of HIV? A systematic review. Stigma Health. 2023;8(3):393–408. doi:https://doi.org/10.1037/sah0000414
SangK. Gender, ethnicity and feminism: An intersectional analysis of the lived experiences of feminist academic women in U.K higher education. J Gender Stud. 2018;27(2):192–206. doi:https://doi.org/10.1080/09589236.2016.1199380
9.
Odum-SackeyB. Intersectionality: A systematic review of the application of the concept in studies on Ghana. Adv Soc Sci Res J. 2022;9(10):454–470.
10.
LogieCHEarnshawVNybladeL, et al.A scoping review of the integration of empowerment-based perspectives in quantitative intersectional stigma research. Glob Public Health. 2022;17(8):1451–1466. doi:https://doi.org/10.1080/17441692.2021.1934061
11.
KrantzGDang VungN. The role of controlling behaviour in intimate partner violence and health effects: A population-based study from rural Vietnam. BMC Public Health. 2009;9(1):1–10.
12.
WanderaSOKwagalaBNduggaPKabagenyiA. Partners’ controlling behaviours and intimate partner sexual violence among married women in Uganda. BMC Public Health. 2015;15(1):214.
13.
AntaiD. Controlling behavior, power relations within intimate relationships and intimate partner physical and sexual violence against women in Nigeria. BMC Public Health. 2011;11(1):511. doi:https://doi.org/10.1186/1471-2458-11-511
14.
SethPWingoodGMDiClementeRJRobinsonLS. Alcohol use as a marker for risky sexual behaviours and biologically confirmed sexually transmitted infections among young adult African American women. Womens Health Issues. 2011;21(2):130–135.
15.
PartKRahuKRahuMKarroH. Gender differences in factors associated with sexual intercourse among Estonian adolescents. Scand J Public Health. 2011;39(4):389–395. doi:https://doi.org/10.1177/1403494810395820
16.
OnoyaDReddyPSifundaS, et al.Transactional sexual relationships, sexually transmitted infection risk, and condom use among young Black women in peri-urban areas of the Western Cape Province of South Africa. Womens Health Issues. 2012;22(3:e277-e282. doi: 10.1016/j.whi.2011.11.006
17.
AnderssonNCockcroftA. Choice-disability and HIV infection: A cross-sectional study of HIV status in Botswana, Namibia and Swaziland. AIDS Behav. 2012;16(1):189–198.
18.
HarlingGSubramanianSVBärnighausenTKawachiI. Income inequality and sexually transmitted infections in the United States: Who bears the burden?Soc Sci Med. 2014;102:174–182.doi:10.1016/j.socscimed.2013.11.025. Available at: https://www-sciencedirect-com-443.web.bisu.edu.cn/science/article/pii/S027795361300628X. Accessed December 5, 2024.
NankingaOMisindeCKwagalaB. Gender relations, sexual behaviour and risk of contracting sexually transmitted infections among women in a union in Uganda. DHS Working Papers No. 117. Rockville, MD: ICF International; 2015.
21.
OdimegwuCODe WetNBandaPC. Risky sexual behaviour among women: Does economic empowerment matter? Case of Gabon, Mozambique, Sierra-Leone, and Zambia. Afr J AIDS Res. 2016;15(4):333–340
22.
ThurstonWETamDMYDawsonM, et al.The intersection of gender and other social institutions in constructing gender-based violence in Guangzhou China. J Interpers Violence. 2016;31(4):694–714. doi:https://doi.org/10.1177/0886260514556109
23.
AlgarinABZhouZCookCLCookRLIbañezGE. Age, sex, race, ethnicity, sexual orientation: Intersectionality of marginalized-group identities and enacted HIV-related stigma among people living with HIV in Florida. AIDS Behav. 2019;23(11):2992–3001. doi:https://doi.org/10.1007/s10461-019-02629-y
24.
BajunirweFSemakulaDIzudiJ. Risk of HIV infection among adolescent girls and young women in age-disparate relationships in sub-Saharan Africa. AIDS. 2020;34(10):1539–1548.doi: 10.1097/QAD.0000000000002582. PMID: 32443063.
25.
WoolforkMNFoxASwartzendruberA, et al.Empowerment and HIV risk behaviours in couples: Modeling the theory of gender and power in an African context. Womens Health Rep. 2020;1(1):89–101. doi:https://doi.org/10.1089/whr.2019.0020
26.
AizpuruaECoppJRicarteJJVázquezD. Controlling behaviors and intimate partner violence among women in Spain: An examination of individual, partner, and relationship risk factors for physical and psychological abuse. J Interpers Violence. 2021;36(1-2):231–254. doi:https://doi.org/10.1177/0886260517723744
27.
SwahnMHCulbrethRMasynKE, et al.The intersection of alcohol use, gender-based violence, and HIV: Empirical findings among disadvantaged service-seeking youth in Kampala, Uganda. AIDS Behav. 2021;25(10):3106–3114.
28.
PalmSLe RouxE. Learning from practice: Exploring intersectional approaches to preventing violence against women and girls. United Nations Trust Fund to End Violence against Women; 2021.
29.
KebedeTDayuMGirmaA. The burden of HIV infection among pregnant women attending antenatal care in Jimma University Specialized Hospital in Ethiopia: A retrospective observational study. Interdiscip Perspect Infect Dis. 2022;2022:1–11. doi:https://doi.org/10.1155/2022/3483767.PMID: 35378872; PMCID: PMC8976672.
30.
LendadoTATekleTDawitD, et al.Determinants of syphilis infection among pregnant women attending antenatal care in hospitals of Wolaita zone, Southern Ethiopia, 2020. PLoS One. 2022;17(6). doi:https://doi.org/10.1371/journal.pone.0269473
31.
SwayzeEJCambouMCMeloM, et al.Ineffective penicillin treatment and the absence of partner treatment may drive the congenital syphilis epidemic in Brazil. AJOG Glob Rep. 2022;2(2):100050. doi:https://doi.org/10.1016/j.xagr.2022.100050
32.
HudaMNAhmedMUUddinMB, et al.Prevalence and demographic, socioeconomic, and behavioral risk factors of self-reported symptoms of sexually transmitted infections (STIs) among ever-married women: Evidence from nationally representative surveys in Bangladesh. Int J Environ Res Public Health. 2022;19(3):1906. doi:https://doi.org/10.3390/ijerph19031906.PMID: 35162926; PMCID: PMC8835257.
33.
RoyS. Portrayal of women characters in selected contemporary Pakistani television drama. Imperial J Interdiscip Res. 2016;2(5):1041–1045.
34.
SarwarGHumaZ. Aurat March and women empowerment: Perceptions and perspectives of women in Pakistan. J Dev Soc Sci. 2021;2(4):1052–1062. doi:https://doi.org/10.47205/jdss.2021(2-IV)83
35.
BatoolSM. Bringing the focus back: Aurat March and the regeneration of feminism in Pakistan. J Int Womens Stud. 2021;22(9):316–330.
36.
SaigolR. Contradictions and ambiguities of feminism in Pakistan, 2020.
37.
ZamanUShafiqM. Socio-cultural determinants of sexually transmitted infections in Pakistan: A qualitative study. BMC Public Health. 2019;19(1):121.
38.
RizviFZaidiSAARizviJ. Pelvic inflammatory disease and infertility in developing countries: A systematic review. Obstet Gynecol Sci. 2020;63(6):793–804.
39.
KhawajaNG. Knowledge, attitudes, and practices regarding sexually transmitted infections among women in Pakistan. East Mediterr Health J. 2018;24(3):221–228.
40.
MumahJNJackson-SmithD. Do the factors associated with female HIV infection vary by socioeconomic status in Cameroon?J Biosoc Sci. 2014;46(4):431–448. doi:https://doi.org/10.1017/S0021932013000631
41.
RehanMWaheedUSarwarM, et al.Knowledge, attitude, practices, and awareness regarding HIV/AIDS among university students of Islamabad and Rawalpindi, Pakistan. Ann Pak Inst Med Sci. 2016;12(2):86–89.
42.
ZafarMNisarNKadirM, et al.Knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in coastal areas of Karachi. BMC Public Health. 2014;10(14):437.
