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Primary Submission Category: Reproductive health
Sexual Assault and Women’s Sexual Autonomy: Evidence of Diverging Recovery Pathways in West and Central Afric
Authors: Nigel James, Dahyshana Williams, Brianna Ontaneda, Maggie Slusar, Jorden Jackson,
Presenting Author: Margot Clough*
Sexual autonomy is a critical determinant of reproductive health, HIV prevention, and women’s agency in health decision-making, and unequal power within relationships remains an important driver of gender-based health inequities. Yet little is known about how experiences of sexual violence shape women’s ability to exercise autonomy in intimate relationships in low- and middle-income countries. This study examines how sexual assault is associated with sexual autonomy among women in West and Central Africa and explores whether survivors follow distinct recovery trajectories depending on the characteristics of the assault.
We use Demographic and Health Survey (DHS) data from five countries—Angola, Chad, Nigeria, Rwanda, and Togo—focusing on women aged 15–45 with information on lifetime experience of sexual violence and current relationship dynamics. Sexual autonomy is measured along two dimensions: the ability to refuse sex and the ability to negotiate condom use with a partner. Logistic regression models compare autonomy outcomes between women who have and have not experienced sexual assault. Among survivors, latent class analysis identifies profiles based on perpetrator relationship and timing of the assault.
This study advances population health research by examining sexual autonomy as a dimension of post-assault recovery and identifying heterogeneous survivor trajectories.
Preliminary results show that survivors report higher autonomy in refusing sex compared with women who have not experienced assault, while survivor status is not significantly associated with condom negotiation. Among survivors, two distinct profiles emerge: recent assault by a current partner and past assault by non-partners. Women in the past-assault group exhibit higher autonomy in both refusing sex and negotiating condom use, whereas those experiencing recent partner violence show lower condom negotiation.
These findings suggest that recovery trajectories following sexual assault are not uniform and highlight the importance of tailored support strategies that address ongoing partner violence while strengthening sexual autonomy to improve reproductive health and HIV prevention outcomes.