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ArticleInternational journal of behavioral medicine2026

Safer Sex Negotiation Among Women in Sexual Unions in Tanzania: Analysis of the 2022 Demographic and Health Survey and Malaria Indicator Survey.

Sanun Ally Kessy, Elihuruma Eliufoo Stephano, Jovin R Tibenderana, Mtoro J Mtoro, Immaculata P Kessy, Victoria Godfrey Majengo, Erick Donard Oguma, Tegemea Patrick Mwalingo, Mussa Hassan Bago, Azan Abubakar Nyundo

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Article in International journal of behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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10 authors.

Sanun Ally KessyBenjamin Mkapa Hospital, Iyumbu, Dodoma, United Republic of Tanzania. sahnunally@outlook.com.
Elihuruma Eliufoo StephanoThe University of Dodoma, Iyumbu, Dodoma, United Republic of Tanzania. ufooeli1@gmail.com.
Jovin R TibenderanaSt. Francis University College of Health and Allied Sciences, Ifakara, United Republic of Tanzania.
Mtoro J MtoroTILAM International, Dar es Salaam, United Republic of Tanzania.
Immaculata P KessyTILAM International, Dar es Salaam, United Republic of Tanzania.
Victoria Godfrey MajengoDodoma Regional Referral Hospital, Dodoma, United Republic of Tanzania.
Erick Donard OgumaThe University of Dodoma, Iyumbu, Dodoma, United Republic of Tanzania.
Tegemea Patrick MwalingoThe University of Dodoma, Iyumbu, Dodoma, United Republic of Tanzania.
Mussa Hassan BagoThe University of Dodoma, Iyumbu, Dodoma, United Republic of Tanzania.
Azan Abubakar NyundoThe University of Dodoma, Iyumbu, Dodoma, United Republic of Tanzania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSexual autonomy among women in sexual unions has various benefits. These benefits include the reduction of sexually transmitted infections and informed decisions on sexual and reproductive health. Therefore, this study aimed to identify the prevalence of safer sex negotiation among women in sexual unions and associated factors in Tanzania.

methodThis analytical cross-sectional study analyzed data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey, conducted between February and July 2022. A two-stage, stratified sampling design, based on geographic region and urban/rural areas, was employed. Modified Poisson regression analysis was used to identify factors associated with women's safer sex negotiation, and results were presented as prevalence ratios (PR) with 95% confidence intervals (CI). Statistical significance was set at p < 0.05.

resultsThe overall prevalence of safer sex negotiation was 75.8% (95%CI, 74.0-77.5). In the adjusted analysis, women in primary education (adjusted prevalence ratio [APR] = 1.16; 95%CI, 1.09-1.25) and secondary/higher education (APR = 1.21; 95%CI, 1.12-1.30), women in middle quintile households (APR = 1.10; 95%CI, 1.06-1.15), those in rich households (APR = 1.12; 95%CI, 1.05-1.17), women with media exposures (APR = 1.14; 95%CI, 1.09-1.18), women who were working (APR = 1.06; 95%CI, 1.03-1.10), aware of sexually transmitted infections (APR = 1.17; 95%CI, 1.12-1.22), and internet users (APR = 1.04; 95%CI, 1.01-1.07) were more likely to have safer sex negotiation. Partners with primary education (APR = 1.06; 95%CI, 1.01-1.12) and those with secondary/higher education (APR = 1.07; 95%CI, 1.01-1.14) were associated with safer negotiate sex than their counterparts. Geographical zones revealed a strong association with safer sex negotiation among women in sexual unions in Tanzania.

conclusionThis study revealed several factors that enhance safer sex negotiation among women in Tanzania, including higher education, better socioeconomic status, access to mass media, internet use, and geographical context. These findings reinforce the imperative for context-specific interventions to empower women and promote sexual autonomy.

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Safer sex negotiationSexual unionTanzaniaWomen

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