Married women's negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

Objective: Married women's ability to negotiate for safer sex is important for HIV prevention in subSaharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women's sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. Methods: We analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. Results: We found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR = 0.87; p < .05) and that they can ask for condom use during sexual intercourse (OR = 0.62; p < .001) than their counterparts who had not undergone genital mutilation, while controlling for theoretically relevant variables. Conclusion: Our findings indicate that the experience of female genital mutilation may influence married women's ability to negotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage. (C) 2017 Published by Elsevier B.V.