Spatial pattern and influence of mass media exposure on sexual exposure among women with disabilities in sub-Saharan Africa.

Background: Globally, people with disability have significant limitations in expressing their sexuality, and studies suggest that women with disability have an increased risk of sexually related problems due to impairment in one or more functional domains affecting their sexual desire. Thus, this current study investigated the spatial patterns and the influence of mass media exposure on the sexual exposure of women with disability in sub-Saharan Africa (SSA).

Methods: We utilised the latest secondary dataset with disability module from a demographic health survey conducted in 10 countries in SSA between 2010 and 2022. A sample size of 16,517 women with disabilities was included. We utilised spatial analysis to show the predicted prevalence of sexual exposure, whilst multilevel binary logistic regression was used to examine the association between mass media exposure, the included covariates and sexual exposure. The five models developed were presented using adjusted odds ratio (aOR) with corresponding 95% confidence intervals (CI), and statistical significance was determined at p < 0.05.

Results: The country with the highest prevalence of sexual exposure among women with a disability was Rwanda (77.13%), followed by Mali (72.03%), and the lowest was South Africa with 52.01%. Furthermore, women with disability who were exposed to mass media [aOR = 1.22; 95%(CI = 1.12-1.32)] had higher odds of being sexually exposed compared to those who had no mass media exposure. At the same time, those within the richest wealth index [aOR = 1.33; 95%(1.12-1.59)] were more likely to be sexually exposed compared to those who were within the poorer wealth index. On the other hand, women with disability who reside in communities with higher literacy levels [aOR = 0.80; 95%(CI = 0.71-0.90)] had lower odds of being sexually exposed compared to those who reside in communities with lower literacy levels. CONCLUSIONS AND RECOMMENDATIONS: Findings from this study revealed that the majority of women with disability in SSA were sexually exposed, with those exposed to mass media having a higher risk of being sexually exposed. Thus, there is a need for policymakers to institute educational programs that promote the sexual and reproductive health of women with disability through the mass media.