Beyond consent: exploring women’s empowerment and risky sexual decisions in Ghana

Understanding the relationship between women’s empowerment and their ability to refuse risky sexual advances is important for policies aimed at reducing unintended pregnancies, sexually transmitted infections, and poor maternal health outcomes, in line with SDG 5. This study examined the association between women’s empowerment and their ability to refuse sex when their partners are involved with other women.The study used data from the 2022 Ghana Demographic and Health Survey, with a sample of 8,584 women in consensual relationships. Analysis was conducted using Stata v17. Chi-square tests first identified variables associated with the outcome, followed by probit regression to assess the relationship between empowerment and refusal of risky sexual advances while controlling for potential confounders.Findings showed that 36.35% of women in consensual unions were unable to refuse risky sexual advances from their partners. The social independence and decision-making domains of the SWPER index significantly predicted women’s ability to refuse risky sex, increasing the probability by 4.65% and 11.4%, respectively. Media exposure, marital status, and religion were also significant predictors.The study concludes that social autonomy and decision-making power are positively associated with women’s ability to refuse risky sexual advances, highlighting empowerment as vital for improving women’s sexual health and safety.