­Examining the Factors Associated with Sexual Violence Against Women in Sierra Leone: A Nationwide Cross-Sectional Study

Abstract

Background: In 2019, Sierra Leone declared a national emergency over rape and other forms of sexual violence (SV), hence diverting resources from other issues to tackle SV. However, little is known about nationwide risk/protective factors for SV, and this has been a source of critique for the new policy. To fill this gap in knowledge, we investigated the factors for SV towards women using a nationally representative sample. Methods: We analyzed the 2013 Demographic and Health Survey (DHS) data, including 16,658 women, ages 15-49. The outcome was current SV, defined as being physically forced to have sexual intercourse within the last 12 months. We examined respondent's background, sexual activities, and domestic violence characteristics. Logistic regression analyses were performed using STATA/SE v.15.1, accounting for survey design and sample weights. P-values <0·05 were considered statistically significant. Findings: About 258 (6·25%) women experienced SV. In adjusted analysis, women in the north (compared to south), (2·88;95%CI:1·44-5·75), and women circumcised between ages 1-14 (1·67;95%CI:1·10-2·54) were at increased risk for SV, respectively. Women who had sex >25 times/year were 6·9 times more likely to experience SV, compared to those with 1-24 times (6·91;95%CI:1·48-32·19). The odds of SV were 6 times higher among women who experienced recent physical violence (5·86;95% CI:2·49-13·80) or had a history of sexual abuse (6·34;95%CI:2·57-15·65). Interpretation: Women in the north, circumcised between ages 1-14, had sex great than 25 times/year, experienced physical and sexual abuse, were at increased risk for SV. While more research is needed, these findings will help inform the current emergency operations against sexual violence. Funding: No financial support was reported for this paper. Declaration of Interest: No conflicts of interest were declared for this manuscript. Ethical Approval: Data used for this study is publicly available on the DHS website online data access tools and downloadable public-use data files.