Sexual Abuse Experienced by Egyptian Married Women

1. Aboubakr Elnashar
Mona Hassan
Mohy EL-Dien Ibrahim
Magdy EL-Desoky
Olfat Ali
Email: elnashar53@hotmail.com
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2. Prevalence of FSA ???
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3. •Sexuality
Important part of health
quality of life
general wellbeing.
Human right.
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4. Domestic violence
violation of basic human rights.
affects millions of women worldwide
cuts across cultural & religious
barriers [Bakr & Ismaail, 2005].
± physical, emotional or sexual.
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5. Female sexual abuse (FSA)
= forced sexual intercourse
:increased risk for
genital irritation
pelvic pain
UTI
physical abuse
mistimed/unwanted pregnancies
abortions [Campbell et al, 1999].
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6. •Epidemiologic data on SA in married
women
relatively scanty & vary widely.
important:
plan & develop appropriate service
apropriate resource allocation.
In Egypt: No
This stimulated us to the current study.
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7. Our objective
to study the prevalence and
associated factors of SA
among married women
in Lower Egypt.
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8. •Survey:
A cross sectional clinic/hospital
based
•The study sample:
selected from women in Dakahlia
governorate as representative of Lower
Egypt {fairly similar demographic and cultural
characteristics in most governorates of this area according to
Egyptian Demographic Health Survey, 2000}.
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9. Aboubakr Elnashar

10. •Total of:
1000 married women were selected.
•Age:
16-49 ys, mean age was 29.9±7.7 ys.
•Response rate:
93.6%
936 women complied with the study while 64
refused to participate
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11. •Data were collected:
personal interview in a questionnaire
format.
•The questionnaire
used to measure sexual function & SA in
the past year.
•SA:
forced physically or psychologically to
practice SI
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12. Wife NO (%)
Age < 20 years 86 (9.2)
20-29 years 458 (48.9)
30-39 years 289 (30.9)
40-49 years 103 (11.0)
Residency: Rural 556 (59.4)
Urban 380 (40.6)
Type of family: Extended 166 (17.7)
Nuclear 770 (82.3)
Education: illiterate 268 (28.6)
Primary 135 (14.4)
Secondary 449 (48)
University 84 (9.0)
Work status: Professional 175 (18.7)
Farmer 48 (5.1)
Laborer 54 (5.8)
House wife 659 (70.4)
Circumcision 845 (90.3)Aboubakr Elnashar

13. Husbands
No %
936 100
Age: 20-29 219 (23.4)
30-39 399 (42.6)
40-49 197 (21.1)
> 50 121 (12.9)
Residency: Urban 383 (40.9)
Rural 488 (52.1)
Abroad 65 (6.9)
Education: Illiterate 271 (29)
Primary 151 (16.1)
Secondary 371 (39.6)
University 143 (15.3)
Work status: Professional 198 (21.2)
Private business 521 (55.6)
Laborer 140 (15)
Farmer 77 (8.2)
Smoking 484 (51.7)Aboubakr Elnashar

14. •Frequency No %
Once/D 118 12.6
>1/D 25 2.7
Once/W 114 12.2
2-4/W 547 58.5
<1-2/month 132 14
•Satisfaction of current frequency
Satisfied 597 63.8
Not satisfied 339 36.2
Satisfying frequency
1/W 116 34.2
2/W 87 25.7
3/W 58 17.1
Others* 78 23.0Aboubakr Elnashar

15. Groups No %
No apparent sex problems 291 31.1
Women with sex problems 537 57.4
Women with sex problems and
sexually abused
108 11.5
Total 936 100
Prevalence of sex problems and SA among
studied women according to women's
perceptions
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16. Wife Total Women
without SA
Women with
SA
p
No %
936 100
No %
828 100
No %
108 100
Age: < 20 y 86 (9.2) 75 (9.1) 11 (10.2) 0.69
0.45
0.72
0.23
20-29 y 458 (48.9) 408 (49.3) 50 (46.3)
30-39 y 289 (30.9) 257 (31.0) 32 (29.6)
40-49 y 103 (11.0) 88 (10.6) 15 (13.9)
Education
0.002
0.014
0.009
0.015
Illiterate 268 (28.6) 228 (27.5) 40 (37.0)
Primary school 135 (14.4) 112 (13.2) 23 (21.2)
Secondary school 449 (48) 408 (49.3) 41 (38.0)
University 84 (9.0) 80 (9.7) 4 (3.8)
Reasons of attendance
0.026
0.80
0.99
0.0001
0.99
Accompany a patient 239 (25.5) 217 (26.2) 22 (20.3)
Sex problems 40 (4.3) 35 (4.2) 5 (4.6)
Obstetric reasons 180 (19.2) 164 (19.8) 16 (14.8)
Gynecological reasons 333 (35.8) 283 (34.2) 52 (48.1)
Family planning 142 (15.2) 129 (15.6) 13 (12.0)
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17. Wife Total Without
SA
With SA
Menstrual pattern No (%) No (%) No (%) 0.16
Normal 627 (67.0) 563 (68.0) 64 (59.3)
Abnormal 309 (33.0) 265 (32.0) 44 (40.7)
Parity
0.40
0.001
0.002
0.001
Nullipara 126 (13.5) 110 (13.3) 16 (14.8)
1-2 deliveries 434 (46.4) 408 (49.3) 26 (24.1)
3-5 deliveries 301 (32.2) 290 (35.0) 11 (10.2)
> 5 deliveries 75 (8.1) 20 (2.4) 55 (50.9)
Circumcision 845 (90.3) 741 (89.5) 104 (96.3) 0.024
Surgical
procedures
-
0.0001
0.76
0.089
Non 631 (67.4) 572 (69.1) 59 (54.6)
Gynecological 137 (14.6) 110 (13.3) 27 (25.0)
Non gynecological 141 (15.1) 125 (15.1) 16 (14.8)
Spine and traumatic 27 (2.9) 21 (2.5) 6 (5.6)
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18. Husband
Total Women
without SA
Women
with SA p
No %
936 100
No %
828 88.5
No %
108 11.5
Age: 20-29 219 (23.4) 195 (23.6) 24 (22.2)
30-39 399 (42.6) 369 (44.0) 35 (32.4)
40-49 197 (21.1) 178 (21.4) 19 (17.6)
> 50 121 (12.9) 91 (11.0) 30 (27.8)
Education
0.001
0.014
0.003
0.008
Illiterate 271 (29.0) 221 (26.7) 50 (46.3)
Primary school 151 (16.1) 128 (15.5) 23 (21.3)
Secondary school 371 (39.6) 341 (41.1) 30 (27.8)
University 143 (15.3) 138 (16.7) 5 (4.6)
Smoking 484 (51.7) 413 (49.9) 71 (65.7) 0.001
Medical disorders* 84 (9.0) 77 (9.3) 7 (6.5) 0.967
Drugs usage 125 (13.4) 96 (11.6) 29 (26.9) 0.001
Surgical procedures
-
0.58
0.92
Absent 831 (88.8) 732 (88.4) 99 (91.2)
Varicocele & hernia repair 55 (5.9) 51 (6.2) 4 (3.7)
Spine & trauma 50 (5.3) 45 (5.4) 5 (4.6)
Aboubakr Elnashar

19. •23% were satisfied by their current
sexual relationship despite presence of
one or more sex problems.
DD: Actual frequency & preferred frequency.
Sexual behavior & desire
Women may be engaged in sexual activity
because of
religious causes
marital commitment
financial reason
to avoid sense of guilt
to avoid husband’s extra marital sexual
relationship. Aboubakr Elnashar

20. •Commonest aggravating factors for
the problems
1. Husband choice of unsuitable time for SI
2. Unfavorable socioeconomic circumstances
e.g. lack of adequate privacy at home
3. Marital conflicts, disharmony
4. Lack of emotional closeness
5. Pregnancy related.
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21. Strengths of the study:
1.Clinic/hospital-based to determine the prevalence
of SA among Egyptian married women.
2.The characteristics of abused women & abusive
husband have been identified :
improve screening
service provision for victims.
assist in the design of both individual and societal
level intervention efforts
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22. Limitations of the study:
1. Cross sectional: time sequencing between the onset of
SA and the associated characteristics of abusive men
cannot be determined. Causal connections are thus
speculative.
2. Face-to-face interviews: underreporting biases {lack of
adequate privacy during interviews}
3. Problems of the male partners was provided by their
wives: under- or over reporting bias.
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23. Conclusion
1.The commonest frequency of SI is 2-
4/w
2.One third are not satisfied with their
current frequency of SI
3.Prevalence of SA is 11.5%
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24. Abused wife
1. Illiteracy
2. Circumcision
3. High parity
4. Attendance for
gynaecological reasons
5. History of gynaecological
operations
4.The characteristics of
Abusive husband
1. Illiteracy
2. Smoking
3. Drug usage
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25. Thank you
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