REVIEW PAPER
The relationship of women’s empowerment with high-risk sexual behaviors and HIV-preventive measures: a systematic review
1
Department of Midwifery, School of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran
2
Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
3
Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
4
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Submission date: 2023-09-23
Final revision date: 2023-11-02
Acceptance date: 2023-11-23
Publication date: 2026-06-10
Corresponding author
Robab Latifnejad Rudsari
Corresponding Author: Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Corresponding Author: Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
KEYWORDS
TOPICS
ABSTRACT
Biological and socio-structural factors result in susceptibility of women to human immunodeficiency virus (HIV) infection compared with men. This systematic review aimed to assess the relationship between women's empowerment with high-risk sexual behaviors and HIV preventive measures.
For this systematic review, which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist, a literature search was conducted in databases, including Scopus, PubMed, and Web of Science, until February 2022. Studies were included if they reported on relationship between women's empowerment with high-risk sexual behaviors and HIV-preventive measures. Two independent authors were involved in studies’ selection, data extraction, and quality assessment. A total of eleven observational studies with 126,701 participants were included in this review. Higher education and wealth, living in a society with a high proportion of women with higher education, and a moderate level of poverty were significantly accompanied by multiple sexual partners and engaging in high-risk sexual encounters. By contrast, higher education and wealth level, being employed, having high sexual autonomy, and positive attitudes toward safer sex negotiation, increased the likelihood of HIV testing. The relationship between different empowerment indicators and the use of female and male condoms or the acceptance of their use were contradictory in different studies at individual and national levels.
Although this study shows the relationship between some indicators of women's empowerment with high-risk sexual behaviors and/or HIV-preventive measures, due to the existing contradictions, further studies are recommended to assess other factors contributing to the engagement of women in high-
risk behaviors in different cultural contexts.
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