Association of sexual perceptions, behavior, and intimate partner violence with sexually transmitted infection (STI) among Filipino women.

BACKGROUND: Sexually transmitted infections (STI) remain prevalent in the Philippines despite being both preventable and treatable. Women are particularly vulnerable when less prioritized than high-risk groups and unable to speak up in abusive intimate relationships. Although studies on behavior and STI have been conducted, they vary by culture and region, highlighting the importance of representative studies. This study aimed to identify sexual perceptions and practices, and intimate partner dynamics associated with STI in Filipino women. METHODS: A secondary analysis of the 2022 Philippine Demographic Health Survey was conducted: 19,228 sexually active women in relationships, weighted by region. The outcome: a composite of self-reported STI and related symptoms in the last 12 months. Variables tested: sociodemographic factors, safe sex practices, and perceptions, such as the ability to refuse sex and ask a partner to wear a condom, justifying partner violence, and intimate partner coercion and abuse. Descriptive statistics and modified Poisson regression analysis were conducted to identify significant factors and estimate their risk ratios; the p-value (p) was set at < 0.05. RESULTS: One thousand three hundred thirty-nine females reported having an STI (6.96% [CI: 6.19%, 7.73%]). Reproductive coercion nearly doubled the risk of STI. Women who perceived domestic abuse to be justified increased their risk of STI by 12%. Emotional violence and fear of one's partner consistently increased the risk for STI (ARR: 1.29 and 1.33, respectively). Physical and sexual abuse were also associated with STI. CONCLUSION: Routine STI testing of IPV victims is recommended as well as expanding STI risk assessment to sexual perceptions and history of IPV. STI surveillance is incomplete when focused on high-risk groups only. Human rights-based approach on sexual practices, and gender equality should be values instilled in mandatory pre-marriage family planning seminars and sex education, grounded on mutual respect, and consent. Without correcting harmful perceptions on domestic abuse and IPV prevention, STI control may not be completely achieved.