First, our findings showed that low self–esteem and poor communication occurred between AGYW mothers and their partners, resulting in a lack of safe sex negotiations and thus increasing the extent of IPV experienced among this group. The life course of AGYW slums is characterized by poverty, the non-availability of parents, and violence that has been normalized, which reinforces their sexual behavior. Due to the low socioeconomic situation at which participants permeated the study sites, AGYW was always at the mercy of their partners or advanced. They were usually regarded as objects and were often approached as individuals who needed financial help in exchange for sex. This, therefore, affects the self-esteem of AGYW, which usually results in fear of negotiating safe sex, as individuals yield to the demands of their partners. Adolescent girls with low self-esteem were more likely to be sexually active and exposed to high-risk sex; this finding corroborated the findings of Enejoh et al. on the impact of self-esteem on risky sexual behavior [31]. Our findings complement the results of previous studies in Nigeria. Michele et al reported fear as one of the predictors of not negotiating safe sex among more than half of AGYW patients, while a study by Awoleye and colleagues [32] showed that sociocultural systems influenced the negotiation of safe sex, as women were subjected to obeying their husbands or partners. Similarly, societal expectations require young girls to marry before they become pregnant, and pregnancy out of wedlock is often regarded as a form of deviant behavior. This explains why most AGYW individuals, especially men who did not show commitment to their relationships, resist unprotected sex. AGYW exhibited the worst relationships, coupled with age and socioeconomic status [32]. Findings from other settings showed that the experiences of AGYW in negotiating safe sex in Nigeria were mostly similar to what has been observed in the majority of individuals in low-middle-income countries and others [11, 33]
Men are usually custodians of power in heterosexual relationships, which is common in sub-Saharan African countries, including Nigeria. According to our study, AGYW recognized that this power imbalance existed in their relationships, as they were most affected by the sexual autonomy decisions of their partners. The results of our study highlighted that male partners without any negotiation automatically assumed autonomous decisions in their relationships, and it was usually difficult for AGYW to assert their sexual rights. AGYW were usually in a dilemma of asserting their sexual right, which could be due to their economic status, lack of sexual empowerment, or the patriarchal system that gives power to men. These findings support previous studies showing that the sexual assertiveness of women increases with greater social equality and that sociocultural aspects that exist in the Nigerian system continue to empower males.
Factors associated with difficulties in negotiating safe sex and circumstances surrounding rejecting sexual advances in our study are related primarily to AGYW. In our study, the participants mentioned that the acceptable conditions for rejecting sex were usually when they were menstruating, were in a bad mood, or had a newborn child. However, an untenable circumstance that was not accepted by AGYW by a male partner was a frequent demand for sex, which usually resulted in disagreement and, if not well managed, caused violence (sexual, physical, and emotional). These results are from previous reports on tendencies to negotiate safe sex, which increases the likelihood of IPV [19]. Others mentioned having extramarital affairs or being in multiple relationships. With these circumstances, negotiating safe sex often resulted in IPV in a relationship, as some of the male participants believed that if their wife or girlfriend rejected the sexual advances, it was because she was seeing another man or usurping her authority.
Regarding the challenges faced by AGYW in negotiating safe sex in intimate relationships, our findings are congruent with previous studies on the greater extent of violence due to negotiations of safe sex. Previous studies have shown that all forms of IPV are more common when a woman or an adolescent girl in a heterosexual relationship tries to negotiate safe sex, which sometimes results in forced sex and reproductive coercion [34, 35]. In addition, our study showed that the low socioeconomic status of one’s partner determined the level of violence experienced by the participants, and vice versa. Some of the AGYW emphasized that the financial irresponsibility of their partners would make the demands for sex difficult to accept, which usually results in violence. This was also expressed by previous studies, although age and economic asymmetry were directly related to having a sexual relationship with an older person [36, 37].
Adolescent girls and young women’s ability to make autonomous choices regarding their SRH remains a public health concern. From our study, it was evident that acceptance of the dictate of the male partner was related to AGYW’s lack of understanding of their sexual rights. This lack of understanding has resulted in difficulties in negotiating sex among AGYW to avoid any form of violence in their sexual relationship. In the context of the SDG of which Nigeria is part, indicator 5.6.1 [20], which is a woman’s ability to make autonomous choices, is nowhere near the awareness that is required by young women, and this continues to cause increases in violent experiences. These studies support the findings of previous studies showing that the education of both women and their partners, household wealth status, area of residency, exposure to media, age, and knowledge of SRH rights at the individual level were factors influencing the decision-making of women. Our study showed that AGYW in slum areas lacked knowledge of sexual rights. The study participants were young and already with sexual partners, while many were already married but were confronted with the problem of negotiating safe sex to reduce experiences of IPV. A power imbalance is still one of the prominent factors influencing the negotiation of safe sex among people with AGYW and people with low socioeconomic status. This finding is consistent with a study that showed that sexual assertiveness increases when social equality increases [35].
Our study showed that AGYW has many limitations in terms of negotiating safe sex, which can result in violence. First, the issue of power, which is mostly asserted by their partners in their relationships, makes them ignorant of the sexual rights they are entitled to demonstrate as individuals. This could be due to low levels of education in sexual empowerment and low socioeconomic status, which automatically make them vulnerable. However, in navigating negotiation and IPV, it is evident that this has not been easy due to the sociocultural factors, low social equality, and masculinity that exist among intimate partners. Previous studies have also shown concerns about masculinity, sociocultural factors, and women’s economic status, which are mentioned as predictors of negotiating safe sex and autonomous sexual rights [5, 17, 18, 32].
Limitations and Direction for Future Research
This study provides a unique, comprehensive exploration of the negotiation of safe sex among AGYW who were in an intimate heterosexual relationship with IPV, the power imbalance that occurred within these relationships, and the male perspectives on power imbalance in heterosexual relationships and how it leads to violence. Replication of our study in other settings with different samples will contribute more to the body of knowledge. There are several limitations of the current study that should be mentioned. First, the study participants were not only those who had experienced IPV in their heterosexual relationships but also others who had a sexual relationship in recent years. This finding suggests that both AGYW who have experienced IPV and those who have not participated in this study. This may have introduced bias in the data collection. We cannot generalize our findings due to the small sample size resulting from the sensitive nature of our approach. Second, the study was geographically limited to two sites, two slums in two of the largest populated cities; therefore, the experiences examined in this study may not be present at the other sites. It is worth noting that, in the past, some of the male participants in our study were unable to disclose whether they had engaged in abusive behavior toward their partners. Therefore, the context of violence in their relationship was not entirely clear. However, the experiences some of them shared were based on what they had witnessed happening to others, which could have potentially biased their perspective. Fourth, it is possible that participants framed their responses in a way that did not offend the interviewer or other participants, as is the case with any other FGD [38, 39], and that they reflected a particular self-perception and limited the information obtained during the interview.
Implications
The implications of our findings for AGYW's experiences of IPV in heterosexual relationships are significant. First, the power imbalance in AGYW relationships continues to drive the reinvention of GBV, which is not limited to IPV but also includes verbal abuse, domestic violence, and interpersonal violence, particularly in low-income communities in urban centers. Second, AGYW is disadvantaged by socioeconomic status, age, and gender. Third, gendered expectations have placed AGYW in a predictable situation where they must rely on their partner’s decisions, which complicates the decision and leads them to engage in violence in heterosexual relationships. These effects render AGYW who do not conform to gender expectations victims of IPV. Finally, some of these responses from two groups of our study participants reinforce inequality in interpersonal relationships, as male participants believe that men should be in charge of and control the affairs of AGYW. This will continue to lead to conflicts that escalate into violence, as some males view AGYW as objects to be controlled sexually and otherwise.
It is essential for various stakeholders, including educators, the health system, youth leaders, community leaders, and civil society organizations, to address the gender inequality that contributes to difficulties in negotiating safer sex. Such inequality leads to violence against girls and women, including but not limited to interpersonal violence, sexual violence, abuse, and IPV.