Women’s ability to negotiate for safer sex has been found to be dependent on their household decision making power. However, there is paucity of studies investigating the association between women’s household decision making power and safer sex negotiation in Ghana. Thus, we examined the association between women’s household decision making autonomy and safer sex negotiation among Ghanaian women in sexual unions using the 2014 Ghana’s Demographic and Health Survey. Descriptive statistics, Chi-square test, and multivariable logistic regression models were performed. Statistical significance was set at p < .05 at 95% confidence interval. The results showed high prevalence of safer sex negotiation among women with high household decision-making capacity (91.6%). Compared to women with low household decision making autonomy, those with high autonomy in household decision making were more likely to negotiate for safer sex (aOR = 2.06; CI = 1.32–3.21). Women aged 25–34 were more likely to negotiate for safer sex compared to those aged 15–24 (aOR = 1.50; CI = 1.07–2.11). Higher odds of safer sex negotiation were found among women with comprehensive HIV and AIDS knowledge (aOR = 1.49; CI = 1.09–2.05), women who had tested for HIV (aOR = 1.57; CI = 1.27–1.95) and those exposed to newspaper (aOR = 1.80; CI = 1.17–2.78) compared to those who had no comprehensive knowledge on HIV and AIDS, those who had never tested for HIV and those who were not exposed to newspaper, respectively. However, women who belonged to other ethnic groups and the Islamic religion had lower odds of safer sex negotiation compared to Akans (aOR = 0.68; CI = 0.48–0.96) and Christian women (aOR = 0.63; CI = 0.46–0.85). Women empowerment programmes need to be intensified to enable Ghanaian women with low household decision making autonomy to negotiate for safer sex with their partners. Ghana could achieve the Sustainable Development Goals (SDGs), particularly, SDG 3.7 (universal access to sexual and reproductive health services), and SDG 5 (achieve gender equality and empower all women and girls) when household decision-making capacity among women is further strengthened.

研究发现，妇女争取安全性行为的能力取决于她们的家庭决策权。然而，很少有研究调查加纳妇女的家庭决策权与安全性行为谈判之间的关系。因此，我们利用 2014 年加纳人口和健康调查，研究了加纳妇女在性结合中的家庭决策自主权与安全性行为谈判之间的关系。进行了描述性统计、卡方检验和多变量逻辑回归模型。统计显着性设定为p 95% 置信区间时 < .05。结果显示，在家庭决策能力较高的女性中，安全性行为谈判的比例很高（91.6%）。与家庭决策自主权较低的女性相比，家庭决策自主权较高的女性更有可能通过谈判获得安全性行为（aOR = 2.06；CI = 1.32–3.21）。与 15-24 岁的女性相比，25-34 岁的女性更有可能协商安全性行为（aOR = 1.50；CI = 1.07-2.11）。具有全面艾滋病毒和艾滋病知识的女性（aOR = 1.49；CI = 1.09–2.05）、接受过艾滋病毒检测的女性（aOR = 1.57；CI = 1.27–1.95）以及接触报纸的女性，进行安全性行为谈判的几率更高（aOR = 1.80；CI = 1.17–2.78）与那些对艾滋病毒和艾滋病没有全面了解的人相比，分别为从未检测过艾滋病毒和未接触过报纸的人。然而，与阿肯族女性（aOR = 0.68；CI = 0.48–0.96）和基督教女性（aOR = 0.63；CI = 0.46–0.85）相比，其他族裔和伊斯兰宗教的女性进行安全性行为谈判的几率较低。需要加强妇女赋权计划，使家庭决策自主权较低的加纳妇女能够与伴侣协商安全性行为。当妇女的家庭决策能力进一步提高时，加纳可以实现可持续发展目标 (SDG)，特别是 SDG 3.7（普遍获得性健康和生殖健康服务）和 SDG 5（实现性别平等并赋予所有妇女和女童权力）加强了。与阿肯族 (aOR = 0.68; CI = 0.48–0.96) 和基督教妇女 (aOR = 0.63; CI = 0.46–0.85) 相比，其他族裔群体和伊斯兰宗教的妇女进行安全性行为谈判的几率较低。需要加强妇女赋权计划，使家庭决策自主权较低的加纳妇女能够与伴侣协商安全性行为。当妇女的家庭决策能力进一步提高时，加纳可以实现可持续发展目标 (SDG)，特别是 SDG 3.7（普遍获得性健康和生殖健康服务）和 SDG 5（实现性别平等并赋予所有妇女和女童权力）加强了。与阿肯族 (aOR = 0.68; CI = 0.48–0.96) 和基督教妇女 (aOR = 0.63; CI = 0.46–0.85) 相比，其他族裔群体和伊斯兰宗教的妇女进行安全性行为谈判的几率较低。需要加强妇女赋权计划，使家庭决策自主权较低的加纳妇女能够与伴侣协商安全性行为。当妇女的家庭决策能力进一步提高时，加纳可以实现可持续发展目标 (SDG)，特别是 SDG 3.7（普遍获得性健康和生殖健康服务）和 SDG 5（实现性别平等并赋予所有妇女和女童权力）加强了。需要加强妇女赋权计划，使家庭决策自主权较低的加纳妇女能够与伴侣协商安全性行为。当妇女的家庭决策能力进一步提高时，加纳可以实现可持续发展目标 (SDG)，特别是 SDG 3.7（普遍获得性健康和生殖健康服务）和 SDG 5（实现性别平等并赋予所有妇女和女童权力）加强了。需要加强妇女赋权计划，使家庭决策自主权较低的加纳妇女能够与伴侣协商安全性行为。当妇女的家庭决策能力进一步提高时，加纳可以实现可持续发展目标 (SDG)，特别是 SDG 3.7（普遍获得性健康和生殖健康服务）和 SDG 5（实现性别平等并赋予所有妇女和女童权力）加强了。