Determinants of sexual self-efficacy among Iranian married women: a path analysis using the WHO framework

Sexual self-efficacy is a critical factor in promoting protected and satisfying sexual health. This study aimed to examine the relationship between structural/intermediary health determinants (socioeconomic status, social support, stress, intimate partner violence) and sexual self-efficacy among Iranian women of reproductive age, using path analysis. In this cross-sectional study, 424 reproductive-aged women completed validated questionnaires that assessed socio-demographics, socioeconomic status, perceived social support, perceived stress, intimate partner violence, and sexual self-efficacy. Data were analyzed using SPSS 27 for descriptive statistics and AMOS 24 for path analysis. According to the path analysis, perceived social support and socioeconomic status were positively associated with sexual self-efficacy, while perceived stress and intimate partner violence were negatively associated with sexual self-efficacy. Therefore, intimate partner violence, perceived stress and social support play a mediating role between age, socioeconomic status and sexual self-efficacy. The model demonstrated a strong fit, with RMSEA = 0.05, GFI = 0.99, CFI = 0.99, NFI = 0.96, and χ²/df = 1.56, confirming its strength. Based on the results of this study, it is crucial to focus more on the sexual self-efficacy of women, particularly those with low socioeconomic status. Furthermore, it is advisable to implement specialized programs to alleviate stress and reduce domestic violence, as well as to increase social support for women facing sexual issues.