Hamadan University of Medical Sciences Journal of Research in Health Sciences 2228-7795 25 4 2025 09 15 The Role of Marital Status in Sexual Violence Against Women Among Ghanaian Couples: Evidence From the 2022 Ghana Demographic and Health Survey e00663 e00663 10.34172/jrhs.9086 EN Leny Latifah https://orcid.org/0000-0002-8528-4975 Agung Dwi Laksono Marizka Khairunnisa Diah Yunitawati Sri Handayani Journal Article 10.34172/jrhs.9086 2025 03 04 2025 06 17 Background: Cohabitation is vulnerable from a legal perspective. However, legal marriage does not exempt women from experiencing sexual abuse, while marriage is often misused as a justification. This study aimed to examine the impact of marital status on the incidence of sexual violence against women within couples. Study Design: A cross-sectional study. Methods: The secondary analysis examined the 2022 Ghana Demographic and Health Survey, which included data from 8811 respondents. The study used sexual violence and marital status as outcome and exposure variables, respectively. Meanwhile, five control variables, including age, marital status, education, employment, wealth, and recent sexual activity, were analyzed in this study. Finally, the results were analyzed by binary logistic regression (P<0.05) using SPSS 21. Results: Sexual violence was reported by 5.3% of women living with a partner and 2.6% of married women (P<0.001). Based on marital status, women in a cohabitation relationship were 1.57 times more likely to experience sexual violence than married ones (adjusted odds ratio [AOR]: 1.857, 95% confidence interval: 1.857–1.858). Several factors were also significantly associated with increased risk of sexual violence, including urban residence (AOR: 1.139), younger age (e.g., 20–24 years: AOR: 1.766), lower education/no education (AOR: 2.045), unemployment (AOR: 1.415), lack of pregnancy (AOR: 1.221), recent sexual activity (AOR: 1.266), and women in middle-income and richer groups (AOR: 1.175 and AOR: 1.414). Conclusion: The evaluation revealed that marital status was related to sexual violence against women among Ghanaian couples. Women living in cohabitation with a partner were more likely to experience sexual violence than married women.