The Intersection of Men's Sexual Violence Perpetration and Sexual Risk Behavior: A Literature Review

Alcohol Expectancies for Sexual Enhancement, Event-Level Alcohol Use, and Likelihood of Sexual Aggression Perpetration: A Timeline Followback Approach

Sexual aggression (SA) is a significant public health problem, with the majority of SA involving alcohol. The present study examined associations between alcohol expectancies for sexual enhancement, event-level alcohol use, and the likelihood of SA perpetration. Young, adult non-problem drinking men participated in a laboratory session and completed a background survey that included measures of alcohol expectancies. Subsequently, men completed 6-week and 3-month follow-up surveys in which they reported their sexual experiences each day during the intervening 6-week period using Timeline Followback procedures. The analytic sample consisted of the 421 men (Mage = 24.66, SD = 2.69) who reported having sex at least once during the follow-up period. Multilevel models showed a significant alcohol expectancies X alcohol use interaction at the between-person level: Controlling for time and alcohol expectancies for aggression, stronger alcohol expectancies for sexual enhancement were associated with greater SA perpetration likelihood among men who consumed high amounts of alcohol before sexual encounters but not among men who consumed low amounts. Alcohol prevention programs should consider addressing men's alcohol expectancies for sexual enhancement to reduce risk for SA perpetration.

LGBTQ+ Adult Sexual Violence Critical Scoping Review: Victimization Risk Factors

Sexual violence experienced by LGBTQ+ adults is a rapidly expanding field of academic study. Therefore, there is a need for a synthesis and critical analysis of the research. The aim of this review was to conduct a critical review of the academic literature on adult LGBTQ+ sexual violence and to provide recommendations for future research. A total of 10,845 papers were identified through a comprehensive scoping review approach and 108 met the criteria for inclusion. The findings are reported across two papers. This second paper reports on the risk factors for victimization: alcohol and other drugs (AOD); homophobia, biphobia, transphobia, and minority stress; "risky" sexual behavior and HIV transmission; and child sexual abuse (CSA). AOD use was seen as a risk factor for sexual violence, yet the causal relationship was not always clear. Minority stress was conceived of as an individual issue with undertones of victim-blaming. "Risky" sexual behavior research, at times, framed LGBTQ+ sex as "risky" and failed to account for the specific needs of LGBTQ+ communities. Research on adult sexual violence risks had a focus on CSA that often neglected broader structural issues. In general, across the studies, there was a focus on individual-level research that analyzed survivor behavior, resulting in victim blaming. This paper advocates for expanding LGBTQ+ sexual violence research beyond just individual risk factors, shifting research away from constructing LGBTQ+ people as "risky," and expanding research to include a more intersectional analysis that goes beyond heteronormative and cisnormative inquiry.

Motives for Sex and Sexual Perpetration in College Men: An Exploratory Study

OBJECTIVE

Prior research has rarely focused on sexual motives (e.g., motives for having sex) when studying sexual violence perpetration prevention. The current study examined the role of sexual motives alongside other risk factors like alcohol expectancies in predicting sexual violence.

METHOD

We analyzed data from 205 male college students; 36% reported sexual perpetration of some type. Participants completed a series of questionnaires in a randomized order, including: measures of prior sexual perpetration, sexual motives, rape myth acceptance, alcohol expectancies, and a measure of social desirability. Data were analyzed using a series of T-tests and logistic regressions.

RESULTS

With one exception (coping motives), all sexual motives (intimacy, enhancement, self-affirmation, peer approval, and partner approval) were endorsed at higher levels by individuals who perpetrated sexual violence than those who did not (p < .05, Cohen's d = .25-.56). The partner approval motive significantly predicted sexual violence perpetration on its own. The enhancement motive, both independently and in interaction with alcohol expectancies for aggression, predicted sexual violence perpetration. Two other motives, intimacy and self-affirmation, were only significant in interaction with alcohol expectancies for aggression.

CONCLUSION

All sexual motives were endorsed more frequently by those who perpetrated sexual violence than those who did not. Sexual motives had a complex interaction with alcohol expectancies in predicting sexual violence perpetration. The results suggest that intervention programs should emphasize healthy, consensual sexual relationships that do not involve alcohol.

College men's use of protective behavioral strategies for sexual aggression, risky sexual behavior, and heavy episodic drinking

OBJECTIVE

Sexually aggressive behavior (SAB), risky sexual behavior (RSB), and heavy episodic drinking (HED) are serious behavioral health problems among college men. The present study substantially revises and validates protective behavioral strategies (PBS) measures in the SAB and RSB domains; evaluates the relations among PBS usage in the SAB, RSB, and HED domains; and determines whether college men with SAB, RSB, or HED histories report lower PBS usage.

METHOD

College students who identified as men (n = 1,121) completed measures of PBS, SAB, RSB, HED, rape-supportive attitudes, sociosexuality, and bar/party attendance.

RESULTS

Factor analyses resulted in three PBS scales (SAB, RSB-General, and RSB-Protection) that showed good fit and cross-validated well. Average scores for all four PBS measures converged moderately to strongly. Men reporting histories of SAB, RSB, or HED reported much lower domain-specific PBS use, and domain-specific PBS predicted concurrent SAB, RSB, or HED in the presence of other established predictors.

CONCLUSIONS

Four well-developed and validated PBS measures now provide an expanded set of potential harm-reduction strategies for college men who drink and engage in sexual activity. Given the strong concurrent associations between PBS use and problems, as well as the interrelatedness of PBS use across domains, future research should examine the impact of simultaneous personalized normative feedback on PBS use across alcohol and sexual domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Alcohol intoxication, condom use rationale, and men's coercive condom use resistance: The role of past unintended partner pregnancy

OBJECTIVE

Cisgender men's condom use resistance (CUR), deliberate attempts to avoid using a condom with a partner who wishes to use one, may include coercive strategies, such as deception and force, and places their partners at risk for unintended pregnancy and sexually transitted infections (STIs). This investigation used an alcohol administration design to examine one distal (history of unintended partner pregnancy) and two proximal (acute alcohol intoxication, condom use rationale) contributors to men's intentions to engage in coercive CUR.

METHOD

Nonproblem drinking, cisgender men (N = 313) completed questionnaires, then were randomized to a beverage condition (control, placebo, low dose [.04%gm], and high dose [.08%gm]). Participants completed a sexual risk analog and reported their coercive CUR intentions after a hypothetical, female partner provided a condom use rationale (STI avoidance or pregnancy avoidance).

RESULTS

Men who received the pregnancy condom use rationale reported higher intentions to engage in coercive CUR when they received a high alcohol dose relative to sober men. For men who had a history of unintended partner pregnancy, receiving a pregnancy condom use rationale was associated with greater intentions to have forced, condomless sex if they received a high alcohol dose relative to sober men.

CONCLUSIONS

Intoxicated men may be more likely to engage in coercive CUR; this may indicate that when intoxicated, pregnancy risks are less salient relative to STI-related outcomes. As reproductive rights are being decimated, effective interventions targeting CUR, particularly when intoxicated, are needed in tandem with policies that affirm one's ability to prevent and terminate pregnancy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Theory-Based Intervention to Reduce Risk and Vulnerability Factors of Sexual Aggression Perpetration and Victimization in German University Students

The current study evaluated an intervention program, designed by the authors and based on the theory of sexual scripts and social learning theory, to reduce empirically established risk and vulnerability factors of sexual aggression. A sample of 1,181 university students in Germany (762 female) were randomly assigned to an intervention and a no-intervention control group. The intervention group completed six modules addressing established antecedents of sexual aggression perpetration and victimization: risky sexual scripts, risky sexual behavior, low sexual self-esteem, low sexual assertiveness, acceptance of sexual coercion, and perceived realism of pornography. After baseline (T1), intervention effects were measured one week after the last module (T2), nine months later (T3), and another 12 months later (T4). The intervention group showed significantly less risky sexual scripts and higher sexual self-esteem at T2, T3, and T4. The intervention indirectly reduced risky sexual behavior at T3 and T4 via less risky sexual scripts at T2 and increased sexual assertiveness at T3 and T4 via higher sexual self-esteem at T2. No intervention effects were found on the acceptance of sexual coercion and pornography realism. The implications of the findings for reducing the prevalence of sexual aggression perpetration and victimization are discussed.

Youth sexual offending in Hong Kong: examining the role of self-control, risky sexual behaviors, and paraphilic interests

Introduction

Little is known about the nature and prevalence of sexual offending among youth in Hong Kong.

Methods

Testing self-control theory and sexual health risk factors (i.e., risky sexual behaviors [general and two subtypes] and paraphilic interests [general and 14 subtypes]), the prevalence of self-reported sexual offending behaviors (i.e., threat of sexual assault, penetrative sexual assault, and nonpenetrative sexual offense) was examined in a community-based sample of 863 young people (aged 17 to 20) in Hong Kong.

Results

In this study, men reported significantly higher levels of threat of sexual assault and of general and 12 subtypes of paraphilic interests than women; and women reported a significantly higher level of a specific paraphilic interest subtype (i.e., transvestic fetishism) than men. Logistic regressions found that, in general, a low level of self-control and high levels of risky sexual behaviors and paraphilic interests were important factors in the participants' likelihood of issuing threats of sexual assault and engaging in penetrative and nonpenetrative sexual assault.

Discussion

Important practical implications for reducing the tendency of young people to engage in sexual offending behavior can be derived from this study.

Intimate Partner Violence and Willingness to Use Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Chengdu, China

Intimate partner violence (IPV) is common in men who have sex with men (MSM). MSM also face increased risk of human immunodeficiency virus infection. However, it is not known whether IPV experience of MSM in China would affect their attitudes toward pre-exposure prophylaxis (PrEP) use. A cross-sectional study was conducted to explore the associations between different types of IPV and willingness to use PrEP in a sample of 608 MSM from November 2018 to May 2019 in Chengdu, China. Univariate and multivariate logistic regression analyses were used to explore the associations between different types of IPV and willingness to use PrEP. The average age of the participants was 31.8 ± 12.3 years, 48.9% of them were aware of PrEP before this study, and only 7.2% were aware of long-acting injectable PrEP (LAI-PrEP). The overall willingness to use any type of PrEP in the next 6 months was 82.2%. Approximately one third of the participants (n = 198) had experienced at least one type of IPV. We found that experience of sexual perpetration was negatively associated with the willingness to use on-demand PrEP (adjusted odds ratio [ORa] = 0.33, 95% CI = 0.16-0.67) and the overall willingness to use any type of PrEP (ORa = 0.31, 95% CI = 0.15-0.64). The willingness to use LAI-PrEP also had negative associations with any type of monitoring IPV (ORa = 0.58, 95% CI = 0.38-0.91), controlling victimization (ORa = 0.41, 95% CI = 0.21-0.82), and emotional victimization (ORa = 0.58, 95% CI = 0.35-0.97). The findings of this study demonstrate that IPV experiences are negatively associated with willingness to use PrEP among MSM, suggesting that PrEP promotion programs should consider IPV screening and develop explicit intervention strategies for both perpetrators and victims.

Power-Related Emotions, Alcohol Intoxication, and Nonconsensual Sex Intentions: The Role of Fear of Intimacy

The problem of alcohol-involved sexual assault against women highlights the need to identify how the presence of alcohol interacts with risk factors associated with sexual assault perpetration. One risk factor for sexual assault perpetration is fear of intimacy, the inhibited capacity to exchange vulnerable thoughts and emotions with a valued individual. Men who have perpetrated sexual violence report higher fear of intimacy and alcohol use than those who have not. However, little research has investigated how fear of intimacy may contribute to sexual assault perpetration in the context of alcohol intoxication. This study examined alcohol intoxication, fear of intimacy, proximal power-related emotions, and nonconsensual sex intentions. Non-monogamous, male social drinkers (N = 94) completed measures and were randomly assigned to an alcohol condition (alcohol [BrAC = .10%] versus control). Participants then read a sexual assault analogue scenario depicting sexual assault against a hypothetical woman and reported power-related emotions and nonconsensual sex intentions. Self-reported fear of intimacy differed across types of past perpetration. Results found that for intoxicated men only, fear of intimacy was positively associated with power-related emotions, and power-related emotions were positively associated with nonconsensual sex intentions. These associations were not observed for men in the control condition who did not consume alcohol. Future research should examine intimacy-related interventions for sexual assault prevention programming.

Risky Sexual Behavior, Paraphilic Interest, and Sexual Offending: The Study of a Community Sample of Young Adults in Hong Kong

Limited information is available on the prevalence and nature of sexual offending in Hong Kong. This cross-sectional study seeks to explore the role of risky sexual behavior (RSB) and paraphilic interests in self-reported sexual offending behavior (i.e., nonpenetrative-only, penetrative-only, and nonpenetrative-plus-penetrative sexual assault) in a community sample of young adults in Hong Kong. Using a large sample (N = 1885) of university students, the lifetime prevalence of self-reported sexual offending was 18% (n = 342; 23% males (n = 166), 15% females (n = 176)). Based on the study subsample of 342 participants who self-reported sexual offending (aged 18-35), the findings indicated that males reported significantly higher levels of general, penetrative-only, nonpenetrative-plus-penetrative sexual assault; and paraphilic interest in voyeurism, frotteurism, biastophilia, scatophilia, and hebephilia than females; while females reported a significantly higher level of transvestic fetishism than males. No significant difference was found in RSB between males and females. Logistic regressions found that the participants who possessed a higher level of RSB, particularly penetrative behaviors, and paraphilic interest in voyeurism and zoophilia were less likely to engage in a nonpenetrative-only sexual offense. Conversely, the participants who possessed higher levels of RSB, especially penetrative behaviors, and paraphilic interest in exhibitionism and zoophilia, were more likely to engage in nonpenetrative-plus-penetrative sexual assault. The implications for practice in areas such as public education and offender rehabilitation are discussed.

Sexual Behavior Patterns of Black Young Adults in Georgia: Results from a Latent Class Analysis

The state of Georgia ranks first in the rate of new diagnosis of HIV/AIDS, yet studies focused on understanding the drivers of this epidemic in the most at-risk groups outside the Atlanta Metropolitan Statistical Area (MSA) remain sparse. Among the many consequences of this is the inability to effectively design tailored intervention programs that appropriately address the reduction of HIV/AIDS and other STDS in the state. Reducing disparities in HIV/AIDS remains an important goal in the National HIV/AIDS Strategy. Given the disproportionate burden of the HIV/AIDS epidemic among Blacks in the state of Georgia, there is a significant need to focus research attention on the sexual behavior of young people that predisposes them to increased risk of HIV/AIDS infection. The current study used latent class analysis (LCA) to examine the sexual behavior patterns of Black young adults living in Georgia. LCA results revealed a two-class fit with distinct sexual behavior patterns. Gender and educational attainment emerged as significant predictors of class membership. Our findings contribute to the vast literature showing that sexual behavior patterns of Black young adults are not homogenous, and underscore the significance of socio-demographic and contextual factors in shaping sexual risk behavior.

Association between lifetime sexual violence victimization and selected health conditions and risk behaviors among 13-24-year-olds in Lesotho: Results from the Violence Against Children and Youth Survey (VACS), 2018

BACKGROUND

Sexual violence is a serious public health concern worldwide. In Lesotho, one in seven women and one in twenty men aged 18 years and older experienced sexual violence during childhood. Sexual violence victimization may lead to long-term mental and physical health issues among victims, regardless of gender.

OBJECTIVE

To estimate the prevalence of lifetime sexual violence victimization (SV) among 13-24-year-olds in Lesotho and assess its association with selected health conditions and risk behaviors.

PARTICIPANTS AND SETTING

Data from 13 to 24-year-old participants (n = 8568) of the 2018 Lesotho Violence Against Children and Youth Survey were analyzed.

METHODS

SV was defined as reporting one or more types of sexual violence at any age. Logistic regression analyses measured associations between SV and selected health conditions (suicidal thoughts, self-harm behaviors, mental distress, STIs, and HIV), and risk behaviors (binge drinking in the past 30 days, drug use in the past 30 days, infrequent condom use in the past 12 months, multiple sex partners in the past 12 months, and transactional sex in the past 12 months).

RESULTS

After controlling for study covariates, SV was significantly associated with self-harm behaviors, suicidal thoughts, ever having an STI, binge drinking in the past 30 days, infrequent condom use in the past 12 months, and multiple sex partners in the past 12 months for both males and females; and mental distress and transactional sex in the past 12 months for females.

CONCLUSIONS

Preventing SV against children and youth in Lesotho may improve their health and wellbeing.

Posttraumatic cognitions and sexual assault: Understanding the role of cognition type in posttraumatic stress symptoms and problematic alcohol use

Identifying potential mechanisms underlying the association between posttraumatic stress symptoms (PTSS) and problematic alcohol use is an important target among college women who have experienced sexual assault. This study examined the role of posttraumatic cognitions in this association among college women (N = 530) who experienced either an alcohol-involved assault or non-alcohol-involved assault, using baseline assessment data from a larger study examining cognitive and emotional risk factors for problem drinking. Conditional path analysis was used to examine the indirect effects of posttraumatic cognitions on the association between PTSS and alcohol use consequences, with assault type as a moderator. The findings revealed a significant indirect path from PTSS to alcohol use consequences through posttraumatic cognitions, B = 0.21, SE = 0.04, p < .001, 95% CI [0.13, 0.29], β = .16, R2 = .32. Exploratory analyses revealed a significant conditional indirect effect through self-blame cognitions, R2 = .31, whereby the indirect effect of self-blame on the association between posttraumatic stress and alcohol consequences was present among participants who experienced alcohol-involved assault, B = 0.10, SE = 0.03, p < .001, 95% CI [0.06, 0.16], β = .07, but not among those who experienced a non-alcohol-involved assault, B = 0.03, SE = 0.03, p = 0.32, 95% CI [-0.02, 0.08], β = .02. Posttraumatic cognitions are a potential mechanism underlying the link between posttraumatic stress and alcohol consequences. Addressing posttraumatic cognitions, particularly those related to self-blame, may be an important target for interventions promoting healthy recovery following alcohol-involved assault.

Intimate partner violence perpetration and sexual risk behaviour: Identifying shared determinants among young men in Tanzania

In this study we examined factors that predict involvement in different patterns of sexual risk behavior and IPV perpetration among young men in Tanzania (n = 979), with a focus on identifying factors that distinguish men who engage in both behaviours from those who do not. Risk factors were drawn from three domains thought to be upstream drivers of both IPV and sexual risk: poverty, adverse childhood experiences, and inequitable gender norms. A three-step latent class analysis was used to assess whether and how factors from each domain distinguished subgroups of men whose behaviour patterns were characterised as comorbid (involvement in IPV and sexual risk behaviour), IPV-only, sexual risk only, and normative (low risk). Consistent with expectations, greater food insecurity, adverse childhood experiences, and inequitable gender norms related to violence and sexual behaviour predicted increased risk of membership in the comorbid group compared to other sub-groups. Findings support the promise of integrated prevention programmes targeting the common causes of IPV perpetration and sexual risk behaviour.

The Interplay of Sexual Arousal and Power-Related Emotions in Men's Alcohol-Involved Sexual Aggression Intentions

Research has identified power/dominance and sexual arousal as key motivators of men's sexual aggression; however, little research has examined the interplay of these two factors in alcohol-involved sexual aggression. Two alcohol administration experiments investigated the roles of power-related sex motives and power- and sexual arousal-related emotions on men's sexual aggression intentions. In Study 1, participants (N = 96) read a sexual aggression scenario after random assignment to consume either an alcoholic (target peak BrAC = .10%) or nonalcoholic beverage. Results indicated that power-related sex motives indirectly predicted stronger sexual aggression intentions through greater in-the-moment power-related emotions but not through sexual arousal-related emotions. Intoxicated men with more severe perpetration histories reported stronger sexual aggression intentions. In Study 2, participants (N = 203) completed similar measures after random assignment to receive either a brief emotion regulation-focused intervention (cognitive restructuring or mindfulness) or a control, followed by either alcohol (target peak BrAC = .08%) or nonalcoholic beverage consumption. Results demonstrated that greater power-related sex motives indirectly predicted stronger sexual aggression intentions through greater feelings of power and sexual arousal. Additionally, findings suggest that cognitive restructuring approaches may mitigate these relationships in sober men, while mindfulness approaches may exacerbate these relationships in intoxicated men.

A perspective review of cannabis use and sexual offenses

Substance abuse is an established risk factor for crime and violence, including sexual violence. Nevertheless, the link between cannabis use and sexual offenses remains poorly understood. Cannabis use has a broad effect on sexual functioning and can have both acute and lasting adverse effects on psychological functioning, which in turn can elevate the risk of sexual offending behavior. Yet there is a scarcity of studies that have examined the link between cannabis use and sexual offending. To help fill the gap, this perspective review investigates the link between substance use and crime with a particular emphasis on cannabis use and its effects on sexual and psychological functioning. It then explores how these mechanisms may contribute to sexual offenses and recidivism, with a final discussion on how cannabis use should be conceptualized as a risk factor for sexual violence.

Acute Alcohol Intoxication, State Anger, and Sexual Assault Perpetration: The Role of State Emotion Regulation

OBJECTIVE

Alcohol-involved sexual assault remains a pervasive problem, with extensive individual- and societal-level costs. Emotion regulation (ER), the process through which an individual modulates emotional states, remains an understudied predictor of sexual assault perpetration, with past research focusing on general ER tendencies (e.g., trait ER) as predictors of sexual assault perpetration. This study sought to examine the associations between state ER on sexual assault perpetration in the context of state anger and acute alcohol intoxication.

METHOD

Single, male social drinkers aged 21-30 with a history of sexual risk-taking (N = 92) participated in an alcohol administration paradigm and were randomly assigned to an alcohol condition [sober control vs. intoxicated (BrAC = .10%)]. Intoxicated and sober participants completed a sexual assault analogue that assessed state anger, state ER, and sexual assault perpetration intentions against a hypothetical female partner.

RESULTS

Path analysis demonstrated interactive effects of state ER and state anger on sexual assault perpetration intentions. Relative to men with low and moderate levels of anger, state ER was associated with lower intentions to perpetrate sexual assault for men with high levels of anger. Alcohol intoxication did not directly predict state ER, state anger, or sexual assault perpetration intentions.

CONCLUSIONS

The results suggested that state ER may be protective against sexual assault perpetration for men who experience anger in response to a partner's expression of non-consent. Because replication is necessary, the results carry tentative implications for state ER as an intervention target for sexual assault prevention programming.

The Role of Alcohol-Related Behavioral Risk in the Design of HIV Prevention Interventions in the Era of Antiretrovirals: Alcohol Challenge Studies and Research Agenda

HIV/AIDS remains a significant health threat and alcohol is a robust contributing factor. After 25 years of alcohol challenge studies investigating alcohol-related behavioral risk (ARBR), much has been learned delineating how drinking influences sexual transmission. We examine this research and consider its relevance for interventions in the era of antiretrovirals. We consider prototypic alcohol challenge methods, illustrative findings, and prevention/intervention implications, noting three perspectives: (a) scale up/extend existing interventions, including identifying under-targeted risk groups and intersecting with PrEP/PEP interventions; (b) modify existing interventions by cultivating psychoeducational content related to alcohol expectancies, alcohol myopia, sexual arousal, risk perception, sexual abdication, and condom use resistance; and (c) innovate new interventions through Science of Behavior Change approaches and repurposing ARBR paradigms. Finally, we suggest research directions concluding that until HIV incidence diminishes significantly, psychosocial interventions addressing the nexus of alcohol use, sexual transmission, and adherence to biomedical protocols will be an important priority.

Unique and Shared Correlates of Sexual Violence Perpetration and Sexual Risk Behavior Among South African Adolescent Boys

Associations between sexual risk behavior (SRB) and sexual violence perpetration (SVP) contribute to the intersecting HIV and sexual violence epidemics in South Africa. We examined SVP and SRB, and their potential correlates among South African boys (N = 80; ages 15-17). Fifty-one percent endorsed SVP in the past year; 61% engaged in past-3-month SRB. Whereas most unique correlates were socio-structural, family, or community factors, correlates shared across behaviors were behavior-specific social norm perceptions and cognitive factors. In final multivariate models, food insecurity and positive attitudes toward delaying sex were associated with SVP (odds ratios [ORs] = 3.05 and 0.37, respectively), and community violence exposure, gender equitable social norm perceptions, positive attitudes toward delaying sex, and intentions to obtain sexual consent were associated with SRBs (ORs = 1.56-1.57, 0.90-0.38, 0.58-0.60, respectively). Interventions to address HIV/sexual violence risk among adolescents in South Africa should be integrated and multilevel.

Sexual violence experiences and pornography media exposure with sexual risk behavior among PLWHA MSM in Bandung, Indonesia

Background

HIV number continues to increase, especially among the minority of Men who have Sex with Men (MSM) due to the high risks of their sexual behavior. This study aims to identify the correlation between sexual violence experiences and pornography media exposure to sexual risk behavior among people with HIV/AIDS (PLWHA) MSM.

Design and Method

The study employed a cross-sectional design with the consecutive sampling technique and involved 258 PLWHA MSM under the guidance of an NGO in Bandung, Jawa Barat, Indonesia. The data were collected by employing an online questionnaire.

Result

The results show that there is a significant correlation between sexual violence experiences and sexual risk behavior (p-value = 0.000, α = 0.05; OR = 6.496), pornography media exposure and sexual risk behavior (p-value = 0.000, α = 0.05; OR = 4.271). The multivariate analysis of multiple logistics regression results reveals that the sexual violence experience is the factor that mostly influences the sexual risk behavior among PLWHA MSM (p-value = 0.000, α = 0.05; OR = 3.784).

Conclusions

The sexual violence experiences and pornography media exposure have a significant positive relationship to sexual risk behavior. Therefore, nurses need to improve a comprehensive assessment, counseling, and personal education to reduce sexual risk behavior that can transmit HIV and other sexually transmitted diseases and create innovations through positive activities to reduce pornography consumption.

Selection and socialization accounts of the relation between fraternity membership and sexual aggression

OBJECTIVE

The current project aims to enhance our understanding of the well-established relation between fraternity membership and sexual aggression on college campuses. Most prior research has been cross-sectional and unable to distinguish selection and socialization accounts of the relation, and only one prior longitudinal study has simultaneously examined selection and socialization effects.

METHOD

Fraternity membership, sexual aggression, binge drinking, sociosexual attitudes and behaviors, and perceived peer sexual aggression were assessed for 772 male participants (n = 116 fraternity members) in a longitudinal survey study from the summer prior to college through Year 2 of college.

RESULTS

Longitudinal path analyses revealed three key findings. First, fraternity membership was prospectively correlated with sexual aggression in Years 1 and 2 of college (socialization effect), controlling for selection effects, when the two prospective paths were constrained to be equivalent. Second, more frequent binge drinking and sociosexual attitudes prior to college prospectively correlated with an increased likelihood of joining a fraternity (selection effect), and both selection variables indirectly correlated with future sexual aggression via fraternity membership. Third, fraternity membership was associated with increased binge drinking and perceived peer sexual aggression (socialization effects).

CONCLUSIONS

These findings identify critical targets for the prevention of sexually aggressive behavior that are linked to fraternity membership: Binge drinking and sociosexual attitudes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Protective behavioral strategies for sexual aggression and risky sexual behavior

Sexual aggression (SA) is a serious public-health problem on college campuses, and there is a pressing need for basic research fostering the development of novel prevention strategies. The current study (a) developed measures of protective behavioral strategies (PBS) for sexual aggression (SA) and risky sex (RS); (b) characterized college men's PBS use; and (c) evaluated whether those who reported engaging in SA and RS showed lower PBS use. Undergraduate men from two universities (n = 567) who endorsed sexual attraction toward women completed measures of PBS, SA, RS, rape-supportive and sociosexual attitudes, and alcohol consumption. On average, participants reported using PBS for SA and RS fairly often, but a sizeable number indicated that they seldom or never used the strategies. Men who reported SA engagement in the last year, relative to their peers, endorsed sharply lower reliance on SA PBS and RS PBS. Men who reported at least one RS behavior in the last year used RS PBS far less often than their peers. The PBS measures converged as expected with other attitudinal and behavioral measures. The new PBS measures reference cognitive-behavioral approaches that a large percentage of college men use on a regular basis, making them potentially acceptable prevention targets. Further, men at greater risk of exhibiting SA are much less likely to take steps to reduce the risks associated with sexual behavior, in comparison with their peers. Thus, future work could evaluate the potential usefulness of incorporating PBS for SA and RS into primary prevention programming in both domains.

STI prevalence among men living with HIV engaged in safer conception care in rural, southwestern Uganda

HIV care provides an opportunity to integrate comprehensive sexual and reproductive healthcare, including sexually transmitted infection (STI) management. We describe STI prevalence and correlates among men living with HIV (MLWH) accessing safer conception care to conceive a child with an HIV-uninfected partner while minimizing HIV transmission risks. This study reflects an ongoing safer conception program embedded within a regional referral hospital HIV clinic in southwestern Uganda. We enrolled MLWH, planning for pregnancy with an HIV-uninfected partner and accessing safer conception care. Participants completed interviewer-administered questionnaires detailing socio-demographics, gender dynamics, and sexual history. Participants also completed STI laboratory screening for syphilis (immunochromatographic testing confirmed by rapid plasma reagin), and chlamydia, gonorrhea, trichomoniasis, and HIV-RNA via GeneXpert nucleic acid amplification testing. Bivariable associations of STI covariates were assessed using Fisher's exact test. Among the 50 men who completed STI screening, median age was 33 (IQR 31-37) years, 13/50 (26%) had ≥2 sexual partners in the prior three months, and 46/50 (92%) had HIV-RNA <400 copies/mL. Overall, 11/50 (22%) had STIs: 16% active syphilis, 6% chlamydia. All participants initiated STI treatment. STI prevalence was associated with the use of threats/intimidation to coerce partners into sex (27% vs 3%; p = 0.03), although absolute numbers were small. We describe a 22% curable STI prevalence among a priority population at higher risk for transmission to partners and neonates. STI screening and treatment as a part of comprehensive sexual and reproductive healthcare should be integrated into HIV care to maximize the health of men, women, and children.

Intimate partner violence by men living with HIV in Cameroon: Prevalence, associated factors and implications for HIV transmission risk (ANRS-12288 EVOLCAM)

OBJECTIVES

Intimate partner violence (IPV) against women is frequent in Central Africa and may be a HIV infection risk factor. More data on HIV-positive men (MLHIV) committing IPV are needed to develop perpetrator-focused IPV and HIV prevention interventions. We investigated the relationship between IPV and HIV transmission risk and IPV-associated factors.

METHODS

We used data from the cross-sectional survey EVOLCam which was conducted in Cameroonian outpatient HIV structures in 2014. The study population comprised MLHIV declaring at least one sexual partner in the previous year. Using principal component analysis, we built three variables measuring, respectively, self-reported MLHIV-perpetrated psychological and physical IPV (PPV), severe physical IPV (SPV), and sexual IPV (SV). Ordinal logistic regressions helped investigate: i) the relationship between HIV transmission risk (defined as unstable aviremia and inconsistent condom use) and IPV variables, ii) factors associated with each IPV variable.

RESULTS

PPV, SPV and SV were self-reported by 28, 15 and 11% of the 406 study participants, respectively. IPV perpetrators had a significantly higher risk of transmitting HIV than non-IPV perpetrators. Factors independently associated with IPV variables were: i) socio-demographic, economic and dyadic factors, including younger age (PPV and SPV), lower income (PPV), not being the household head (SPV and SV), living with a main partner (SPV), and having a younger main partner (SPV); ii) sexual behaviors, including ≥2 partners in the previous year (PPV and SPV), lifetime sex with another man (SPV), inconsistent condom use (SV), and >20 partners during lifetime (SV); iii) HIV-related stigma (PPV and SV).

CONCLUSION

IPV perpetrators had a higher risk of transmitting HIV and having lifetime and recent risky sexual behaviors. Perpetrating IPV was more frequent in those with socioeconomic vulnerability and self-perceived HIV-related stigma. These findings highlight the need for interventions to prevent IPV by MLHIV and related HIV transmission to their(s) partner(s).

Predicting rape events: The influence of intimate partner violence history, condom use resistance, and heavy drinking

Sexual aggression perpetration is a public health epidemic, and burgeoning research aims to delineate risk factors for individuals who perpetrate completed rape. The current study investigated physical and psychological intimate partner violence (IPV) history, coercive condom use resistance (CUR), and heavy episodic drinking (HED) as prospective risk factors for rape perpetration. Young adult men (N = 430) ages 21-30 completed background measures as well as follow-up assessments regarding rape events perpetrated over the course of 3 months. Negative binomial regression with log link function was utilized to examine whether these risk factors interacted to prospectively predict completed rape. There was a significant interaction between physical IPV and HED predicting completed rape; men with high HED and greater physical IPV histories perpetrated more completed rapes during follow-up than men with low HED at the same level of physical IPV. Moreover, psychological IPV and coercive CUR interacted to predict completed rape such that men with high coercive CUR and greater psychological IPV histories perpetrated more completed rapes throughout the follow-up period than men with low coercive CUR at the same level of psychological IPV. Findings suggest targets for intervention efforts and highlight the need to understand the topography of different forms of aggression perpetration.

Perpetration of Intimate Partner Violence Among Men Living with HIV in Northern Vietnam

We examined the prevalence of intimate partner violence (IPV) perpetration and characteristics of HIV-infected male perpetrators. The cross-sectional study was conducted in Vietnam with male antiretroviral treatment clients (N = 1099; mean age = 40.2 years). Bivariable associations were tested between psychological or physical/sexual IPV perpetration in the last 12 months and sociodemographic, psychosocial, and sexual behavioral factors using prevalence ratios. Factors significant at p < 0.10 were entered in multivariable models for each IPV outcome using a modified Poisson approach. Results showed 15.6% (N = 171/1099) reported perpetrating psychological IPV and 7.6% (N = 84/1099) perpetrating physical/sexual IPV in the last 12 months. HIV risk behaviors, including hazardous drinking and multiple sexual partners, having witnessed interparental violence as a child, and depressive symptoms were associated with perpetrating IPV. HIV interventions targeting HIV-infected men in Vietnam should intervene on IPV perpetration by addressing the co-occurring factors of sexual risk, depression, alcohol use, and child maltreatment that are correlated with IPV.

Sociosexuality and Sex With New Partners: Indirect Effects Via Drinking at Parties and Bars

OBJECTIVE

The desire for many novel, concurrent, uncommitted sex partners (i.e., unrestricted sociosexuality) may encourage individuals to seek out contexts that facilitate casual sex. We tested a model in which the effects of sociosexuality on sex with new partners were mediated via drinking in specific contexts. We hypothesized that drinking at parties and bars, which are known to facilitate casual sex (but not drinking at home), would contribute to sex with new (but not with previous) partners.

METHOD

Participants were 427 male freshmen from a large, public northeastern university. They completed a baseline survey in their first semester followed by 56 days of daily reports on drinking and sexual activity during their second semester.

RESULTS

As predicted, sociosexuality measured at baseline positively predicted occasions of sex with a new partner, but not sex with a previous partner. In support of the model, effects were partially mediated by frequency of drinking at parties and bars across the 56-day reporting period, but not by drinking at home.

CONCLUSIONS

Previous research has demonstrated associations among sociosexuality, drinking, and casual sex. Our study is unique in suggesting that drinking in specific contexts--that is, drinking at parties and bars, but not drinking at home--partially mediates the effects of sociosexuality on sex with new partners. This pathway suggests that men with a desire for many novel, concurrent, uncommitted sex partners seek out drinking contexts as a way of facilitating these encounters.

Sociosexuality and Sex With New Partners: Indirect Effects Via Drinking at Parties and Bars

OBJECTIVE

The desire for many novel, concurrent, uncommitted sex partners (i.e., unrestricted sociosexuality) may encourage individuals to seek out contexts that facilitate casual sex. We tested a model in which the effects of sociosexuality on sex with new partners were mediated via drinking in specific contexts. We hypothesized that drinking at parties and bars, which are known to facilitate casual sex (but not drinking at home), would contribute to sex with new (but not with previous) partners.

METHOD

Participants were 427 male freshmen from a large, public northeastern university. They completed a baseline survey in their first semester followed by 56 days of daily reports on drinking and sexual activity during their second semester.

RESULTS

As predicted, sociosexuality measured at baseline positively predicted occasions of sex with a new partner, but not sex with a previous partner. In support of the model, effects were partially mediated by frequency of drinking at parties and bars across the 56-day reporting period, but not by drinking at home.

CONCLUSIONS

Previous research has demonstrated associations among sociosexuality, drinking, and casual sex. Our study is unique in suggesting that drinking in specific contexts--that is, drinking at parties and bars, but not drinking at home--partially mediates the effects of sociosexuality on sex with new partners. This pathway suggests that men with a desire for many novel, concurrent, uncommitted sex partners seek out drinking contexts as a way of facilitating these encounters.

Examining the Roles of Heavy Episodic Drinking, Drinking Venues, and Sociosexuality in College Men's Sexual Aggression

OBJECTIVE

College men's alcohol consumption is positively associated with sexual aggression perpetration, yet men's drinking does not typically predict later sexual assault after accounting for risk factors, such as impersonal sexuality. In the present study, we tested an indirect effects model whereby college men's impersonal sex orientation and heavy episodic drinking (HED) were hypothesized to contribute to sexual aggression perpetration via more frequent attendance at drinking venues (parties, bars).

METHOD

Freshman males (N = 1,043) were recruited to participate in a five-semester study. Key measures included the Sociosexuality Index as a measure of impersonal sex attitudes and behaviors, frequency of HED, and frequency of attending drinking venues (parties, bars). The dichotomous outcome measure was based on the Sexual Strategies Survey, a measure of tactics used to convince a female partner to have sex. Structural equation modeling was used to examine whether sociosexuality attitudes, sociosexuality behaviors, and HED (all measured at Wave 1) would have direct and indirect effects on use of Wave 5 sexual aggression tactics, through effects on Wave 3 venue attendance.

RESULTS

The model supported the hypothesized indirect effects of sociosexuality and HED via men's subsequent drinking venue attendance and was preferred over alternative models.

CONCLUSIONS

College men who more frequently attended drinking "hot spots" were more likely to perpetrate subsequent sexual aggression, supporting a growing body of evidence on the importance of drinking venues in college sexual assault. Findings also help to explicate the mechanism underlying the robust role of impersonal sex orientation in sexual aggression.

"Stealthing": Factors associated with young men's nonconsensual condom removal

OBJECTIVE

The purpose of this study was to investigate the rates, predictors, and associated sexual risk indices of young men's nonconsensual condom removal (also known as stealthing).

METHODS

Participants were 626 male inconsistent condom users aged 21-30 years recruited from an urban area in the Pacific Northwest. Participants completed survey measures assessing sexual aggression history, sexual aggression-related attitudes, sexually transmitted infection history, unplanned pregnancies, and nonconsensual condom removal experiences.

RESULTS

Almost 10% of the participants (n = 61) reported engaging in nonconsensual condom removal since the age of 14 years, with an average of 3.62 times (SD = 3.87) and range of 1-21 times (maximum possible). After controlling for condom use self-efficacy, men with greater hostility toward women (odds ratio = 1.47) and more severe sexual aggression history (odds ratio = 1.06) had significantly higher odds of engaging in nonconsensual condom removal behavior. χ2 analyses demonstrated that men who had a history of nonconsensual condom removal were significantly more likely to have had a sexually transmitted infection diagnosis (29.5% vs. 15.1%) or have had a partner who experienced an unplanned pregnancy (46.7% vs. 25.8%).

CONCLUSIONS

Nonconsensual condom removal, which involves elements of both sexual risk and sexual aggression, confers multiple sexual risks to its recipients, thus meriting increased clinical and research attention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Misperceptions and stereotypes in nursing care for sexually transmitted infections and domestic violence: a qualitative exploratory study

Background: Sexually transmitted infections (STI) and domestic violence (DV) are common healthcare issues experienced worldwide with DV increasing the risk of acquiring STI/s. Although nurses are well-placed to provide care for both issues, little is known about how and whether nurses perceive STI risk within the context of DV and whether this informs nursing care.Aim: To explore nurses' perceptions of STI acquisition within the context of DV and whether this informs nursing care.Design: Qualitative exploratory descriptive design.Methods: Eight participant narratives were collected from Australian Registered Nurses (RNs), with 1-17 years of clinical practice in varied settings. Participants were required to be registered with the Australian Health Practitioner Regulation Agency (AHPRA) and converse in English. Semi-structured interviews were undertaken via face-to-face, telephone and computer-mediated communication (CMC). Thematic analysis was guided by Braun and Clarke (2006).Results: Three themes emerged from the data: 'Perceptions: They don't talk about it, 'Stereotypes: Just that stigma and 'Provision of Care for STIs/DV: Physical and emotional. Participants held various perceptions associated with STIs and DV including the covert nature of both issues, the care of STIs within the context of DV, and how the nature of nursing care differed between STIs and DV.Conclusions: Nurses need to recognise the impact that nurse perceptions and stereotyping have on disclosures and provision of care for STIs, particularly in the context of DV. Consideration is also needed in relation to sexual and reproductive autonomy, the impact on disclosure and provision of care.

A Prospective Examination of Men's Condom Use Resistance: Event-Level Associations with Sexual Aggression, Alcohol Consumption, and Trait Anger

Burgeoning research suggests that men engage in a variety of coercive and non-coercive tactics to avoid condom use (condom use resistance; CUR), suggesting a risk nexus regarding sexual risk and sexual aggression (SA). Laboratory-based research has found that acute alcohol intoxication is associated with CUR; however, no study has examined event-level associations among alcohol consumption, SA history, and CUR or the moderating effects of trait anger. Non-problem drinking young adult men who have sex with women (N = 430) completed a background survey and follow-up assessments regarding their sex events and alcohol consumption over three months. CUR was reported in 113 sex events; 6.2% of these involved SA and 40.7% involved alcohol consumption. Generalized estimating equations demonstrated that men with more severe SA histories were more likely to perpetrate CUR. Men lower in trait anger were more likely to perpetrate CUR the more they increased above their typical level of alcohol consumption, whereas men higher in trait anger were similarly likely to perpetrate CUR regardless of their alcohol consumption. Results suggest that men with greater SA histories and high trait anger are at increased risk of perpetrating CUR, and that risk of CUR increases among other men the more they increase their alcohol consumption beyond their average.

Examining the Roles of Heavy Episodic Drinking, Drinking Venues, and Sociosexuality in College Men's Sexual Aggression

OBJECTIVE

College men's alcohol consumption is positively associated with sexual aggression perpetration, yet men's drinking does not typically predict later sexual assault after accounting for risk factors, such as impersonal sexuality. In the present study, we tested an indirect effects model whereby college men's impersonal sex orientation and heavy episodic drinking (HED) were hypothesized to contribute to sexual aggression perpetration via more frequent attendance at drinking venues (parties, bars).

METHOD

Freshman males (N = 1,043) were recruited to participate in a five-semester study. Key measures included the Sociosexuality Index as a measure of impersonal sex attitudes and behaviors, frequency of HED, and frequency of attending drinking venues (parties, bars). The dichotomous outcome measure was based on the Sexual Strategies Survey, a measure of tactics used to convince a female partner to have sex. Structural equation modeling was used to examine whether sociosexuality attitudes, sociosexuality behaviors, and HED (all measured at Wave 1) would have direct and indirect effects on use of Wave 5 sexual aggression tactics, through effects on Wave 3 venue attendance.

RESULTS

The model supported the hypothesized indirect effects of sociosexuality and HED via men's subsequent drinking venue attendance and was preferred over alternative models.

CONCLUSIONS

College men who more frequently attended drinking "hot spots" were more likely to perpetrate subsequent sexual aggression, supporting a growing body of evidence on the importance of drinking venues in college sexual assault. Findings also help to explicate the mechanism underlying the robust role of impersonal sex orientation in sexual aggression.

Young Women's Experiences with Coercive and Noncoercive Condom Use Resistance: Examination of an Understudied Sexual Risk Behavior

OBJECTIVES

To investigate young women's engagement in and receipt of condom use resistance (CUR; attempts to avoid condom use with a partner who wants to use one), including nonconsensual condom removal ("stealthing"), with male partners.

METHODS

Participants were 503 women aged 21-30 years with increased sexual risk characteristics recruited from 2013 to 2017. Participants completed measures assessing sexual victimization history and CUR experiences.

RESULTS

Findings indicated that 87% of women experienced noncoercive CUR from a partner and 49% experienced coercive CUR. Of these women, 58% and 19% reported having engaged in noncoercive and coercive CUR, respectively. Twelve percent of women had a partner engage in stealthing; none of the women engaged in stealthing. The severity of sexual victimization history was positively associated with both use and receipt of coercive and noncoercive CUR. Diagnoses of sexually transmitted infections were positively associated with receipt of, but not engagement in, CUR.

CONCLUSIONS

Findings demonstrate that sexual victimization and both the use and receipt of CUR are positively related for young women, suggesting that prevention efforts focusing on women's sexual health would benefit from joint consideration of sexual violence and risk behaviors and that such efforts should target victims of sexual violence.

Men's Coercive Condom Use Resistance: The Roles of Sexual Aggression History, Alcohol Intoxication, and Partner Condom Negotiation

Condom use resistance (CUR) through coercive tactics is a significant public health concern. The present study investigated CUR risk factors through an alcohol administration experiment using a sexual risk analog with a community sample of male nonproblem drinkers ( N = 321). Utilizing a path analysis framework, results demonstrated that men with more severe sexual aggression histories displayed stronger in-the-moment power and control responses, which was associated with greater coercive CUR and unprotected sex intentions. A significant interaction between sexual aggression history, risk rationale, and alcohol condition also predicted coercive CUR intentions. These findings emphasize the relationship between sexual aggression and sexual risk behaviors and highlight the importance of targeting these constructs in intervention and prevention efforts.