Minority Stress and the Risk of Unwanted Sexual Experiences in LGBQ Undergraduates

'Show Us a Kiss!': The Everyday Sexual Harassment Experiences of Female Lesbian, Bisexual, and Queer Students

This study explored the experiences of lesbian, bisexual, and queer (LBQ) students' (N = 9, aged 19-24) of sexual harassment via semistructured interviews. Data were analysed using a thematic analysis. Three overarching themes emerged: (a) the paradox of men's unwanted sexual attention, (b) the negative impact on relationships, and (c) the LGBTQ* community as a refuge. The women reported enduring unwanted heteronormative sexual attention, and heterosexist and homophobic harassment which forced some to conceal their sexuality. Support for the LGBTQ* community was central in developing confidence to call-out harassment. The findings call for the inclusion of LBQ-specific messages in sexual violence awareness and prevention interventions.

Emotion Regulation Difficulties Moderate the Association Between Typical Drinking and Sexual Assault Victimization Among Sexual and Gender Minority University Students

Sexual and gender minority (SGM) students report higher alcohol consumption, emotion regulation difficulties, and sexual assault victimization severity than cisgender, heterosexual individuals. A sample of 754 undergraduate students completed an online survey assessing alcohol use, emotion regulation, and sexual victimization. Regression analyses indicated that, among SGM students with higher emotion regulation difficulties, typical weekly drinking was positively associated with sexual assault victimization severity, but among cisgender, heterosexual students and SGM students with lower emotion regulation difficulties, there was no association between drinking and victimization severity. Thus, SGM students benefit from interventions targeting alcohol use and emotion regulation difficulties.

Examination of the Multilevel Sexual Stigma Model of Intimate Partner Violence Risk Among LGBQ+ College Students: A Prospective Analysis Across Eighteen Institutions of Higher Education

Sexual stigma operates at multiple levels (institutional, group, individual), which serves to disadvantage sexual minority (LGBQ+) individuals and increases risk for deleterious outcomes. The current study evaluated a novel multilevel sexual stigma model of intimate partner violence (MLSSM-IPV) that incorporates multiple levels of sexual stigma as related to IPV risk via several pathways (e.g. hazardous drinking, affective symptoms). We evaluated this model in a longitudinal study of LGBQ+ undergraduate college students (n = 2,415) attending 18 universities who completed surveys in the Fall and Spring semesters. Group-level sexual stigma on each campus was assessed via surveys with heterosexual students (n = 8,517) and faculty, staff, and administrators (n = 2,865), and institutional-level stigma was evaluated via a campus climate assessment. At the campus level, institutional stigma was related to LGBQ+ students' self-stigma and identity concealment. Moreover, self-stigma prospectively predicted IPV victimization, and hazardous drinking mediated the relations between self-stigma and IPV perpetration and victimization. Results suggest that interventions addressing stigma and hazardous drinking may be efficacious in reducing IPV among LGBQ+ students. Further, comprehensive efforts to improve campus climate for LGBQ+ students are likely to produce a plethora of benefits for these students.

Preventing sexual violence in sexual orientation and gender diverse communities: A call to action

Background: Members of the lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender diverse (SOGD) communities are at disproportionately higher risk for sexual violence compared to cisgender heterosexual people. Despite this elevated risk, relatively few sexual violence prevention efforts effectively reduce these victimization disparities based on sexual orientation or gender identity.Objective: This narrative review provides an overview of the prevalence of sexual violence in the SOGD communities, delineates risk factors for sexual victimization among SOGD community members, and reviews and evaluates existing prevention efforts for the SOGD communities. We outline specific recommendations for ensuring that prevention efforts meet the needs of the SOGD communities.Method: Drawing on ecological systems theory and public health approaches to sexual violence prevention, we outline current approaches and opportunities for preventionists and scholars to push the field forward.Results: There have been promising prevention programmes designed to be implemented within SOGD communities specifically; however, it is important that general primary prevention programmes endeavour to specifically address sexual violence perpetrated against SOGD people. While many packaged programmes that endeavour to prevent sexual violence across all gender identities and sexual orientations are inclusive of SOGD participants, more programming is needed that integrates anti-oppression training to target social norms that perpetuate SOGD-specific rape myths and normalize sexual violence against SOGD community members.Conclusion: Ecological prevention strategies in line with a public health approach for primary prevention may be particularly valuable for reducing victimization disparities based on SOGD status and identity. Comprehensive sexual education and anti-discrimination policies should be considered front-line prevention programming. To assess if these strategies are effective, the implementation of large-scale surveillance surveys that use comprehensive assessments of sexual orientation, gender identity, and sexual violence are needed. Using theoretically grounded implementation strategies for prevention programmes can ensure effective programme delivery.

Ecological factors associated with child sexual abuse among 15- to 17-year-old adolescents in mainland China: implications for intervention

Background

Child sexual abuse is a major public health problem with adverse consequences for victims' physical, mental, and reproductive health. This cross-sectional study aimed to determine the prevalence of child sexual abuse and its associated factors among 15- to 17-year-old adolescents in mainland China.

Methods

From September 8, 2019 to January 17, 2020, a total of 48,660 participants were recruited by 58 colleges and universities across the whole country to complete the self-administered, structured, online questionnaire. This analysis was restricted to 3,215 adolescents aged between 15 and 17 years in mainland China. Chi-square tests and multivariate Logistic regression analyses were performed to identify individual, relationship, and community factors associated with child sexual abuse.

Results

The overall prevalence of child sexual abuse was 12.0%. More specifically, 13.0% of girls and 10.6% of boys reported that they were sexually abused prior to 18 years of age. At the individual level, being female, sexual minority identity, younger age, and higher levels of knowledge, skills and self-efficacy regarding condom use were significantly related to increased odds of reporting sexual abuse. At the relationship and community level, adolescents from disrupted families and those entering into a marriage, having casual sexual partners, and having first intercourse at a younger age were more likely to report sexual abuse. On the contrary, those who had never discussed sex-related topics with their family members at home and were offered school-based sexuality education later (vs. earlier) were less likely to report sexual abuse.

Conclusion

Multilevel prevention programs and strategies, including targeting adolescents with high-risk characteristics, educating young children and their parents about child sexual abuse prevention and optimizing the involvement of parents, school, community, society and government in comprehensive sexuality education, should be taken to reduce child sexual abuse among 15- to 17-year-old adolescents.

Sexual and Relationship Violence Among LGBTQ+ College Students: A Scoping Review

Although there has been increased attention to campus sexual and relationship violence (SRV) because of Title IX and the #MeToo movement, much of that attention has focused on victimization of cisgender heterosexual women. This scoping review uncovers information from empirical studies on what is known about LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, queer, and nonbinary) students' experiences of campus SRV. Using rigorous scoping review methods (i.e., searches of 15 databases, searches of expert websites, hand searching, reference harvesting, and forward citation chaining), we identified 60 documents published since 2000 that contained findings from empirical studies related to LGBTQ+ students and SRV on U.S. college and university campuses. Through content analysis, we summarized findings around five key themes: (1) extent and types of victimization, (2) negative outcomes, (3) knowledge of and attitudes about SRV, (4) perspectives on SRV services and prevention education programs, and (5) recommendations from study authors based on their findings. Implications for research, practice, and policy based on these findings are discussed.

Sexual Victimization Outcomes and Adjustment Among Bisexual Women: A Review of the Quantitative Literature

Bisexual women experience worse mental health outcomes than lesbian and heterosexual women, which may be explained by greater rates of sexual violence among bisexual women. The current comprehensive literature review aimed to synthesize research on mental health and substance use outcomes related to lifetime sexual violence among bisexual women. A comprehensive literature search was conducted within the PsycINFO and Medline databases (final search conducted in August, 2021). Inclusion criteria required articles to examine a mental health or substance use correlate/outcome of lifetime sexual victimization experiences among bisexual women. Fifteen studies met inclusion criteria and were reviewed. Results indicate that there are significant gaps in this literature, including limited research on psychological distress outcomes. Most notably, there is a limited focus on the experiences of bisexual women specifically and the role of bisexual minority stress. Findings indicate that lifetime sexual victimization experiences are linked with increased posttraumatic stress, depression, and alcohol (and other substance) use and consequences. It appears that bisexual women are vulnerable to cumulative victimization, which may further exacerbate outcomes. Clinicians working with bisexual women should provide bisexual-affirmative care, help bisexual women access positive social supports, and build more effective coping strategies for managing post-trauma distress. Future research on outcomes of violence among bisexual women would benefit from contextualizing adjustment following sexual assault within a bisexual minority stress-informed approach for a more comprehensive understanding of this process.

Sexual Assault and Behavioral Health: What Can We Learn From a Probability Sample of Young Sexual Minority Men?

BACKGROUND

Previous research indicates that young sexual minority men (YSMM) are at increased risk of experiencing sexual assault compared to their heterosexual peers. While this increased risk is documented in comparison studies, very little is known about the specific range of sexual assault experiences. The aim of this study was to investigate prevalence of sexual assault experiences and their association with depression and alcohol use for YSMM.

METHODS

In 2017 and 2018, 124 YSMM (18-24 year-olds) were recruited to participate in an online study using probability-based sampling methods, in Los Angeles, CA. Participants answered items about lifetime and recent sexual assault experiences (i.e., unwanted touching, oral rape, penetrative rape), characteristics of the coercive behaviors, recent alcohol use, and depression. Analysis of variance (ANOVAs) and multiple linear regressions investigated the relationships between sexual assault experiences and behavioral health.

RESULTS

The sample reported a range of lifetime sexual assault experiences: 70% unwanted touching and 28% penetrative rape. Fifty-five percent of the sample reported some type of recent sexual assault, with 17% reporting a recent penetrative rape. ANOVAs of the impact of different forms of sexual assault on behavior health indicated that unwanted touching was associated with higher depression and alcohol use. Further investigation of recent unwanted touching indicated that frequency is associated with depression and binge drinking. Of participants who reported experiences of unwanted touching, 61% reported it occurred while they were intoxicated.

DISCUSSION

Findings support previous evidence of high rates of sexual assault among YSMM. Further, the majority of men who reported sexual assault indicated that it occurred while they were intoxicated, suggesting that unwanted touching is occurring while men are drinking alcohol, likely in bars. The culture of gay bars may encourage nonconsensual touching during intoxication and these experiences of sexual assault have consequences (i.e., higher levels of depression and alcohol use).

Campus Climate and the Sexual Assault Victimization of LGBQ College Students

Sexual minority college students are disproportionately impacted by sexual assault in college, however, there is a paucity of research exploring the role of the college environment in victimization. This study explores the relationship of campus climate with sexual assault victimization for these students. This sample included 1,110 current college students in the United States who identified as a sexual minority. Logistic regression results indicated that the more observations of harassment and discrimination of sexual minority students by participants, the more likely they were to experience sexual assault victimization in college. Also, the more out a participant was on campus, and the stronger sense of belonging they had to their college, the less likely they were to experience sexual assault victimization. Sexual assault prevention efforts on college campuses would benefit from programming and policies that support belonging and address discrimination and harassment.

An Exploration of Factors that Mediate the Relationship Between Adverse Childhood Experiences and Sexual Assault Victimization Among LGBTQ+ College Students

Despite alarming rates of sexual assault on college campuses, little research has examined risk factors for sexual victimization among LGBTQ+ college students. This exploratory study aims to examine adolescent sexual assault, internalized homonegativity, and problematic alcohol use as mediators linking several types of adverse childhood experiences (ACEs; i.e., childhood sexual abuse, parental abuse, and household disorder) to collegiate sexual assault. Utilizing data from 241 LGBTQ+ college students, path analysis findings demonstrated that these proposed mediators increased risk for sexual assault and that various types of ACEs exerted differential impacts on sexual re-victimization, internalized homonegativity, and problematic alcohol use. Practice-based implications are offered, including the need for affirming programming that includes problem drinking prevention components and considers the role of ACEs and internalized homonegativity in increasing risk for sexual assault during college as well as the need for LGBTQ+ resource centers on campus.

Linking minority stress to substance abuse in LGB adults: the mediating effect of sexual harassment

OBJECTIVE

Employing a psychological mediation framework, the study investigated the interaction between minority stress and psychoactive substance abuse mediated by sexual harassment among LGB individuals.

METHOD

One hundred and forty-seven LGB individuals answered a questionnaire measuring internalized homophobia, concealment, discrimination, sexual harassment, and psychoactive substance abuse. Logistic hierarchical regression models were conducted to test the proposed relations and mediating hypotheses.

FINDINGS

Incidents of discrimination and internalized homophobia correlated with cigarette smoking and alcohol drinking. Sexual harassment was related to the use of cannabis and hard drugs. Sexual harassment mediated the relationships between the dimensions of minority stress and the use of cannabis and hard drugs.

CONCLUSION

Minority stress appears to be linked directly and indirectly, via sexual harassment, to the use of psychoactive substances by LGB individuals. Interventions addressing the prevention or mitigation of sexual harassment experienced by LGB individuals are likely to attenuate the negative effects of minority stress on their levels of substance use.

Gender and sexual identity and harms from others' drinking among U.S. college students: Results from a multi-campus survey

BACKGROUND

College is a critical life stage for alcohol-related harms to others (AHTOs), gender, and sexual identity. We tested associations between inclusively-defined gender and sexual identities (separately) and AHTOs among college students.

METHODS

The Healthy Minds Study (n = 8,308) provided data about three AHTOs: (1) babysitting a drunk student, (2) alcohol-related unwanted sexual advance, and (3) alcohol-related sexual assault. Independent variables included gender and sexual identity.

RESULTS

One in four students (25.5%) reported babysitting, 6.2% reported unwanted advances, and 1.2% reported sexual assaults. Compared to cisgender males, cisgender females had higher odds of reporting babysitting (aOR = 1.36, p < 0.001) and unwanted advances (aOR = 2.59, p < 0.001); trans masculine students had higher odds of reporting sexual assaults (aOR = 4.49, p = 0.04).

CONCLUSIONS

AHTOs are prevalent on college campuses, and cisgender female and trans masculine students have higher odds of experiencing them. Alcohol interventions may protect cisgender female and gender minority students from the drinkers around them.

Forcible, Substance-facilitated, and Incapacitated Sexual Assault Among University Women: A Canadian Sample

This study examined the frequency of sexual assault experiences in a sample of university women to understand the conditions under which sexual assault occurs, and compare alcohol and drug consumption patterns on the likelihood of experiencing sexual victimization. While patterns of victimization have been examined in American contexts, research on contemporary Canadian contexts is scant at present. We found that roughly 58% of the 377 university women in our sample attending one of three large Western Canadian universities in British Columbia reported having been sexually assaulted. These women reported a total of 528 incidents of sexual assault, with 56% of these involving substance-related nonpenetrative sex acts; 312 incidents were substance-related and 216 involved forcible sexual assault. The likelihood of sexual assault victimization was the highest among participants who identified as a sexual minority, consumed marijuana, and reported greater severity of recent alcohol consumption. The present research aims to inform sexual assault prevention and education efforts to reduce occurrences of victimization.

Sexual violence among male sexual minority college students in Guangdong, China: a cross-sectional study

This study aims to provide an estimate of lifetime sexual violence (SV) among male sexual minority college students with differing sexual orientations and contribute to the evidence base on the association between SV experience, stress, and depressive symptoms. The data stemmed from the 2019 Internet Survey on HIV/AIDS and Sexual Health in Colleges and Universities in Guangdong province, China. Lifetime SV victimisation (including non-sexual harassment, physical contact sexual harassment, and rape), level of stress, and depressive symptoms were examined among 1441 male sexual minority students from 37 colleges and universities in Guangdong province. Linear regression analyses were adopted to examine associations between independent variables and depressive symptoms. 23.4% (337/1441) of the participants reported lifetime non-contact harassment, while 8.8% (127/1441) and 2.4% (35/1441) of the participants reported physical contact sexual harassment and rape, respectively. Homosexual students reported the most physical contact sexual harassment (48/127, 37.8%) and bisexual students reported the most non-contact sexual harassment (102/337, 30.3%) and rape (10/35, 28.6%) among sexual minority participants; 85.6% participants reported high levels of stress. The experience of SV and the level of stress were significantly associated with depressive symptoms, and stress completely mediated the path from SV experiences to depressive symptoms. This study specifically showcases SV as a pervasive problem affecting Chinese male sexual minority college students and highlighting the severity of stress and depressive symptoms among this population. These findings emphasise the urgency of implementing effective practices and policies to address SV and depressive symptoms among male sexual minority college students in China.

Sexual and Gender Minorities: Reporting Sexual Assault to the Police

Sexual assault is defined as any type of forced or coerced sexual contact or behavior that happens without consent. Victims seeking justice and personal safety must report their assaults to police, however few survivors report their victimization. Sexual and gender minorities, inclusive of the LGBTQI2-S population, are at an increased risk for experiencing sexual assault yet the vast majority of empirical research on sexual victimization has been conducted through a hetero-cisnormative lens. Sexual and gender minorities likely have a unique experience of sexual assault compared to heterosexual, cisgender survivors, especially as it relates to their help-seeking behaviors post-assault. Through the use of Sexual and Gender Script Theory, this review explores barriers that sexual and gender minorities may experience when reporting sexual assault to the police, thereby impeding their access to equitable justice. Opportunities for future policy, practice, and research among sexual and gender minorities are presented.

Minority Identity, Othering-Based Stress, and Sexual Violence

Background: Some (minority) groups (MGs) are more vulnerable to sexual violence (SV) exposure than others. Othering-based stress (OBS) may mediate the relationship between minority identification and SV. This study aims to assess the prevalence of SV in different MGs to explore the relationship between minority identification and SV, to investigate whether belonging to multiple MGs moderates this relationship, and to explore OBS SV moderation for different MGs. Method: Through an online survey administered to a nationally representative sample in Belgium, data was collected from 4632 persons, of whom 21.01% self-identified as belonging to a MG (SI-Minority). SV prevalence was measured using behaviorally specific questions based on the WHO definition of SV. SI-Minority participants received an additional scale on OBS. Results: SI-Minority participants reported more SV victimization compared to the non-minorities. However, this increased risk was not moderated by minority identification but linked to the socio-demographic SV risk markers common to minority individuals. Multiple-minority participants were found more at risk of SV compared to single-minority respondents. Lesbian, gay, bisexual, pan-/omnisexual, asexual, and other non-heterosexual (LGB+) participants were found more at risk than heterosexual participants. OBS was found to be significantly correlated to SV in sexual and gender minorities and in cultural minorities. Conclusions: This study contributes to our understanding of the relationship between minority identification, OBS, and SV. Studying both specific and common SV vulnerabilities and outcomes within specific societal subgroups and the general population may inform policy makers when allocating resources to those interventions with the largest societal impact.

Violence and the Academic Lives of College Students at the Intersection of Race/Ethnicity and Sexual Orientation/Gender Identity

To ascertain whether sexual and/or gender minority (SGM) students at a Hispanic-serving institution who experience violence are more likely to experience interference with their academic lives when compared to heterosexual, cisgender students, and how this relationship differs by race/ethnicity. Data came from 736 undergraduate students at a university in the Southwestern United States responding to a 2017 Campus Climate Survey. Multivariable logistic regression was conducted on self-identified SGM students and reported interference with their academic lives. The model was also tested for effect modification by race/ethnicity. Two-thirds (67.65%) of SGM students reported four or more incidences of violence. Nearly one-fifth (18.83%) of SGM students reported being harassed, insulted, threatened, or intimidated, and 2.63% reported being physically hurt (including forced sex), because the perpetrator thought the individual might have been gay, lesbian, bisexual, or transgender. SGM students had 2.44 (95% CI: 1.29, 4.61) increased odds of interference with academic life as a result of violence victimization compared with non-SGM students. When the model was evaluated for effect modification by race/ethnicity, large effect sizes were observed, although the results were not significant. SGM undergraduate students are at significantly increased risk of violence and interference with their academic lives. This research emphasizes the need for institutions of higher education to ensure that their policies and practices support equal access to education by SGM students. Additionally, this study contributes insights into a potential protective effect of Hispanic ethnicity that warrants further research.

Sexual Violence Among Gender and Sexual Minority College Students: The Risk and Extent of Victimization and Related Health and Educational Outcomes

A multisite survey conducted at eight campuses of a southwestern university system provides the data for the present study, total N = 17,039 with 1,869 gender and sexual minority (GSM) students. Sexual violence was measured using the Sexual Experiences Survey (SES), and analysis included both the participant's risk of experiencing sexual violence and the extent (or total count) of sexual violence experienced. This study poses the following research questions: What effects do gender identity and sexual orientation have on the risk and extent of sexual violence among students and, among victims, what is the relationship between gender identity/sexual orientation and mental health (posttraumatic stress disorder [PTSD], depression) and academic environment (disengagement and safety) outcomes for university students? Multilevel, random effect hurdle models captured this sequential victimization dynamic. GSM and cisgender heterosexual (CH) female students are predicted to be 2.6 and 3 times, respectively, as likely to experience sexual violence compared with CH male students. In addition, GSM students experiencing sexual violence are also expected to experience a greater number of sexually violent acts (74% more) over their college career compared with victimized CH male students. The models confirm that the risk of victimization increases over time (13% per year for CH male students), but GSM students are expected to experience an additional (10%) increase in risk of victimization per year compared with CH male students. GSM and CH female students are also predicted to be more likely to have PTSD and experience more severe depression symptoms than CH male students. GSM students are expected to experience significantly higher rates of PTSD, worse depressive symptoms, and greater disengagement than CH female students. The discussion explores how institutions of higher education might recognize the resilience of GSM students and consider the protective potential of social and community support when developing programs or interventions for diverse populations.

Intimate Partner Sexual Violence and Mental Health Indicators Among Chinese Emerging Adults

Intimate partner sexual violence (IPSV) among emerging adults, including heterosexuals and sexual minorities in the Chinese population, is poorly understood. Focusing on college students, the objectives of the present study were to estimate the prevalence of IPSV among Chinese emerging adults, examine the association between sexual orientation and IPSV, and evaluate the mental health and quality of life of survivors of IPSV. Data were collected from four university campuses in Hong Kong. A total of 1,015 participants were included in the data analysis. The prevalence of IPSV as identified by Conflict Tactics Scale (CTS)-2 was 12.1%. There was no gender difference in the prevalence of IPSV. Multiple logistic regression found that being older; having experienced childhood sexual abuse and having a smoking habit; and belonging to a sexual minority were factors associated with IPSV. Multiple linear regression found that IPSV survivors were more likely to have higher levels of anxiety and depression, more severe psychosomatic symptoms, and poorer quality of life in three domains: psychological, social relationships, and environment when compared with those without IPSV experience. The documented factors underscored the importance of awareness that men and sexual minorities might incur IPSV, which should receive more attention in IPSV prevention programs. Also, interventions for IPSV survivors should be targeted at improving their mental health and quality of life and sex education should place more emphasis on sexual consent and sexual health in dating relationships.

Differences in Rape Acknowledgment and Mental Health Outcomes Across Transgender, Nonbinary, and Cisgender Bisexual Youth

The purpose of this study was to document the rates of rape acknowledgment (labeling rape as rape rather than using a minimizing label) and the corresponding mental health correlates using the minority stress framework in a unique and vulnerable sample: racially diverse sexual and gender minority young adults. Participants were 245 young adults who identified their sexual orientation as under the bisexual umbrella. A total of 159 of these participants (65.2%) identified their gender identity as nonbinary. All participants completed a series of online questionnaires regarding their sexual victimization history, mental health outcomes (depression, anxiety, and posttraumatic stress disorder [PTSD]), and constructs relevant to minority stress theory (level of outness, internalized bisexual negativity, connection to LGBTQ [lesbian, gay, bisexual, transgender, questioning] community). Rape acknowledgment was significantly greater among gender nonbinary participants (79.9%) than among trans and cisgender male participants (17.9%). Lack of rape acknowledgment was associated with increased anxiety, depression, and PTSD. Outness was significantly associated with greater rape acknowledgment. Despite the highly increased vulnerability for sexual violence among sexual and gender minorities, very little is understood about the mechanisms of this increased vulnerability or their unique needs for recovery. The results of this study strongly suggest the importance of a minority stress framework for understanding this increased vulnerability and for designing sexual violence prevention and recovery interventions for sexual and gender minority populations.

Facilitators of Self-Initiated HIV Testing Among Youths: A Qualitative Study

BACKGROUND

Youth experience disparities in HIV infection but have significantly low rates of HIV testing that lead to late diagnoses, increased transmission rates, and adverse health outcomes. There is limited knowledge regarding self-initiated HIV testing, which is a promising strategy for improving testing rates among youth.

PURPOSE

This study aimed to identify the facilitators of self-initiated HIV testing among youth.

METHOD

Thirty youths aged 18-24 years were recruited to participate in a qualitative descriptive study. Potential participants were recruited from a combination of HIV testing sites, including community testing events, a community-based organization, an adolescent health clinic, and a college campus. A demographic and sexual history questionnaire and audio-recorded interviews were used to collect data. Transcribed interviews were analyzed using qualitative content analysis.

RESULTS

Salient themes and subthemes that explain the study findings are as follows: testing within the context of a sexual relationship (e.g., infidelity), support and influence from social relationships (e.g., family support), taking the initiative for health (e.g., signs and symptoms of infection), HIV testing preferences (e.g., free testing), and HIV testing experiences (e.g., provision of other health services).

CONCLUSIONS

The findings of this study advance scholarly understanding regarding the predictors of self-initiated testing and provide critical information necessary to further improve evidence-based nursing clinical practice and develop public health nursing interventions that target self-initiated HIV testing. Encouraging self-initiated HIV testing is an effective approach to increasing testing rates and, consequently, preventing new HIV transmissions in this vulnerable population.

Unwanted Sex Due to Intoxication among Australians Aged 16-69 Years

Intoxication can be a factor in unwanted sex, but research on the extent of the issue in both women and men is limited. We assessed the prevalence, correlates, and 10-year time-trends of unwanted sex due to intoxication among a representative sample of 4,279 women and 3,875 men aged 16-69 years in Australia and considered how these vary by gender. In 2012-13, 16% of women and 10% of men reported ever having had a sexual experience when they "did not want to because they were too drunk or high at the time." For both women and men, this was associated with younger age, bisexual activity, and reports of lifetime injection drug use, sexually transmitted infections, and forced sex. Among women only, it was associated with drinking above guideline levels and ever having terminated a pregnancy. Among men only, it was associated with current tobacco smoking, elevated psychosocial distress, and poor general health. Compared with 2001-02 data, fewer men reported unwanted intoxicated sex, while there were no changes for women as a whole. Interpreting these findings through an intersectional assemblage framework supports stronger understanding of the multiple factors influencing sexuality and substance use with implications for promoting equity, safety, and sexual health.

Navigating Uncertainty, Employment, and Women's Safety During COVID-19: Reflections of Sexual Assault Resistance Educators

COVID‐19 affects women in ways unique to the impacts of structural inequalities related to gender, sexuality, disability, race and socioeconomic status. In this article, we reflect on our own experiences of the pandemic, as feminist students, workers and sexual assault resistance educators located in a Canadian post‐secondary setting. Situating ourselves within feminist responses to sexual violence prevention, as facilitators of the Enhanced Assess, Acknowledge, and Act (EAAA) sexual assault resistance education programme for university women, we reflect on the impacts of the COVID‐19 pandemic on our work as EAAA facilitators in our Canadian university. We explore the theoretical possibilities that critical disability theory and queer theory present to the EAAA programme, and argue that incorporating concepts from these frameworks will complement the goals of the EAAA programme and improve inclusivity of queer, trans and disabled participants. We conclude with a look into the future by anticipating the impacts of COVID‐19 on our future work.

Bisexual Women’s Experiences of Stigma and Verbal Sexual Coercion: The Roles of Internalized Heterosexism and Outness

In the current study, we examined how bisexual women’s unique experiences of sexual identity stigma might elevate their risk for verbal sexual coercion. Online survey data were collected from 350 self-identified bisexual women. Hayes PROCESS macro was used to test moderated-mediation and mediation analyses. Results indicated that anti-bisexual experiences (from both heterosexual and lesbian/gay individuals) were associated with greater internalized heterosexism (i.e., internalization of negative societal attitudes and stereotypes about one’s minority sexual orientation), which in turn was associated with increased odds of experiencing verbal sexual coercion. We did not find moderating effects of outness, such that internalized heterosexism mediated the relation between anti-bisexual experiences and verbal sexual coercion regardless of bisexual women’s levels of outness. Findings suggest that anti-bisexual experiences and internalized heterosexism are associated with bisexual women’s elevated risk for experiencing verbal sexual coercion. There is a need for targeted sexual violence prevention and risk reduction efforts that take into account the unique experiences and vulnerabilities of bisexual women in victimization risk. Results also highlight the need for campaigns that reduce sexual orientation-related stigma at the population level in order to prevent negative health outcomes among bisexual women.

Testing a Model of Binegativity, Drinking-to-Cope Motives, Alcohol Use, and Sexual Coercion Among Self-Identified Bisexual Women

In the present study, we tested a sequential mediation model whereby binegativity was associated with sexual coercion through drinking to cope motives and alcohol use. Data were examined from 224 self-identified bisexual women (M age = 22.79; SD = 3.44) who took part in an online survey. Participants reported binegativity, alcohol use, drinking to cope motivations, and sexual coercion experiences for the previous 30 days. A total of 48.0% of the sample (n = 108) experienced sexual coercion in the past 30 days. Sequential mediation indicated more experiences of binegativity were associated with greater drinking to cope motives, which in turn, related to greater alcohol frequency and greater likelihood of sexual coercion. Alcohol quantity was not a significant mediator. Results suggest the importance of studying the impact of binegativity on bisexual women, as well as developing prevention programs that consider how this form of discrimination may contribute to drinking to cope motives, more frequent alcohol use, and increased risk for sexual coercion.

Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women

BACKGROUND

Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women.

OBJECTIVES

The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association.

METHODS

Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who completed an online survey and reported at least one binge drinking episode as well as engaging in sexual activity in the past 30 days.

RESULTS

Of these participants, 57 (53.3%) reported one or more experiences of sexual coercion in the past 30 days. Sexual coercion was associated with negative alcohol-related consequences via drinking to cope motives. Negative affect moderated the association between sexual coercion and drinking to cope motives such that the association was stronger among women with greater negative affect. Conclusions/Importance: Methods of addressing vulnerability to sexual coercion and educating young bisexual women about the association between sexual coercion and potentially problematic affective coping through alcohol use are needed.

Sexual Violence on Campus: Differences Across Gender and Sexual Minority Status

PURPOSE

Sexual violence is a pervasive problem on university campuses. Although previous work has documented greater vulnerability for sexual violence among sexual and gender minority students, little is known about contextual variation in vulnerability to this kind of violence. The goals of the current study were (1) to identify vulnerability among sexual and gender minority students with regard to sexual violence, and (2) to explore if the context of this violence differs across sexual and gender minority status.

METHODS

Undergraduate students (ages 18-24) from six francophone universities in Quebec, Canada (N = 4,264) completed online questionnaires regarding their experience of sexual violence, as well as the context of these acts (e.g., the gender of the perpetrator, the status of the perpetrator, and the location of the violence). They also provided information regarding their sexual and gender minority status. Binary logistic regressions were conducted to assess for variation in experiencing sexual violence across sexual and gender minority status.

RESULTS

Transgender/nonbinary students generally reported higher levels of sexual violence than their cisgender peers, while variation occurred with regard to vulnerability across sexual identity subgroups. Few differences in context were observed across sexual minority identity. Transgender/nonbinary students were significantly more likely to report sexual violence in athletic contexts and during volunteering activities compared to their cisgender peers.

CONCLUSIONS

Findings highlight the higher levels of vulnerability for sexual violence among gender minority and some sexual minority university students. They also point to the contexts in which such violence occurs, suggesting specific strategies for prevention.