Verbal Sexual Coercion Experiences, Sexual Risk, and Substance Use in Women

Systematic review and data synthesis on the treatment of sexual violence victimization by an intimate partner

This study aims to conduct a systematic review and synthesis on the treatment of sexual violence victimization by an intimate partner evaluating specifically the impact of treatment on mental health outcomes of female sexual intimate partner violence (IPV) survivors. We followed the Cochrane Handbook for Systemic Reviews of Interventions guidelines for the process of conducting systematic reviews. We were unable to conduct meta-analyses due to the substantial heterogeneity of the interventions for IPV. A qualitative summary of 6 controlled studies identified no benefit to the treatment of sexual coercion, posttraumatic stress disorder, depression, or anxiety for female sexual IPV survivors. However, we are limited by a paucity of data for each outcome on this subject. In conclusion, sexual coercion is a complex issue that has adverse effects on mental health and the well-being of the survivors. More research is needed that investigates what kind of interventions are effective for this specific population.

Adults and Family as Supportive of Adolescent Sexual Development in the Age of Smartphones? Exploring Cybersexual Violence Victimization, Pornography Use, and Risky Sexual Behaviors

Among adolescents, engagement in risky sexual behavior is an important public health concern. Research has begun to explore the impact of adolescents' online experiences with their social and behavioral health as approximately 95% of adolescents have access to a smartphone connected to the internet. However, little research has specifically examined how online experiences impact sexual risk behaviors among adolescence. To fill gaps in the existing research, the current study sought to investigate the association between two potential risk factors and three sexual risk behavior outcomes. We examined how experiencing cybersexual violence victimization (CVV) and using pornography during early adolescence was associated with condom use, birth control use, and use of alcohol and drugs before sex among U.S. high school students (n = 974). Additionally, we explored multiple forms of adult support as potential protective factors of sexual risk behaviors. Our findings suggest that CVV and porn use may be associated with risky sexual behaviors for some adolescents. In addition, parental monitoring and support from adults at school may be two ways to support healthy adolescent sexual development.

Occasions of Alcohol and Cannabis Use and Associated Risk for Sexual Assault Among College Women With Higher Sexual Risk Alcohol Expectancies

OBJECTIVE

College women report high rates of sexual assault. Research focused on women's risk factors for sexual assault remains necessary to assist women in reducing their risk. Previous work has shown alcohol use and cannabis use to be associated with sexual assault. The current study examined whether individual difference variables moderated women's risk for sexual assault during occasions of alcohol use and cannabis use using ecological momentary assessment (EMA).

METHOD

Participants were 18- to 24-year-old first-year undergraduate women (N = 101) who were unmarried and interested in dating men, consumed three or more alcoholic drinks on one occasion in the month before baseline, and engaged in sexual intercourse at least once. Baseline individual difference variables included sex-related alcohol expectancies, alcohol problems, decision skills, and sexual attitudes. EMA reports, collected three times per day over 42 days, included items regarding alcohol and cannabis use and sexual assault experiences.

RESULTS

Among women who experienced sexual assault during the EMA period (n = 40), those with higher sexual risk expectancies had a higher probability of sexual assault during occasions when they were using alcohol or cannabis.

CONCLUSIONS

Several modifiable risk factors for sexual assault and individual differences factors may exacerbate risk. Ecological momentary interventions may be useful to reduce sexual assault risk for women with high sexual risk expectancies who use alcohol or cannabis.

Substance Use, Risky Sex, and Peer Interactions Predict Sexual Assault Among College Women: An Ecological Momentary Assessment (EMA) Study

Sexual assault is an unfortunately common experience among women in college campuses. This study used ecological momentary assessment (EMA) to gain a better understanding of the contextual determinants of sexual assault among college women. EMA reports inquired about sexual assault experiences, risky sex (sex without a condom and regretted hookups), and substance use (alcohol and cannabis use), as well as what activities participants were engaged in (e.g., pregaming, drinking with peers, and drinking with a casual sexual partner), and whether they experienced peer pressure to engage in casual sex. Participants were 103 freshman undergraduate women (18-24 years old) at a Southwestern university in the United States, who were unmarried, interested in dating opposite-sex partners, engaged in binge drinking (defined as having 3 or more drinks on one occasion) in the past month, and reported at least one experience of sexual intercourse in their lifetime. Participants completed reports (one random and two time-contingent) via EMA three times a day over a 42-day period. Compliance in completing EMA reports was good (84.2% of prompted reports were completed), and time-to-completion of reports once signaled was acceptable (mean = 26 minutes, median = 5.75 minutes). During the 42 days, 40 women (38.8%) reported 75 occasions of sexual assault. The odds of experiencing sexual assault were significantly greater during occasions of regretted hookups and unprotected sex. Additionally, drinking with peers and peer pressure to engage in casual sex were each associated significantly with occasions of sexual assault. Reducing risk for sexual assault among undergraduate women may be possible by targeting these behaviors and contextual features in near real-time via momentary intervention.

The Impact of Sexual Arousal and Emotion Regulation on Men's Sexual Aggression Proclivity

Extant literature supports a relationship between sexual arousal and increased likelihood of sexually coercive behavior in men. The present study investigated the impact of sexual arousal on sexual coercion proclivity and the degree to which emotion regulation moderated this relationship in the context of two separate affect inductions. We predicted that sexual arousal would more strongly predict sexual coercion likelihood for men scoring lower on emotion regulation ability compared with men with above average emotion regulation abilities. Male participants with (n = 38) and without (n = 40) self-reported histories of sexual coercion were recruited from urban sexually transmitted infection testing clinics. Participants completed a measure of emotion regulation, underwent a positive and negative affect induction, viewed an erotic video, and reported on their level of sexual arousal immediately prior to completing a hypothetical sexual coercion likelihood laboratory task. Relationships between emotion regulation, sexual arousal, and sexual coercion likelihood were examined using moderation analyses. Sexual arousal was associated with greater reported sexual coercion likelihood. For men with poorer emotion regulation, sexual arousal significantly and positively predicted sexual coercion likelihood in the positive affect condition. Sexual arousal did not significantly predict sexual coercion for men with above average emotion regulation. Findings may have implications for the assessment of individual risk for coercive sexual behavior as well as primary prevention efforts.

The differential effects of verbal sexual coercion and forcible sexual assault on alcohol use and consequence trajectories in the first year of college

OBJECTIVE

Verbal sexual coercion (VSC) is the most prevalent and pervasive form of sexual victimization that women experience, yet the long-term harmful effects of this type of experience are unknown. The current study examined the effects of verbal sexual coercion versus forcible sexual assault (FSA) on alcohol use and alcohol consequences, two deleterious outcomes that have been linked to sexual victimization.

METHOD

In a sample of college women (N = 649), lifetime history of VSC and FSA were examined as predictors of trajectories of alcohol outcomes with latent growth models. Participants were assessed at six timepoints over their first year of college, a critical transition period of increased risk for both alcohol use and trauma exposure. We also examined the influence of victimization characteristics, such as relationship to the perpetrator and revictimization experiences in these associations.

RESULTS

VSC experiences were predictive of higher levels of alcohol use and alcohol-related consequences (i.e., intercept). This risk was sustained throughout the first year of college. VSC experiences did not predict changes (i.e., slope) in alcohol outcomes over this time. In contrast, FSA was not predictive of either initial level or change in alcohol use and consequences over time.

CONCLUSION

Findings highlight the importance of distinguishing among types of coercive experiences, as they show unique associations with later harmful outcomes. Verbal sexual coercion, common in the lives of young women but often overlooked in the extant literature, is associated with substantial negative impact during the first year of college. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sexual Revictimization in College Women: Mediational Analyses Testing Hypothesized Mechanisms for Sexual Coercion and Sexual Assault

A precollege history of sexual victimization predicts revictimization during college, making it important to understand the mechanisms underlying the victimization-to-revictimization pathway. The study aimed to test whether heavy episodic drinking and personal and peer hookup norms mediate revictimization for two types of unwanted sexual contact: sexual coercion (attempted and/or completed sexual assault by the use of verbal coercion) and sexual assault (attempted and/or completed sexual assault by the use of force, threats, or incapacitation). At college entry, 483 first-year college women completed self-report measures of their precollege experiences, including history of sexual victimization and health behaviors (i.e., alcohol use, personal and peer hookup norms). At the end of the first and second semesters, they also completed measures assessing incident sexual victimization. Nearly one half of women (48%) reported an experience of attempted or completed sexual coercion or assault prior to entering college; 33% endorsed sexual coercion and 15% endorsed sexual assault in their first year of college. Structural equation models demonstrated that heavy episodic drinking and personal and peer hookup norms partially mediated revictimization for sexual assault, but not for sexual coercion. Sexual coercion was the most common tactic leading to unwanted sexual contact in this sample. Alcohol use and personal and peer hookup norms mediated revictimization by force, threats, or incapacitation. In contrast, the hypothesized mediators did not explain the revictimization pathway for verbally coerced assaults. Given the prevalence of sexual coercion, research needs to identify risk factors for verbal coercion to guide prevention efforts.

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.

An Event-Level Investigation of Factors Associated With Young Women's Experiences of Coerced Consensual Sex

Little is known about instances of coerced consensual sex in which women report both that they consented to have sex and that their partner used coercive tactics (e.g., made threats) to get them to have sex when they did not want to. Yet, these experiences are frequently reported by young sexually active women. We examined the relationship between sexual victimization history and the woman's level of alcohol intoxication in the likelihood of experiencing coerced consensual sex using event-level data collected over a 1-year period from 548 young adult nonproblem drinking women who engaged in sexual activity with men. Twenty percent (n = 112) reported at least one incident of coerced consensual sex. A generalized estimating equation model revealed main effects of daily estimated blood alcohol content (eBAC) and sexual victimization severity. The more women increased their alcohol consumption above their own average and the more severe their sexual victimization history, the more likely they were to experience coerced consensual sex. Our findings highlight the fact that coercion and consent are not mutually exclusive in some situations and shed light on this important yet understudied coercive sexual experience.

The Impact of Coercive Control on Use of Specific Sexual Coercion Tactics

There is substantial evidence that women experience unwanted sex under nonviolent duress from partners. This study examined the relationship between coercive control and sexual coercion in heterosexual couples. Among a sample of 136 men arrested for domestic violence, extent of coercive control was used to predict the likelihood of using eight specific sexual coercion tactics. Findings indicated that coercive control predicted significantly greater likelihood of using covert tactics, but not physically violent or overtly aggressive tactics. The tactics that demonstrated the strongest relationship with coercive control seem indicative of a toxic relational environment that may subtly erode victim autonomy and sense of self over time. Implications discuss how use of more covert and insidious tactics maintain invisibility, isolation, blame, and perceived complicitness of victims in clinical, legal, and social settings.

Adolescent Reproductive and Sexual Coercion: Measurement Invariance in a Population-Based Sample of Male and Female High School Students

PURPOSE

Though researchers have documented that adolescents are vulnerable to coercion focused on reproductive and sexual autonomy, measures to assess this type of coercion for both adolescent females and males have not been validated in a population-based sample.

METHOD

The present study used secondary data collected from high school students across Kentucky (n=16,137 from two independent samples in 2010 and 2014) to 1) determine if five items measuring adolescent reproductive and sexual coercion (ARSC) are appropriate for use among both females and males; and 2) estimate prevalence of identified ARSC factors by sex.

RESULTS

For both male and females, given measurement items, the results supported a two-factor model of ARSC comprised of 1) verbal relationship manipulation and 2) contraceptive interference. Measurement invariance by sex was also supported. Additional findings indicated the high prevalence of ARSC and its associated subscales. Approximately 4 in 10 females and 3 in 10 males reported experiencing ARSC in the previous year, with almost all of those reporting contraceptive interference also reporting verbal relationship manipulation.

CONCLUSIONS

Findings suggest verbal relationship manipulation and contraceptive interference (together forming ARSC) may restrict the autonomous sexual and reproductive decision-making of both female and male adolescents.

Using the Theory of Planned Behavior to Examine Beliefs About Verbal Sexual Coercion Among Urban Black Adolescents

This study used the theory of planned behavior to identify urban Black adolescents' beliefs about male-to-female verbal sexual coercion. Interviews were conducted with 91 urban, Black adolescents (53 boys and 38 girls) to identify their behavioral, normative, and control beliefs about verbal sexual coercion perpetration (for males) and resistance (for females). Boys reported that perpetrating verbal sexual coercion could result in negative relationship outcomes, and the main benefit of using this tactic was to obtain sex. Unsupportive peers and some male family members were seen as encouraging boys to use verbal sexual coercion, whereas parents were seen as opposed to the use of coercion. Being in a private context with a girl and having persuasive skill were seen as facilitating the use of coercion, whereas being with an experienced or skilled girl was a barrier. For girls, positive relationship outcomes and sexual health risks were the benefits and pitfalls of resisting verbal sexual coercion. "Real" friends and family were described as supporting girls' resistance to coercion, while "fake" friends, promiscuous girls, and male peers were seen as not supporting resistance. Girls believed being in a safe, public context would make it easier to resist coercion, while being in a stable relationship with an attractive and persistent partner would make it more difficult to resist. Knowing urban, Black adolescents' beliefs about verbal sexual coercion is the first step toward predicting and intervening on their perpetration and resistance behaviors.

Latent Profile Analysis of Alcohol Consumption and Sexual Attitudes Among College Women: Associations With Sexual Victimization Risk

This study used latent profile analysis (LPA) to identify at-risk profiles of college freshman women ( n = 481) using self-reports of alcohol consumption and sociosexuality. Analyses resulted in three profiles labeled low alcohol use-low sociosexuality, high alcohol use-medium sociosexuality, and high alcohol use-high sociosexuality. Baseline victimization predicted latent profile membership. More severely victimized women were more likely to be in the high alcohol-high sociosexuality profile than the high alcohol-medium sociosexuality and low alcohol-low sociosexuality profiles. At follow-up, the high alcohol-high sociosexuality profile had higher mean levels of victimization severity, relative to those in the high alcohol-medium sociosexuality and low alcohol-low sociosexuality profiles.

Exploring Definitions and Prevalence of Verbal Sexual Coercion and Its Relationship to Consent to Unwanted Sex: Implications for Affirmative Consent Standards on College Campuses

Campus sexual assault is a pervasive issue impacting the well-being, quality of life, and education of all students. There have been many recent efforts to prevent and address campus sexual assault, most notably the adoption of affirmative consent standards. (1) Efforts to address sexual assault on college campuses through an affirmative consent standard could be undermined by traditional gender norms, sexual scripts, and the power dynamics inherent in heterosexual relations, which lead to situations in which many women provide consent to unwanted sex. (2) Studies indicate that college women are likely to experience verbal sexual coercion, yet research has failed to come to a consensus on how to define, operationalize, and study verbal sexual coercion. (3) Research on sexual consent is also lacking, in particular as it relates to consent to unwanted sex as a result of the presence of verbal sexual coercion. (4) This article discusses how multiple forms of unwanted sex can be conceptually examined. (5) Policy implications and areas for future research are discussed.

Sex-related marijuana expectancies as predictors of sexual risk behavior following smoked marijuana challenge

Marijuana use has been associated with sexual risk behavior, but the mechanisms that underlie this relationship are not well understood. The present study examined whether marijuana acutely increased sexual risk on a behavioral decision-making task and whether sex-related marijuana outcome expectancies influenced sexual risk decisions after marijuana administration. Participants were heterosexual marijuana users (n = 126) who were randomly assigned to 1 of 4 study conditions using a 2 × 2 factorial design crossing drug administration (received 2.8% delta-9-tetrahydrocannabinol [THC] or 0% THC) with instructional set (told THC or told placebo). Participants completed a self-report measure of sex-related marijuana outcome expectancies at baseline and estimated likelihood of using condoms with a new and a steady partner in an interactive sexual role-play task (SRT) after smoking. In gender-specific analyses, there was a significant interaction of drug administration by sex-related outcome expectancies, such that for men in the received-placebo conditions, more salient sex-related marijuana outcome expectancies were associated with increased likelihood for sex without a condom with a new partner. Among women, there was no interaction or main effect of drug administration but more salient sex-related marijuana outcome expectancies were associated with increased likelihood of sex without a condom with a steady but not new partner. Findings suggest marijuana does not acutely increase risk for engaging in sexual risk behaviors. By contrast, sex-related marijuana outcome expectancies may play a more significant role in sexual decision-making process among marijuana users. (PsycINFO Database Record