Condom Avoidance through Sexual Aggression: Risky Sexual Behavior and Misogyny in a Community Sample of Men

Public health advocates have increasingly relied on encouraging condom use as a means of preventing the spread of HIV and other STI's. Women in heterosexual relations, however, are both more vulnerable to STI's and have less control over the use of condoms. Some men dislike condoms and will use a variety of means to avoid using them, up to and including physical force. Research has demonstrated that the use of sexually aggressive and coercive techniques and reluctance to wear condoms are related phenomena (Neighbors & O'Leary, 2003). Moreover, although studies have shown that sexual assault incidents often do not involve condom use (Davis et al., 2008), it is currently unknown to what extent some men may engage in sexually coercive or aggressive behaviors specifically to avoid condom use. The present study addresses this gap by proposing and testing a theory-based model to predict the use of condom avoidance through sexual aggression in a geographically broad community sample of adult men.

Methods:

Participants (N=289) were recruited through advertisements on Facebook and 29 different regional Craigslist websites. Participants were required to be between ages 18 and 35, unmarried, social drinkers and have histories of heterosexual relationships. Compensation was paid according to IRB approval for completion of the on-line survey. Condom avoidance through sexual aggression was measured using an adapted version of the revised Sexual Experiences Survey (Abbey et al., 2005) and assessed a variety of aggressive behaviors spanning coercion to physical force. Predictor variables were measured using established scales. Structural Equation Modeling was performed using Mplus 5.21 with robust standard errors to correct for non-normality.

Results:

100 participants (35.3%) reported at least one instance of coercion or aggression to avoid using a condom. The initial model tested had a poor fit; results suggested the removal of two nonsignificant paths and the addition of a path between sexual sensation seeking and risky sexual behavior. This final model had satisfactory fit (χ2 = 32.57, p = .01, CFI = 0.97, RMSEA = 0.06, SRMR = 0.03), and accounted for 37% of the variance of condom avoidance through sexual aggression. In this model, the significant effects of sensation seeking and condom displeasure attitudes were completely mediated through risky sexual behaviors and number of sexual partners. Misogyny maintained an independent association with condom avoidance through sexual aggression, and was significantly correlated with condom displeasure attitudes and sexual sensation seeking.

Conclusions:

Findings demonstrate that condom avoidance through the use of sexual aggression is not uncommon among this sample. This report provides the first published attempt to test a theoretically-based model of condom avoidance through sexual aggression, and demonstrates the predictive salience of sexual behaviors and misogyny for aggressive tactics to avoid condom use. This has important implications for prevention programming regarding both sexual aggression and unprotected sexual behavior. A better understanding of the attitudinal and behavioral pathways through which men avoid condom use through aggressive and coercive means will ultimately result in improved education and prevention efforts for at-risk men and women.