Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 11, 2020
Date Accepted: Nov 16, 2020
Sexual coercion and condom use: A moderated mediation model of condom negotiation and sexual orientation in young women
ABSTRACT
Background:
Sexual coercion against young women is a global public health problem. Although the relationship between sexual coercion and condom use consistency has been widely demonstrated, the mechanism of this relationship is still unclear.
Objective:
To test condom negotiation as a mediator of the relationship between sexual coercion and condom use in young Chinese women and to investigate whether sexual orientation was a moderator.
Methods:
A total of 402 young Chinese women were included in the analysis using a web-based questionnaire. Moderated mediation analyses were conducted with sexual coercion as the independent variable, condom use consistency as the dependent variable, condom negotiation as the mediator variable, and sexual orientation as a moderator.
Results:
The results of a moderated mediation analysis indicated that this relationship was significantly mediated by condom negotiation and moderated by sexual orientation. The indirect effect of condom negotiation was significant in heterosexual women (indirect effect:-0.80, 95%Boot-confidence interval(CI): -1.67, -0.36) but not in sexual-minority women (indirect effect: -0.33, 95%Boot-CI: -0.86, 0.31).
Conclusions:
The results showed that sexual orientation meaningfully affects the relationship between sexual coercion and condom negotiation. The difference in the mechanism of the relation between sexual coercion and sexual behaviors in heterosexual and sexual minority women should be considered for future research and interventions aimed at mitigating the adverse effects of sexual coercion.
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