Associations of Sexual Victimization, Depression, and Sexual Assertiveness with Unprotected Sex: A Test of the Multifaceted Model of HIV Risk Across Gender

Abstract

This study examined whether the Multifaceted Model of HIV Risk (MMOHR) would predict unprotected sex based on predictors including gender, childhood sexual abuse (CSA), sexual victimization (SV), depression, and sexual assertiveness for condom use. A community-based sample of 473 heterosexually active men and women, aged 18–46 years completed survey measures of model variables. Gender predicted several variables significantly. A separate model for women demonstrated excellent fit, while the model for men demonstrated reasonable fit. Multiple sample model testing supported the use of MMOHR in both men and women, while simultaneously highlighting areas of gender difference. Prevention interventions should focus on sexual assertiveness, especially for CSA and SV survivors, as well as targeting depression, especially among men.

History of Sexual Abuse and Development of Sexual Risk Behavior in Low-Income, Urban African American Girls Seeking Mental Health Treatment

“…Mental health symptoms resulting from SA may represent an important mediating mechanism. A previous study found that reduced sexual assertiveness mediated the relationship between self-reported SA and unprotected sex in adult women (Morokoff et al, 2009), and similar characteristics might help to explain early sexual risk in adolescent girls. Other potential mediators include perception of sexuality as a way of forming or maintaining close relationships (Browning & Laumann, 1997) or obtaining material needs (Dunlap et al, 2003), a negative view of others and expectations for intimate relationships (Briere, 2002), or poor coping mechanisms (Briere, 2002;Senn et al, 2008).…”

The Influence of Violence Victimization on Sexual Health Behaviors and Outcomes

“…Given previous evidence suggesting associations between history of abuse and diminished sexual assertiveness, 28,44,45 we hypothesized that individuals who had experienced violence would be less likely to communicate with their partners about HIV and as a result less likely to practice consistent condom use. This was not the case among these respondents, however, as violence exposure was associated with greater sexual assertiveness (increased communication with partners), which was not in turn associated with condom use.…”

The Development of the Sexual Assertiveness Questionnaire (SAQ): A Comprehensive Measure of Sexual Assertiveness for Women

“…Most research related to sexual assertiveness has focused on the relationship between sexual assertiveness and condom use. Previous studies have found that higher sexual assertiveness is positively correlated with condom use for young adult women (Morokoff et al, 2009;Noar, Morokoff, & Harlow, 2002). In fact, even though alcohol intoxication is negatively correlated with condom use, higher levels of sexual assertiveness are associated with condom use in women regardless of intoxication level (Stoner et al, 2008).…”