TY - JOUR
T1 - A moderated mediation analysis of condom negotiation and sexual orientation on the relationship between sexual coercion and condom use in Chinese young women
T2 - Cross-sectional study
AU - Zhang, Wen
AU - Choi, Edmond Pui Hang
AU - Fong, Daniel Yee Tak
AU - Wong, Janet Yuen Ha
N1 - Publisher Copyright:
© Wen Zhang, Edmond Pui Hang Choi, Daniel Yee-Tak Fong, Janet Yuen-Ha Wong. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 19.01.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.
PY - 2021/1
Y1 - 2021/1
N2 - Background: The high prevalence of sexual coercion against young women has become a significant public health issue in China and other regions around the world. Young women are also especially vulnerable to engage in inconsistent condom use because of low sexual control. Although the relationship between sexual coercion and condom use has been widely demonstrated, the mechanism of this relationship is still unclear. Objective: The objective of this study was 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 is a moderator. Methods: Data were collected using web-based questionnaires and a total of 402 young Chinese women were included in the analysis. Sexual coercion was measured using a subscale of the Revised Conflict Tactics Scales and condom negotiation was measured using a subscale of the UCLA Multidimensional Condom Attitudes Scale. Sexual orientation was assessed using an item adopted from a previous study and condom use was calculated by the total number of times condoms were used divided by the total number of times sexual intercourse was engaged in during the past 3 months. 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 moderated mediation analysis indicated that the relationship between sexual coercion and condom use 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 CI -1.67 to -0.36) but not in sexual minority women (indirect effect: -0.33, 95% boot CI -0.86 to 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.
AB - Background: The high prevalence of sexual coercion against young women has become a significant public health issue in China and other regions around the world. Young women are also especially vulnerable to engage in inconsistent condom use because of low sexual control. Although the relationship between sexual coercion and condom use has been widely demonstrated, the mechanism of this relationship is still unclear. Objective: The objective of this study was 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 is a moderator. Methods: Data were collected using web-based questionnaires and a total of 402 young Chinese women were included in the analysis. Sexual coercion was measured using a subscale of the Revised Conflict Tactics Scales and condom negotiation was measured using a subscale of the UCLA Multidimensional Condom Attitudes Scale. Sexual orientation was assessed using an item adopted from a previous study and condom use was calculated by the total number of times condoms were used divided by the total number of times sexual intercourse was engaged in during the past 3 months. 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 moderated mediation analysis indicated that the relationship between sexual coercion and condom use 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 CI -1.67 to -0.36) but not in sexual minority women (indirect effect: -0.33, 95% boot CI -0.86 to 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.
KW - Online research
KW - Sex offenses
KW - Sex orientation
KW - Unprotected sex
KW - Women's health
UR - http://www.scopus.com/inward/record.url?scp=85100251992&partnerID=8YFLogxK
U2 - 10.2196/24269
DO - 10.2196/24269
M3 - Article
C2 - 33464220
AN - SCOPUS:85100251992
VL - 7
JO - JMIR Public Health and Surveillance
JF - JMIR Public Health and Surveillance
IS - 1
M1 - e24269
ER -
