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Characteristics and Mental Health Correlates of Nonconsensual Condom Removal Among Undergraduate Students
Alexis A Adams-Clark1,2, Lindy Howe3
1The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA.
Abstract:
Nonconsensual condom removal (NCCR), the removal of a condom during sexual activity without consent, is a common yet underrecognized form of sexual violence that occurs within broader systems of power, identity, and structural inequity. Although prior research links NCCR victimization to emotional distress, research examining identity-based disparities and a broader range of mental health correlates is needed. Among a sample of sexually active college students (N = 977), we investigated the prevalence of NCCR victimization and its association with gender and minoritized racial/ethnic and sexual identities. We also examined associations between NCCR victimization and symptoms of anxiety, depression, dissociation, sleep disturbance, sexual problems, and alcohol use. Among those reporting NCCR, we explored how incident characteristics (i.e. repeat victimization, relationship to perpetrator, unwanted pregnancy/STIs) were associated with distress. Overall, 18.2% experienced NCCR victimization, with higher rates among individuals with minoritized racial/ethnic identities compared to those with white/European identities. NCCR victimization was significantly associated with each mental health outcome, with effect sizes ranging from small (d = .34 for alcohol) to large (d = .70 for sexual problems). Associations between NCCR and symptoms of dissociation, sleep disturbance, sexual problems, and alcohol use remained statistically significant after controlling for sexual violence history. Incident characteristics were not generally associated with higher levels of mental health symptoms among those experiencing NCCR victimization, except for higher anxiety symptoms among participants who contracted an STI or became pregnant. Although cross-sectional, results suggest that NCCR victimization may have negative psychological consequences that warrant targeted prevention and intervention strategies.
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