Receipt of Coercive Condom Use Resistance: A Scoping Review

Abstract

Condom use resistance (CUR) refers to practices used to obtain unprotected sex with a partner who wishes to use a condom. Coercive CUR is a manipulative and aggressive form of CUR, which is associated with detrimental mental, physical, and sexual health consequences. This review synthesizes quantitative evidence on the prevalence and correlates of experiencing coercive CUR. A systematic approach, including title, abstract, and full-text review, was used to identify relevant empirical studies. Thirty-seven articles met the inclusion criteria. Prevalence of experiencing coercive CUR ranged from 0.1% to 59.5%. Significant correlates of receiving coercive CUR included interpersonal violence, sexually transmitted infection (STI) diagnosis, emotional stress, and drug use. Importantly, vulnerable populations (e.g., racial/ethnic minority, men who have sex with men, sex workers) and people with low perceived control and resistive efficacy (i.e., the ability to say “no”) had an increased likelihood of experiencing coercive CUR. Methodological weaknesses in the current literature include a lack of longitudinal studies and studies that examine the effectiveness of interventions, as well as failure to use consistent measures and include samples of men and sexual minorities. Future research should address these limitations. Intervention and prevention strategies should prioritize populations that are at greater risk for experiencing coercive CUR to achieve better health equity outcomes.

Introduction

Sexually transmitted infections (STIs) are a serious public health issue. Approximately one in five Americans has an STI, and STIs total nearly 16 billion dollars in direct medical costs per year (Centers for Disease Control and Prevention [CDC], 2021a). Unintended pregnancies were also prevalent, with an estimated 45% of pregnancies being unintended (CDC, 2021b). Due to the recent overturn of Roe vs. Wade in the U.S., and the particularly high projected mortality rates associated with being denied legal abortions among non-Hispanic Black and Hispanic women, prevention of unintended pregnancy is of utmost importance (Stevenson, 2021). Consistent and correct use of male condoms is an effective way to prevent both STIs and unintended pregnancies (CDC, 2022). However, many individuals do not use condoms consistently or correctly: Data from a nationally representative survey conducted in the U.S. found that only 23.8% of women and 33.7% of men aged 15–44 used a condom during their last intercourse (Copen, 2017). Another U.S. national survey indicated that there was a decline in condom use from 2002 to 2011–2017 among men with high STI risks (Copen et al., 2022). Condom use resistance (CUR) is a common practice to avoid using a condom with a partner who wishes to use one (Davis et al., 2014a), with some studies in the U.S. showing that up to 86.6% percent of heterosexual, high-risk, young women have experienced CUR, and 80% of heterosexually active men have successfully engaged in CUR tactics (Davis, et al. 2014b. Davis et al., 2019).

CUR tactics can be categorized into non-coercive and coercive tactics. Non-coercive tactics include claiming reduced sensation associated with condom use and directly requesting not to use a condom. Coercive CUR violates one’s agency to make consensual sexual health and reproductive decisions by means of threats and violence (Davis et al., 2018). Coercive tactics involve manipulative and aggressive behaviors, such as emotional manipulation and physical threats, to obtain unprotected sex (Davis et al., 2018). Resistance to condom use is not only of great concern because it leads to increased risk for STIs and unintended pregnancies but also because the experience of receiving CUR, particularly CUR that involves coercion, is associated with serious mental health consequences such as stress and anxiety among MSM (Latimer et al., 2018). Thus, understanding the experiences and characteristics of individuals who experience coercive CUR from their sexual partners is crucial to identify those at the highest risk of experiencing coercive CUR and associated health consequences. It is important to provide these individuals with supportive and educational interventions such as STI screening, sexual health education, condom negotiation skills training, etc. to reduce their coercive CUR risks and associated health consequences. That noted, the responsibility for coercive CUR lies with those who perpetrate these behaviors, and ultimately, prevention efforts must focus on reducing coercive CUR perpetration.

Coercive Condom Use Resistance

This review focuses on acts of coercive CUR, which refer to the use of manipulative or aggressive tactics that interfere with another person’s agency to make consensual sexual decisions regarding condom use. Specifically, coercive CUR tactics include emotional manipulation (e.g., telling a partner that using a condom would make one angry), deception (e.g., pretending not to have an STI), physical force (e.g., threatening or using physical force to hurt one’s partner if they insist on using a condom), condom sabotage (e.g., purposefully breaking the condom), and stealthing (e.g., removing a condom without the partner’s knowledge or consent), to avoid condom use (Davis et al., 2018; Davis et al., 2019). Experiencing coercive CUR from a sexual partner is relatively common among women and men who have sex with men (MSM) in Australia (Latimer, 2018). Additionally, in a study of 503 high-risk heterosexual young women in the U.S., 48.9% had experienced coercive CUR, with 28.4% of women reporting having experienced emotional manipulation, 27.2% having experienced deception, 12.2% having experienced stealthing, 11.8% having experienced physical force, and 2.6% having experienced condom sabotage (Davis et al., 2019).

Studies vary regarding the examined contexts in which coercive CUR occurs. One subsection of the literature has studied coercive CUR without stipulating motives underlying the perpetrator’s behavior. Although those studies do not specifically assess the perpetrators’ motivation, coercive CUR may be initiated because of a dislike for condoms or a desire to “feel good”. In fact, previous work conducted in the U.S. has identified decreased penile sensation as a major factor that influenced young, heterosexual men’s decision to resist condom use in casual sexual encounters (Davis et al., 2014a). Other studies have investigated coercive CUR strategies within the context of controlling reproductive outcomes. Known as “reproductive coercion” (RC), this phenomenon describes instances in which a male perpetrator is motivated to intentionally control female reproductive outcomes such as pregnancy (Tarzia et al., 2020). Notably, RC involves a range of controlling behaviors that include, but are not limited to, condom non-use. For example, partners may limit access to reproductive healthcare or birth control (Miller et al., 2014). Thus, coercive CUR focuses on behaviors to resist condom use without specifying motivations, while RC focuses on the intention to control reproductive outcomes through a range of behaviors. That noted, there is some overlap between these phenomena (Figure 1). For example, and as illustrated in the center portion of Figure 1, some RC strategies, such as intentionally breaking condoms with the specific goal of controlling reproductive health outcomes (Grace & Anderson, 2016), involve elements of both coercive CUR (i.e., condom avoidance behaviors) and RC (i.e., reproductive control motives).

Figure 1.

Conceptual Differences Between Coercive CUR and RC.

Negative Consequences of Coercive Condom Use Resistance

While both partners involved in coercive CUR may experience negative consequences (e.g., STI transmission), the health and well-being of individuals on the receiving end tend to be impacted more severely. Specifically, compared to women who have never experienced coercive CUR, women who have received coercive CUR are more likely to have poor sexual health outcomes such as STI diagnoses and unplanned pregnancies (Davis et al., 2019; Miller et al., 2014a). Additionally, experiencing coercive CUR is associated with negative mental health consequences. For example, the feeling of being bothered, disrespected, or experiencing fear, anger, and upset were reported following experiencing stealthing by a Canadian sample of undergraduate students (Czechowski et al., 2019) and Australian women attending a women’s health clinic (Tarzia et al., 2020). Women who experience stealthing also report decreased ability to maintain control in sexual encounters and lower confidence in resistive efficacy (i.e., the ability to say “no” to unwanted sexual advances; Boadle et al., 2021). MSM report significantly higher rates of anxiety and depression after experiencing stealthing (Latimer et al., 2018). Finally, receiving coercive CUR is associated with being a victim of physical and psychological interpersonal violence and sexual assault among Canadian undergraduate students (Czechowski et al., 2019) and women attending community college in the United States (Orchowski et al., 2020).

Purpose of this Review

Current evidence suggests that coercive CUR is not only common but is also associated with a multitude of physical, sexual, and psychological health concerns that present serious threats to public health and individual well-being. However, there are currently no intervention efforts that address coercive CUR recipients’ unique psychological and physical health consequences, prevention efforts for coercive CUR. A review that critically synthesizes the evidence on coercive CUR is essential in informing such efforts. However, to our knowledge, there are currently no review articles that focus on coercive CUR experiences. Given the complexity of the issue, the seriousness of associated consequences, and the nascency of the field, a scoping review that critically synthesizes in-depth and broad evidence (Arksey & O’Malley, 2003) is essential in guiding prevention, intervention, and policy efforts for recipients of coercive CUR. Additionally, a scoping review is appropriate for answering exploratory research questions in an emerging field and identifying existing gaps in knowledge (Munn et al., 2018). Therefore, the current scoping review focuses on research that examines experiences among recipients of coercive CUR. We applied a systematic approach to provide an overview of the current extent of the literature, with the goal of identifying potential gaps and informing future research and prevention efforts to reduce coercive CUR and its negative effects. This review includes articles examining coercive CUR that stipulate reproductive control motivations and those that do not, in order to identify differences in samples and consequences, which will be useful for guiding specific intervention and prevention efforts to reduce the incidence of coercive CUR. Additionally, including both types of articles allowed us to draw from the largest possible amount of data on CUR prevalence and correlates.

Method

Stages of Scoping Review

A systematic approach was used to comprehensively examine the literature on recipients’ experiences with coercive CUR. The current scoping review consisted of five stages: (1) establishing a research question and eligibility criteria, (2) identifying relevant studies, (3) selecting relevant studies, (4) charting data, and (5) organizing and summarizing data. Details on each stage are described below.

Establishing a Research Question and Eligibility Criteria

The research question guiding the key concepts in this review and the scope and focus of our literature search was: What is known about the prevalence, predictors, and consequences examined in the current literature on the receipt of coercive CUR? Given our focus on the prevalence and predictors of coercive CUR, only quantitative data were included in this review. Eligible articles included peer-reviewed studies in English examining empirical, quantitative data focused on the self-reported experiences of individuals who received coercive CUR. Articles that (a) were not peer-reviewed, (b) were not journal articles (i.e., conference abstracts etc.), (c) focused solely on experiences of coercive CUR perpetration, (d) asked questions solely on perceptions of or attitudes about coercive CUR receipt, (e) were review articles, (f) included only qualitative data, and (g) did not specifically examine coercion regarding condom use (e.g., did not separate coercive CUR tactics from other coercive behaviors [such as limiting access to reproductive health care; throwing away birth control pills]) were excluded from the current review. Due to the limited research on this topic, there were no limitations with regards to population or time of publication.

Identification of Relevant Studies

A literature search was conducted by reviewing the following databases: Cumulative Index of Nursing & Allied Health Literature (CINHAL), PsycInfo, and PubMed. The following terms were used to search for relevant articles across each database using ‘OR’ as conjunctions: “coercive condom use resistance,” ”birth control sabotage,” “condom coercion,” “stealthing,” “condom sabotage,” “nonconsensual condom removal,” “reproductive coercion,” “male partner contraceptive interference,” “condom manipulation,” “reproductive control,” “coercion to obtain unprotected sex,” “pregnancy coercion,” “unwanted unprotected sex,” “protection deception,” “condom use resistance,” “coerced unprotected sex,” and “contraceptive sabotage”.

Selection of Studies

Selection of articles followed a systematic process, including a title and abstract review, followed by a full-text review. Study titles, year of publication, and author names were entered into a spreadsheet. Zotero reference management software was used to store articles and remove duplicates. All five authors were involved in the study selection process. At each stage of study selection, articles were evenly distributed among four authors such that at least two researchers were assigned to review each article for inclusion independently. Any inconsistencies in decision-making were brought forward to a discussion with the fifth author.

Title and abstract review.

A total of 610 articles were identified in the literature search of the three databases. Of these articles, 159 duplicates were removed manually and using the duplicate detection function in Zotero. The 451 remaining article titles and abstracts were screened for eligibility based on their relevancy to the research question. Articles were excluded due to absence of any reference in the title or abstract to condom non-use (n = 231), did not examine coercive CUR receipt (i.e., articles were focused on coercive CUR perpetration) (n = 15), did not contain empirical evidence (n = 12), were reviews (n = 18), authors were unable to access the full text (n = 7), were dissertations (n = 2), were a corrigendum (n = 1), focused on perceptions of CUR instead of CUR experiences (n = 4), leaving 161 articles for the full-text review.

Full-text review.

Of the 161 remaining articles, articles were removed because their full texts indicated that they lacked quantitative data measuring coercive CUR (n = 124). Articles were brought forward for a team discussion with the last author if uncertainty occurred. The remaining 37 articles were included in this scoping review (see Figure 2).

Figure 2.

PRISMA Flow Diagram Outlining Identification, Screening, and Inclusion of Article

Extracting the Data

To identify key findings, data extracted from the remaining 37 articles were charted by two authors using an Excel spreadsheet. The following information was extracted: study design, study population, recruitment criteria, operationalization of coercive CUR, and key findings. Study design presents the methods of the investigation and study population includes sample size, demographic information, and mean and standard deviation of age. Recruitment criteria provides information regarding study inclusion and exclusion criteria. Operationalization includes specific key terms and measurement of coercive CUR behavior or intentions.

Organizing and Summarizing Data

Articles were sub-divided into two categories based on whether the article assessed coercive CUR experiences that were motivated by reproductive control or did not stipulate perpetrator motive. Twenty-eight articles examined coercive CUR as strategies to control a partner’s reproductive outcomes and nine articles focused on coercive CUR without stipulating the perpetrator’s motivation.

Results

The present review identified 37 quantitative research articles examining recipients’ experiences of coercive CUR behavior. Publication dates spanned exactly one decade, from 2011 to 2021, with the majority of articles (n = 23) being published after 2017. Of the identified articles, all utilized a cross-sectional design. Items from the Reproductive Coercion Questionnaire (e.g., “Has someone you were dating or going out with made you have sex without a condom so you would get pregnant?” and “Has someone you were dating or going out with taken off the condom while you were having sex, so you would get pregnant?”; Miller et al., 2007, 2010, 2011, 2014, 2016) were used in 16 studies. Six studies assessed coercive CUR via items adapted from a combination of measures, including items from the Reproductive Coercion Questionnaire along with items from Clark et al. (2014), Dick et al. (2014), Kazmerski et al. (2015), McCauley, Dick, et al. (2014), McCauley et al. (2017), and Moore et al. (2010). Other studies involved the Condom Use Resistance Tactics Scale, which asks participants how often a sex partner has avoided using a condom when they wanted to use one and what tactics the sex partners used to avoid condom use (Davis et al., 2014, n = 2), items adapted from McCauley et al. (2017, n = 1), or author-generated items (n = 3). Six studies did not report the source of their items or measure.

The vast majority of articles included in this review (n = 32, 86.5%) used exclusively female samples. Five articles (Basile et al., 2019; Bonar et al., 2019; Czechowski et al., 2019; Latimer et al., 2018; Willie et al., 2019) included samples that were comprised of both male and female participants. The samples in this review included participants with average ages in their teens (13 studies recruited participants younger than 18 years-old), twenties, thirties, and forties. However, most articles (n = 24, 64.9%) included participants whose ages were in the teens and twenties.

Articles Examining Coercive CUR with Reproductive Control Motives

Overview of articles.

The majority (n = 28) of articles included in this review assessed coercive CUR through items that stipulated that the perpetrator’s motivation was to control reproductive outcomes (i.e., RC). Two of the 28 articles recruited participants who were currently in a steady relationship (Anderson et al., 2017; Wood et al., 2020); the other 26 articles did not have recruitment criteria pertaining to relationship status. The RC samples included in this review ranged broadly in size (from N = 21 [Lévesque & Rousseau, 2019; Sutherland et al., 2014] to N = 41,174 [Basile et al., 2019]) and composition (e.g., community, clinical, and college student samples of adults and teenagers), and were diverse with regards to race and ethnicity, although most articles focused on the experiences of female young adult recipients. The methodology used included cross-sectional surveys, and the majority of studies were situated in the United States (n = 30, 81%).

Coercive CUR prevalence rates identified in articles.

The most commonly assessed coercive CUR behaviors to control reproductive outcomes asked whether a partner “made you have sex without a condom,” “took off the condom while you were having sex,” “broke a condom on purpose while you were having sex,” and “put holes in the condom” with the intention of increasing pregnancy likelihood. Prevalence rates of coercive CUR receipt ranged from 0.1% (“put holes in condom so you would get pregnant”; Sutherland et al., 2015) to 59.7% (“male partner removed condom during sex”; Alexander et al., 2016). However, comparison of prevalence rates across articles should be done with caution as the studies included in this review did not all assess the same acts of coercive CUR (e.g., some articles focused on breakage while other focused on condom removal). Additionally, some studies collapsed across multiple types of CUR behaviors when providing prevalence statistics (e.g., by combining condom removal and breakage items) while others reported on rates of individual behaviors.

Coercive CUR correlates identified in articles.

Of these 28 articles, 27 collapsed across different forms of coercive CUR behaviors (i.e., including acts of birth control sabotage and pregnancy coercion) when conducting inferential data analyses. Thus, conclusions about coercive CUR receipt specifically as it relates to other predictors and outcomes in these 27 articles cannot be drawn. The article that provided specific inferential statistics on coercive CUR behavior studied ethnic differences, showing that in their sample, women and men who identified as Non-Hispanic Black (11.7% and 7.5%) or Hispanic (8.2% and 6.1%) were more likely to report lifetime experiences of condom refusal than Non-Hispanic White women and men (5.0% and 2.1%) (Basile et al., 2019). Other studies included in this review that collapsed across behaviors (e.g., Holliday et al., 2017) also showed particularly high risk of experiencing coercive CUR within the context of RC among Black and Multiracial groups.

Articles Examining Coercive CUR Receipt without Reproductive Control Motives

Overview of articles.

Nine of the articles included in this review examined the receipt of coercive CUR, including stealthing and other coercive techniques, without the stipulation that perpetrators were intending to control reproduction outcomes through their behavior. None of these nine studies required participants to be in a steady relationship. Eight studies were survey-based and one included interviews; All were cross-sectional. Samples were collected in Australia, New Zealand, the U.S., and Canada and included college student, community, sex worker, and clinical samples. CUR receipt in these articles was defined as reporting that one’s partner used physical force, deception, or other forms of coercion to avoid using a condom during intercourse. In addition to examining experiences of coercive CUR receipt among women, three of the studies (Bonar et al., 2019; Czechowski et al., 2019; Latimer et al., 2018) included MSM.

Coercive CUR prevalence rates identified in articles.

Prevalence of experiencing different coercive CUR tactics was high, ranging from 39.9 to 87%; Prevalence of the receipt of nonconsensual condom removal (NCCR) or “stealthing” ranged from about 5% to 34%. In the studies that included MSM, receipt of stealthing behaviors tended to be higher among women than among men (e.g., 18.9% vs 5.0%, Bonar et al., 2019; 32.0% vs 19.0%, Latimer et al., 2018). Studies with sex workers showed relatively high rates of condom coercion from clients as compared to non-paying partners (see Decker et al., 2020).

Coercive CUR correlates identified in articles.

The results of studies included in this review indicated that certain factors were associated with increased risk for experiencing coercive CUR from a partner, including racial/ethnic minority status. Among young adults in the U.S., non-Hispanic Whites were significantly less likely to eceive stealthing compared to other race/ethnicities (OR = 0.28, CI: 0.16, 0.49, p <.001) (Bonar et al., 2019). Female sex workers of Hispanic or other race were significantly more likely to receive condom coercion and inconsistent condom use compared to non-Hispanic White female sex workers (AOR = 1.86, CI: 0.73, 4.73, p < .05) (Decker et al., 2020). Additionally, women who reported experiencing stealthing were more likely to be current sex workers compared to those who had never reported experiencing stealthing (AOR= 2.87, CI: 2.01, 4.11, p <.001) (Latimer et al., 2018). Receiving coercive CUR was also correlated with other forms of interpersonal violence. For example, in Czechowski et al.’s 2019 study, half of the participants who reported experiencing non-consensual condom removal also reported experiencing sexual abuse. Also, more experiences with receiving coercive CUR was associated with a more severe history of experiencing sexual assault among women in the U.S. (B = 0.027, IRR = 1.03, CI: 1.02, 1.04) (Davis et al., 2019). Female sex workers who experience condom coercion are more likely to experience intimate partner violence compared to those who did not experience condom coercion (AOR = 3.01, CI: 1.05, 8.63, p <.001) (Decker et al., 2020). Receiving coercive CUR is also associated with alcohol and drug use. Compared to those who had never experienced stealthing, experiencing stealthing is associated with binge drinking (OR = 1.39, CI:1.12, 1.73, p <.01), cannabis use (OR = 1.37, CI:1.17, 1.60, p < .001), and illegal drug use (OR = 1.43, CI:1.07, 1.91, p < .05) (Bonar et al., 2019). Female sex workers who had experienced condom coercion were more likely to be intoxicated during sex (AOR = 4.09, CI: 0.35, 4.37, p < .01) (Decker et al., 2020). The majority (73%) of women who reported being stealthed were under the influence of drugs and alcohol during sex (Latimer et al., 2018).

Moreover, experiencing coercive CUR from a sexual partner was associated with a number of negative outcomes. For example, Latimer et al. (2018) identified that MSM who had experienced coercive CUR were more likely to report mental health concerns such as anxiety and depression (AOR 2.13, 95% CI: 1.25, 3.60, p = .01) as compared to those who had not experienced coercive CUR. Boadle et al. (2021) found that women who had experienced coercive CUR perceived that they had less control (U = 6,700.50, p = .05) and were less able to say “no” (termed “resistive efficacy”) during sexual encounters (U = 6,797.50, p = .04) than women who had not experienced coercive CUR. Finally, compared to women who reported not receiving CUR, women who reported receipt of coercive CUR were more likely to have ever been diagnosed with an STI (χ2 = 19.54, p < .001) (Davis et al., 2019).

Discussion

The current scoping review identified 37 articles that examined experiences of coercive CUR receipt; 28 articles studied coercive CUR motivated by the perpetrator wanting to control reproductive outcomes, and nine articles studied coercive CUR without reproductive control stipulations. Findings confirmed that coercive CUR receipt – independent of whether the motivation to control reproductive outcomes was stipulated – is relatively common (Davis et al., 2019) and is associated with multiple negative psychological and physical health consequences (Latimer et al., 2018). Moreover, our review suggests that certain demographic groups, such as racial/ethnic minorities, women, and MSM, may be at particularly high risk for experiencing coercive CUR from a sexual partner.

The majority of articles included in this review (n = 28) focused on contexts in which coercive CUR was used to control reproductive outcomes. Here, prevalence of coercive CUR ranged from 0.1% to 59.6%, with condom sabotage being the least common and condom manipulation being the most common coercive CUR tactic (Sutherland et al., 2015; Wood et al., 2020). Moreover, receiving coercive CUR in the context of RC was more prevalent among Black or Hispanic women and Black men (Basile et al., 2019). However, because most studies in this review that studied coercive CUR within the context of RC did not examine inferential statistics specific to coercive CUR, the underlying mechanisms that may help explain these racial disparities are unclear.

Among the articles that examined coercive CUR without the stipulation of reproductive control, prevalence rates ranged from 1.7% to 53%, which was similar to the prevalence of coercive CUR used to control reproductive outcomes. Overall, prevalence rates of receiving coercive CUR appeared higher among women as compared to MSM. Significant correlates of coercive CUR receipt included having experienced interpersonal violence, having been diagnosed with an STI, experiencing emotional stress, and using drugs. Importantly, vulnerable populations, such as sex workers and individuals who identified as racial/ethnic minorities, were more likely to experience coercive CUR. Low perceived control and resistive efficacy (i.e., the ability to say “no”), law involvement, and lack of awareness of PrEP were also associated with experiencing coercive CUR. It is possible that perpetrators of coercive CUR intentionally seek out individuals from vulnerable populations. It is also possible that individuals from vulnerable groups are more likely to experience lower self-esteem and assertiveness than those in less vulnerable groups; these characteristics have been identified as risk factors to experiencing sexual coercion (Testa & Dermen, 1999). Moreover, vulnerable populations’ sexual and reproductive health rights can be impacted by upstream factors such as stigma, cultural and linguistic impediments, poor economic conditions, etc. (Egli-Gany et al., 2021). It is possible that such systemic and social factors increase the risks of experiencing coercive CUR in some populations. Future research should examine the underlying individual mechanisms as well as social and systemic inequities that contribute to potential coercive CUR risk disparities.

Some notable distinctions emerged between articles that examined coercive CUR within and outside of the context of reproductive control: All but one of the articles that examined coercive CUR with the motive to control reproductive outcomes collapsed across different control tactics, preventing us from drawing conclusions about the effects of specific coercive CUR tactics. On the other hand, articles that examined coercive CUR outside of the context of reproductive control lacked information on the specific motivations for CUR behaviors, opening questions about the goals underlying perpetrators’ behaviors. Such goals may overlap with the goals of RC (i.e., controlling reproductive outcomes) or may be quite different, such as a dislike for condoms and hopes for increased sexual pleasure (Lévesque et al., 2021; Tarzia et al., 2020), or other intentions not yet studied in the current literature such as power or dominance. Importantly, studying behavioral motivations from the perspective of a recipient is challenging, as the recipient may not know why their sexual partner acted the way they did. As such, future research should investigate motivations for coercive CUR from both the recipient’s and the perpetrator’s perspectives.

Gaps in the Current Literature and Future Directions

The current review uncovered some notable gaps in the literature on coercive CUR receipt that could be addressed in future research. First, all identified studies in this review employed cross-sectional designs, preventing us from drawing causal conclusions and assessing the long-term effects of coercive CUR receipt. Future studies could consider employing longitudinal designs to investigate the long-term consequences of experiencing coercive CUR. Second, there is a lack of consistency in the measures used to assess receipt of coercive CUR across studies, making it difficult to compare prevalence statistics and to draw conclusions. The majority of the studies in this review utilized items from the Reproductive Coercion Questionnaires (Miller et al., 2007, 2010, 2011, 2014, 2016) to measure the receipt of coercive CUR, followed by items from the Condom Use Resistance Scale (Davis et al., 2014b). Whereas RC questionnaires typically stipulate the perpetrator’s motives for engaging in RC (i.e., impregnating their partner), other CUR measures do not include perpetrator motivation as part of the assessment. Additionally, measures of coercive CUR did not explicitly clarify whether coercion was involved. Some less aggressive tactics that are noncoercive (e.g., complaining about decreased penile sensation associated with condom use) could become coercive if they are used frequently to pressure a partner who does want to use a condom. This lack of focus on underlying motivations and coercion might result in inconsistent results regarding the prevalence and negative consequences associated with experiencing coercive CUR. Future research would benefit from agreeing on consistent, gold-standard measures to better capture the experiences of receiving coercive CUR. Qualitative research will also be helpful in obtaining more nuanced insights about experiences of coercion and contexts of CUR. Third, there is a lack of data on the relationship contexts in which coercive CUR occurs. Only two of the 28 studies that examined coercive CUR in the context of reproductive control required participants to be in a steady relationship and none of the studies that examined coercive CUR more generally reported the relationship status in which coercive CUR occurs. Future research that investigates the prevalence and correlates of coercive CUR in different relationship contexts is needed to develop effective individual and dyadic intervention and prevention efforts. Fourth, we did not identify any studies examining the effectiveness of coercive CUR interventions. Such programs might decrease the incidence of CUR and its negative health consequences. Future studies aimed at developing and testing prevention and intervention strategies may prove beneficial. Lastly, although the studies we identified recruited samples from diverse geographical locations and racial/ethnic backgrounds, most studies collapsed ethnic and racial data and did not specifically examine how cultural factors impact the receipt of coercive CUR. Future research could consider examining cultural factors to better inform policy and educational interventions. The majority of studies in this review (33 out of 37) only recruited cisgender women; the experiences of men who experience coercive CUR are less researched. Although receiving CUR is more prevalent among women, some men (especially MSM) also experience coercive CUR (Latimer et al., 2018; Bonar et al., 2019). Similarly, CUR among sexual and gender minority individuals, who experience high rates of sexual assault (Stotzer, 2009; Rothman et al., 2011), is understudied. Future research could consider recruiting men, non-binary, and transgender individuals to examine their experiences.

Limitations of this Review

This review was not without limitations. Given the nature of scoping reviews, we did not include a quality assessment in our screening process (Arksey & O’Malley, 2003). Researchers could consider conducting a systematic literature review that includes an assessment of both quality and bias of published studies. Although the current inclusion and exclusion criteria were chosen carefully, with the overarching aim of composing a succinct yet comprehensive summary of the current literature on coercive CUR receipt, some of these criteria may have prevented us from assessing additional information. For example, we only included studies that were published in English, likely limiting our ability to draw conclusions about coercive CUR experienced in countries where English is not the primary language. Additionally, due to our focus on prevalence rates and correlates of coercive CUR experiences, we only included studies that used quantitative data; Studies that were exclusively qualitative in nature were excluded from this review. This exclusion might limit our ability to explore the meaning and experiences of individuals who have experienced coercive CUR in greater depth. Although not the focus of the current review, future reviews could consider including studies published in languages other than English and analyzing qualitative data to address these limitations.

Implications and Conclusions

This scoping review demonstrates that experiencing coercive CUR is a prevalent phenomenon that is associated with numerous negative consequences. Although additional research delineating the mechanisms underlying coercive CUR receipt and its sequelae is needed, existing research provides initial guidance for clinicians and policy makers. Prevention and intervention efforts may benefit from targeting populations that experience coercive CUR at disproportionate rates, such as women, individuals who identify as racial or ethnic minorities, sex workers, and MSM. In addition, the current review highlights associations between coercive CUR receipt and interpersonal violence, drug use, and mental health concerns. Thus, interventions aimed at preventing coercive CUR have the potential to result in far-reaching public health effects, including benefits to both physical and psychological wellbeing.

Coercive CUR strips victims of their sexual and reproductive agency. Given the overturn of Roe vs. Wade in the U.S. and other global challenges to reproductive rights, coupled with poor sexual health outcomes such as STI transmission, continued legislative efforts to codify various forms of coercive CUR as illegal and subject to civil penalties are warranted. Moreover, it is essential for future research in this field to identify mechanisms underlying coercive CUR perpetration in order to create evidence-based interventions that reduce coercive CUR and ultimately improve the sexual and reproductive health of sexually active individuals.

Table 1.

Methodology, Sample Information, and Key Findings of Included Studies Focused on Victims’ Experiences.

Study Authors (Year)	Design	Study Population (Country of recruitment, Sample Size, Demographics, Age)	Recruitment Criteria	Operationalization of Coercion During Condom Negotiation	Key Findings
Articles that Examined Coercive CUR with Reproductive Control Motives
Alexander et al. (2016)	Cross-sectional survey	U.S. N=149 women. 100% Black. M(age)=21.3, SD=2.1	Women who reported sexual activity with a man in the previous 6 months	Lifetime experiences of RC measured by 10-item Reproductive Coercion Scale (Miller et al., 2011);	Of the 57 participants who endorsed at least one RC, 59.6% (21 WSM and 13 WSWM) reported that a male partner removed their condom during sex.
Anderson et al. (2017)	Cross-sectional survey	U.S. N=67 women. 79.1% Black, 9% White, 3% Native American, 4% Other/multiple, 3% Unknown. Median(age)=41.0	Women aged 18 and older who had been in a relationship for at least 1 year recruited from an HIV specialty clinic in Baltimore, MD	Past-year experiences of RC measured by 9-item instrument assessing Reproductive Coercion developed for use in family planning clinic (Miller et al., 2010; Miller et al., 2011)	Taken off the condom while having sex (9.0%). Put holes in the condoms (6.0%). Broken a condom on purpose while having sex (4.5%). Made you have sex without a condom (7.5%).
Basile et al. (2018)	Cross-sectional survey	U.S. N=22,500 women. No additional demographic data provided	Women aged 18+ recruited for an ongoing, national random-digit-dial telephone survey	2 items assessing lifetime RC, source unknown	Of women who were raped by an intimate partner, 23.3% reported that their partner refused to use a condom.
Basile et al. (2019)	Cross-sectional data base analysis	U.S. N=41,174 (22,590 women, 18,584 men) Women/Men: 66.9/66.8% NH White, 13.2/14.6% Hispanic, 12.2/11.1% NH Black, 5/4.7% NH Asian, 1.4/1.4% NH Multiracial, 0.7/0.7% NH American Indian M(age)=46.9/45.1	Women and men aged 18+ recruited for an ongoing, national random-digit-dial telephone survey	2 items assessing lifetime RC, source unknown	6.4% of women and 3.4% of men reported that a partner refused condom use. Among victims of IPV, 11.6% of female and 6.1% of male victims reported partner condom refusal. Black and Hispanic women and Black men were more likely to report partner condom refusal.
Brenner et al. (2021)	Cross-sectional survey	Nicaragua N=384 women. M(age)=25.3, SD=4.5 No additional demographic data provided	Women aged 18–35 recruited from primary health care centers in León city, Nicaragua	Lifetime experiences with RC measured by 6 items assessing contraceptive sabotage, source unknown	Forcing sex without a condom (6.2%). Removing condoms during sex (6.0%).
Dimenstein et al. (2021)	Cross-sectional survey	U.S. N=39 men. 87.2% Black, 10.3% White, 2.6% Hispanic. 41% ages 15–19, 59% ages 20–24	Young men aged 15–24 recruited from 3 primary care, 2 STI clinics in Baltimore, MD	14 items assessing men’s lifetime experience with RC (Miller et al., 2010, 2014)	Convincing you to have sex without a condom when you did not want to (8.0%).
Fay & Yee (2020)	Cross-sectional survey	U.S. N=202 women. 27.5% Black, 14% White, 50% Hispanic, 8.5% Other. M(age)=34.5, SD=10.7	Women aged 18+ recruited from gynecology clinics who had a least 1 prior pregnancy that was delivered in the 2nd trimester or later	Experiences of RC at last pregnancy 10-item Reproductive Coercion Scale (Miller, 2016)	Made you have sex without a condom (10–20%). Broke the condom on purpose while you were having sex (10–20%). Put holes in condom (10–20%). Took off the condom while you were having sex (30–40%).
Fleury-Steiner & Miller (2020)	Cross-sectional survey and interview	U.S. N=172 women. 42% White, 37% Black, 9% Hispanic, 2% Asian, 8% Multi-racial M(age)=35, SD=10.3	Women aged 18+ who were seeking an order of protection against a male current or former intimate partner	6 items assessing lifetime RC on an 8-point scale (0 = never to 7 = every day), source unknown	Telling you not to use contraception even though you wanted to (17.5%). Removing or poking holes in condoms (7.0%).
Grace et al. (2020)	Cross-sectional survey	U.S. N=482 women and girls. 90.9% not U.S.-born. M(age)=30.5, SD=6.9	Women and girls aged 15–45 who self-identified as Latina, Hispanic or Spanish, and had a partner in the past year	Past-year experiences of RC measured by 13 items adapted from Clark et al. (2014); Dick et al. (2014); Kazmerski et al. (2015); McCauley et al. (2014); Miller et al. (2010, 2011, 2014)	Taken condom off while having sex (6.5% of total women, 38.2% of RC experienced women). Made you have sex without a condom (3.5% of total women, 21% of RC experienced women). Put holes in condom or broken condom on purpose while having sex (0.2% of total women, 1.2% of RC experienced women).
Holliday et al. (2017)	Cross-sectional survey	U.S. N=1,234 women and girls. 77.0% non-White. 76.0% ages 16–24. 84.5% U.S.-born.	Women and girls aged 16–29 from family planning clinics in low-income neighborhoods in San Francisco	11 items assessing lifetime experiences of RC adapted from Miller et al. (2010) and Miller et al. (2007)	Removal of condoms during sex to facilitate pregnancy (12.2%).
Katz et al. (2017)	Cross-sectional survey	U.S. N=223 women. 80.3% White, 6.3% Asian, 5.8% Hispanic, 4.9% Black, 2.7% Other. M(age)=19.1, SD=1.2	Undergraduate women who reported past consensual vaginal sex with at least 1 male partner	12 items assessing lifetime experiences of RC adapted from Miller et al. (2010) and Moore et al. (2010)	Took off condom while you were having sex (21.0%). Made you have sex without a condom (14.0%). Broke condom on purpose while you were having sex (1.0%).
Kraft et al. (2021)	Cross-sectional survey	U.S. N=735 women and girls. 100.0% Black. M(age)=17.3	Black women aged 14–19 who had sex in the previous 6 months, not pregnant, wanting to avoid pregnancy, HIV negative	7 items assessing lifetime RC and RC severity adapted from McCauley et al. (2017)	Having a partner take off, put holes in, or break a condom (10.6%). Having a partner make you have sex without a condom (6.7%).
Katz & LaRose (2019)	Cross-sectional survey	U.S. N=213 women. 81.3% White, 7.9% Asian, 4.7% Hispanic, 3.7% Black, 2.3% Other. M(age)=19.1, SD=1.1	Undergraduate women who had been previously involved in a sexual relationship of at least 1 month’s duration with a male partner	Lifetime experiences of RC assessed by 6 items adapted from Miller et al. (2010)	Made you have sex without a condom (16.3%). Took off the condom without your agreement while you were having sex (10.2%). Took condoms or other birth control away from you (2.4%). Broke condoms on purpose while you were having sex (0.5%).
Katz & Sutherland (2017)	Cross-sectional survey	U.S. N=146 women. 83.4% White, 7.6% Asian, 3.4% Hispanic, 2.8% Black, 2.8% Other. M(age)=19.1, SD=1.1	Undergraduate women who were at least 18 years old and had been previously involved in a sexual relationship with a male partner that had lasted at least 1 month	Lifetime experiences of RC measured by 6 items adapted from Miller et al. (2010)	Made you have sex without a condom (19.2%). Took off the condom without your agreement while you were having sex (11.6%). Took condoms or other birth control away from you (2.1%). Broke condoms on purpose while you were having sex (0.6%).
Lévesque & Rousseau (2019)	Semi-structured qualitative interview with cross-sectional survey	Canada N=21 women. 71.0% White, 10.0% Caribbean, 10.0% North African, 5.0% Asian. M(age)=24.9	Women aged 18–29 who had experienced RC in the last 2 years	18-item assessing lifetime RC questionnaire adapted from Clark et al. (2014) and Miller et al. (2010)	NCCR in a relationship with violence (n=5). NCCR in an intermittent uncommitted relationship (n=10). NCCR in a repeated uncommitted relationship (n=1).
McCauley et al. (2014)	Cross-sectional survey	Côte d’Ivoire N=953 women. 61.6% Yacouba. M(age)=37.4	Women aged 18+, collected within 24 villages in rural Côte d’Ivoire	10 items assessing lifetime RC adapted from Miller et al. (2010) and Miller et al. (2014)	Made you have sex without a condom (5.0%). Put holes in the condom (0.5%). Taken off the condom while you were having sex (1.9%). [so you would get pregnant]
McCauley et al. (2015)	Cross-sectional survey	U.S. N=3,455 women and girls. 80.6% White, 13.1% Black, 1.5% Hispanic, 2.9% Multiracial, 1.6% Other. Range(age)=16–29	Women and girls aged 16–29 who had had sex; provided IPV data; had equally male/ female, mostly male, or only male partners	Lifetime RC assessed by 10-item Reproduction Coercion Scale developed by Miller et al. (2010); McCauley et al. (2014)	Condom nonuse against your will (21.8%). Fear of asking partner to use a condom (2.3%).
McCauley et al. (2017)	Cross-sectional survey	U.S. N=4,674 women and girls from CA and PA. CA: 77.0% non-White; 16.0% non-U.S.-born. PA: 19.0% non-White; 2.0% non-U.S.-born. M(age)=24.9, SD=2.9	Women and girls aged 16–29 seeking care at participating clinics	Past three months experiences of RC measured by 9-item Reproduction Coercion Scale assessing RC (Miller et al., 2007)	Made you have sex without a condom (0.8%).Taken off the condom while you were having sex (2.7%). Put holes in the condom (0.4%). Broken the condom on purpose while you were having sex (0.6%) [so you would get pregnant].
Miller et al. (2014)	Cross-sectional survey	U.S. N=3,539 women and girls. 80.0% White, 13.0% Black, 7.0% Hispanic, Asian, Multiracial or Other. 73.0% ages 24 or younger	Women and girls aged 16–29 at 24 family planning clinics in Western Pennsylvania	Past three months RC experiences measured by 10-item Reproduction Coercion Scale (Miller et al., 2010)	Took off the condom during sex (1.6%). Put holes in the condom (0.2%). Broke condom on purpose (0.4%) [so you would get pregnant].
Northridge et al. (2017)	Cross-sectional survey	U.S. N=149 girls. 75.0% Hispanic or Black. M(age)=16.1, SD=1.0	Girls aged 14–17 from primary care/subspecialty clinics, a high school based clinic, and an emergency room	Lifetime experiences of RC assessed by 9-item Reproduction Coercion Scale developed by Miller et al. (2007)	Taken off the condom while you were having sex (43.0%). Broken a condom on purpose while you were having sex (14.0%) [so that you would get pregnant].
PettyJohn et al. (2021)	Cross-sectional survey	U.S. N=136 women and girls. 67.4% Black, 19.3% White, 13.3% Multiracial/Other. Range(age)=16–24	Women and girls aged 16–24 seeking services from youth-serving agencies in Western Pennsylvania	Lifetime experiences of RC assessed by 5-item scale adapted from McCauley et al. (2017); Miller et al. (2010)	Partners taking a condom off during sex (16.2%). Forced condom non-use (10.3%) [to promote a pregnancy].
Phillips et al. (2016)	Cross-sectional survey	U.S. N=97 women. 51.0% Hispanic, 27.0% Black, 7.0% White, 7.0% Asian, 7% Multiracial/Other. M(age)=27.0	Women aged 18–45 who were able to get pregnant and had been sexually active with a man in the past year	5 items assessing lifetime pregnancy coercion and birth control sabotage adapted from Miller et al. (2010)	Partner made you have sex without a condom (7.0%). Partner removed a condom (6.0%) [to get you pregnant].
Rosenfeld et al. (2018)	Cross-sectional national phone survey	U.S. N=1,241 women. 51.0% White, 28.0% Black, 13.0% Hispanic, 8.0% Other. Range(age)=18–44	Women veterans aged 18–44 who had used VA for primary care in the prior 12 months	3 items assessing past-year male partner RC adapted from Miller et al. (2010)	Male sexual partner had removed, broken or refused to use a condom during sex (7.0%).
Sutherland et al. (2014)	Cross-sectional survey	U.S. N=21 women. 71.4% White, 14.3% Black, 4.8% Multiracial. M(age)=38.8, SD=13	English-speaking women aged 18+ from community health clinics	10-item Reproductive Coercion Scale (Miller et al., 2010); timeframe not specified	Partner removed condom (4.8%). Partner made holes in condom (4.8%). Partner purposively broke condom (4.8%). Partner forced sex without condom (14.3).
Sutherland et al. (2015)	Quantitative analysis of cross-sectional secondary data.	U.S. N=941 women. 75.3% White, 10.3% Hispanic, 9.6% Asian, 4.8% Black. M(age)=20.6, SD=2.0	College women aged 18–25, enrolled either full- or part-time, English speaking, who were in a relationship	10-item Reproductive Coercion Scale (Miller et al., 2010); timeframe not specified	Made you have sex without a condom or other birth control method (2.1%). Taken off the condom while you were having sex (1.1%). Broken a condom on purpose while you were having sex (0.3%). Put holes in the condom (0.1%) [so you would get pregnant].
Swan et al. (2020)	Cross-sectional survey	U.S. N=431 female students. 62.4% White, 18.6% Hispanic, 8.4% Black, 10.7% Other. M(age)=22.2	Students aged 18–49 at a public university who were assigned female at birth	4 items assessing past-year RC, source unknown	Made you have sex without a condom (4.0–7.3%). Taken off the condom while you were having sex (6.8–9.6%). Put holes in the condom or broken the condom on purpose (5.8–8.9%) [so you would get pregnant].
Willie et al. (2019)	Quantitative analysis of data collected as part of a longitudinal study	U.S. N=592 participants. Men/boys/women/girls: 48.0/40.0% Black, 36.0/40.0% Hispanic, 15.0/20.0% White. M(age)=18.7, SD=1.6/21.3, SD=4.1	Women/girls aged 14–21 in their second or third trimester, fetuses’ biological fathers aged 14+	Lifetime RC assessed by 7 items adapted from Reproductive Coercion Scale (Miller et al., 2010)	Prior condom sabotage (20.0%). Current condom sabotage (3.0%).
Wood et al. (2020)	Cross-sectional survey and interviews	Nairobi N=327 women. 41.3% Kikuyu, 24.8% Luo, 17.1% Luhya, 3.4% Borana, 0.1% Kamba, 3.4% Other. M(age)=26.6, SD=4.7	Women aged 18–35 who were in a relationship where physical or sexual IPV or fears for safety occurred in the past 3 months	Past three months experiences with RC assessed by 9-item Reproductive Coercion Scale (Miller et al. 2011; McCauley et al. 2017)	59.5% reported condom manipulation. Made you have sex without a condom (52.6%). Taken off the condom while having sex (42.5%). Put holes in the condom (21.7%). Broken the condom on purpose while having sex (30.0%) [so you would get pregnant].
Articles that Examined Coercive CUR Without Reproductive Control Motives
Boadle et al. (2021)	Cross-sectional online survey	Australia or New Zealand N=364 women. 87.4% White. M(age)=24.3, SD=3.3	Women living in Australia or New Zealand who had previously engaged in penetrative sexual intercourse with at least one male partner	4 multiple response items assessing lifetime NCCR developed by authors	Male partner removing condom during intercourse without consent (9.3%). NCCR history was associated with lower perceived ability to maintain control during sexual encounters and resistive efficacy.
Bonar et al. (2019)	Cross-sectional survey	U.S. N=2,550. 52.4% male. 53.9% White. M(age)=20.8, SD=2.3	Adults in the U.S. aged 18–25	2 items assessing stealthing since age 16 developed by authors	5.0% of men, 18.9% of women reported stealthing victimization which was associated with racial minority status, non-heterosexual orientation, and higher substance use among men; older age and racial minority status among women.
Czechowski et al. (2019)	Cross-sectional survey; qualitative interview	Canada N=592. 73.4% cisgender women, 25.8% cisgender men, 0.7% transgender or non- binary. M(age)=19.6, SD=2.6	College students at the University of Ottawa in Canada	2 items assessing lifetime NCCR developed by authors	62 participants reported having received NCCR. Male partner removed condom during/before sex without your consent (n=26); without your knowledge (n=4); without your consent and knowledge (n=32). 29 participants who reported NCCR also reported sexual abuse.
Davis et al. (2019)	Cross-sectional survey	U.S. N=503 women. 71.1% White, 8.3% Asian, 4.9% Black, 2.2% Native American, 12.9% Multiracial/Other. M(age)=25.0, SD=2.7	Women aged 21–30; 1+ times condomless sex in past year; 1+ indicator of sexual risk; 2+ times sex and alcohol use in past month	Coercive CUR experience since age 14 32-item Condom Use Resistance Tactics Scale (Davis et al., 2014)	48.9% reported receipt of coercive CUR from their male sex partners. Receiving coercive CUR was associated with a more severe history of sexual assault.
Decker et al. (2020)	Cross-sectional interviews	U.S. N=250 female sex workers. 66.4% White, 22.8% Black, 10.8% Hispanic or Other	Female sex workers aged 15+ who sold or traded oral, vaginal or anal sex, picked up clients on the street/public places ≥ 3 times in the past 3 months; were willing to undergo HIV and STI testing	Condom coercion in the past three months; Number of items and source not reported.	Client-perpetrated (CP) condom coercion (42.4%). Non-paying partner (NPP) condom coercion (9.9%). CP condom coercion was associated with client violence, IPV, intoxication before sex, client injection drug use, police extortion. NPP condom coercion was associated with being Black, having a pimp or manager, client violence, IPV, Self and NPP intoxication at sex, arrest history, police extortion.
Latimer et al. (2018)	Cross-sectional survey	Australia N=1,189 women and 1,063 MSM. Women: Median(age)=26.0, Men: Median(age)=30.0	Women and MSM attending the Melbourne Sexual Health Centre in Victoria, Australia	7-item measure for lifetime stealthing, source unknown	32.0% women and 19.0% of MSM reported experiencing stealthing. Stealthing was associated with alcohol and drug consumption, emotional stress, worry about STIs and HIV, being a female sex worker, and reporting health issues such as anxiety and depression.
Orchowski et al. (2020)	Cross-sectional survey	U.S. N=212 women. 37.1% White, 18.5% Black, 2.8% American Indian, 1.7% Asian, 30.9% Other. M(age)=19.8, SD=1.7	Women aged 18 to 24 with history of sexual activity who were attending a large community college in the Northeast U.S.	Coercive CUR experience since age 14 assessed by 32-item Condom Use Resistance Tactics Scale (Davis et al., 2014)	Lying by telling you they would pull out before they ejaculated (12.9%). Pretending that the– - have a latex allergy and cannot use condoms (5.6%), had been tested and did not have any STD’s (9.6%), had a vasectomy (2.8%). Agreeing to use a condo– - but intentionally breaking it (2.2%), but intentionally breaking the condom after it was on (1.7%), but removing it before/during sex without telling you (7.9%). Preventing you from getting a condom (5.1%). Threatening to hurt you (1.7%). Using physical force (1.7%).
Teitelman et al. (2011)	Cross-sectional survey and focus group interviews	U.S. N=64 girls. 100.0% Black. M(age)=16.0, SD=1.0	Adolescent girls aged 14–17 recruited in clinic waiting rooms	1 question assessing lifetime experience of vaginal or anal sex without a condom when wanting to use one, source not reported	Vaginal sex without a condom when they wanted to use one (53%). Anal sex without a condom when they wanted to use one (6%).
Tomko et al. (2019)	Cross-sectional survey	U.S. N=232 female sex workers. 50.4% White, 23.3% Black, 11.2% Hispanic or Other. 50.4% below age 35	Female sex workers aged 15+, sold/traded sex, picked up clients on the street/public places ≥ 3 times in past 3 months; were willing to undergo HIV and STI testing	Condom coercion experience in the past three months; number of items and source not reported	Condom coercion from a client was positively associated with not being aware of PrEP and was negatively associated with being interested in PrEP

Note. Findings in the table are verbatim or summarized descriptions of items. NH = Non-Hispanic, CI = Condom interference, CUR = Condom use resistance, HIV = Human immunodeficiency virus, ICU = Inconsistent condom use, NCCR = nonconsensual condom removal, PrEP = Pre-exposure prophylaxis, RC = Reproductive coercion, RCT = Randomized controlled trial, STI = Sexually transmitted infections, U.S. = United States, WSM = women have sex with men only, WSWM = women have sex with women and men.

Table 2.

Critical Findings and Implications.

The majority of articles (33 out of 37 articles) focused on women’s receipt of coercive CUR.

The prevalence of coercive CUR ranged from 0.1% to 59.6% across all articles.

Men and women who identified as racial minorities were at higher risk of experiencing coercive CUR.

Coercive CUR receipt was positively associated with physical health concerns such as Sexually Transmitted Infections, alcohol and drug use, and lack of awareness of pre-exposure prophylaxis.

Given the higher prevalence of coercive CUR among racial/ethnic and sexual minority populations (Blacks, Hispanics, MSM, sex workers) and women, efforts that prioritize screening, education, and prevention strategies among these populations may prove beneficial.

Given associations between coercive CUR experiences and negative physical and mental health consequences, resources and services such as sexually transmitted infection screening and treatment and mental health counseling should be provided to recipients of coercive CUR.

Future research could consider using inferential statistics to investigate correlates of coercive CUR in the context of reproductive coercion to help better understand underlying mechanisms. Due to current inconsistencies in the measurement of coercive CUR used across studies, consistent use of validated measures is recommended.

Future research using longitudinal and/or intervention designs that specifically examine coercive CUR and associated consequences are recommended. Legislative efforts that codify coercive CUR as illegal and subject to civil penalties merit continuation given the substantive harms experienced by coercive CUR victims.