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. 2012 Sep 20;36(3):223–231. doi: 10.1093/swr/svs027

Young Men's Aggressive Tactics to Avoid Condom Use: A Test of a Theoretical Model

Kelly Cue Davis 1,✉, Patricia Logan-Greene 1
PMCID: PMC3490635  NIHMSID: NIHMS287571  PMID: 23139623

Abstract

Although research has demonstrated that men's aggression against women and inconsistent condom use are related phenomena, little is known about what factors increase risk for aggression to avoid condom use. The present article tests a theory-based model of condom avoidance through use of sexual aggression. Adult male participants (N = 289) were recruited nationally through online advertisements. Aggressive tactics to avoid condom use were measured using an adapted version of the revised Sexual Experiences Survey, and a variety of aggressive behaviors spanning coercion to physical force were assessed. One hundred participants (35.3%) reported at least one instance of coercion or aggression to avoid using a condom. Structural equation modeling indicated that attitudes toward women, inconsistent condom use, and number of sexual partners were significant predictors of aggressive tactics to avoid condom use. A better understanding of the attitudinal and behavioral pathways through which men avoid condom use through aggressive and coercive means will ultimately result in improved education and prevention efforts for at-risk men and women.

Keywords: condom avoidance, confluence model, risky sexual behavior, sexual aggression

Despite prevention efforts, sexual assault remains a widespread public health concern estimated to affect 25% of women in the United States, with approximately 300,000 women raped each year (Koss, 1988; Tjaden & Thoennes, 2006). Sexual assault may adversely affect a woman's physical and mental health in a variety of ways, including negative sexual and reproductive health consequences. For example, sexual assault involving penetration results in 3% to 20% of victims acquiring a sexually transmitted infection (STI) (Jenny et al., 1990; Tjaden & Thoennes, 2006). Among women of reproductive age, approximately 5% of those raped became pregnant from the assault, with more than 32,000 pregnancies resulting from rape each year (Holmes, Resnick, Kilpatrick, & Best, 1996). Empirical research investigating the factors that may increase the likelihood of these negative consequences for sexual assault victims would further inform efforts to reduce these harmful outcomes.

The use of a condom during penetrative sexual assault, as during consensual sexual situations, can decrease the risk of both STI transmission and unwanted pregnancies. Although there is very little published research regarding the use of condoms during sexual assault events, these few studies indicated that sexually aggressive acts involving penetration often do not involve condom use (Davis, Schraufnagel, George, & Norris, 2008; Peterson, Janssen, & Heiman, 2010; Raj et al., 2006). For example, Davis et al. found that approximately 40% of sexual assault perpetrators reported that they never used condoms during their assaults, whereas another 30% reported using condoms inconsistently. This nonuse of condoms during rape may be more likely than unprotected consensual sex to result in STI transmission because of the higher likelihood of vaginal tissue injury in sexual assault incidents (Briere, 2004). Moreover, because men who report engaging in sexual or physical violence against women also report more sexual partners (for example, number of partners in the last year, one-night stands) and inconsistent or no condom use during consensual vaginal and anal sexual intercourse, they present an elevated STI transmission risk to their victims (Peterson et al., 2010; Raj et al., 2006).

Because of these associations between sexual violence and risky sexual behavior in heterosexual men, researchers have started examining men's use of coercive and forceful strategies to obtain unprotected sex from a female sex partner who wants to use a condom (Abbey, Parkhill, Jacques-Tiura, & Saenz, 2009; Davis, 2010). Compared with non-perpetrators, men who had previously committed sexual assault reported greater justification for using coercive tactics to obtain unprotected sex in a hypothetical situation (Abbey et al., 2009). To date, these studies have used laboratory-based experimental methods. The present study uses survey methods to assess the frequency and predictors of young men's use of sexually aggressive and coercive tactics to obtain unprotected sex.

APPLICATION OF THE CONFLUENCE MODEL TO CONDOM AVOIDANCE

One of the most widely tested models of sexual aggression perpetration is the confluence model (Malamuth, Sockloskie, Koss, & Tanaka, 1991). According to the confluence model of sexual aggression, two key pathways toward sexual aggression involve negative attitudes toward women (also termed “hostile masculinity”) and impersonal sex. Malamuth et al. (1991) also predicted that the interaction—or confluence—of these pathways would predict the greatest levels of sexual aggression. Measurement of men's negative attitudes toward women has included such factors as rape myth acceptance, sexual dominance, adversarial beliefs about heterosexual relationships, and misogyny (Hersh & Gray-Little, 1998; Lanier, 2001; Wheeler, George, & Dahl, 2002). Impersonal sex originally included age at first intercourse and number of intercourse partners but has also included attitudes toward casual sex, frequency of masturbation, and pornography use (Malamuth, Linz, Heavey, Barnes, & Acker, 1995; Malamuth, Addison, & Koss, 2000). This model has been replicated in multiple reports with diverse populations (for example, Hall, Teten, DeGarmo, Sue, & Stephens, 2005; Martin, Vergeles, Acevedo, Sanchez, & Visa, 2005) and has also been expanded to include other factors pertinent to sexually aggressive behavior (Parkhill & Abbey, 2008; Logan-Greene & Davis, 2011).

On the basis of this model, we predicted three primary pathways to condom avoidance through aggressive and coercive tactics. First, we hypothesized that men's negative attitudes toward women would directly predict their use of aggressive strategies to obtain unprotected sex. Second, we hypothesized that impersonal sex factors, such as inconsistent condom use and more sex partners, would directly predict use of aggression and coercion to avoid condom use and would also correlate with each other, consistent with prior research (Peterson et al., 2010). Third, in accordance with the original model, we predicted that men who report a high degree of both negative attitudes toward women and impersonal sex factors would also report the greatest use of aggression and coercion to obtain unprotected sex. Thus, we tested whether the interactions between these factors would significantly predict use of aggression to avoid condom use.

Because the original confluence model was designed to predict sexual aggression generally and not sexual aggression specific to condom avoidance, we expanded the model to include factors previously shown to be relevant to factors regarding condom use. We included the predispositional variable of sexual sensation seeking, which refers to a general tendency to pursue unconventional and exciting sexual activities (Kalichman & Rompa, 1995) and has been identified as a predictor of high-risk sexual behavior, including having a higher numbers of sex partners (Hendershot, Stoner, George, & Norris, 2007). Thus, we hypothesized that the relationship between sexual sensation seeking and the use of aggression to obtain unprotected sex would be mediated by the impersonal sex factor of number of sex partners.

Attitudes about condoms have also been shown to be a significant predictor of condom use (Sheeran, Abraham, & Orbell, 1999). In particular, men are more likely than women to be concerned that condom use will interfere with their sexual pleasure, and the more strongly one believes that condoms disrupt sexual pleasure, the more likely one is to avoid using condoms (Conley & Collins, 2005). We thus hypothesized that the relationship between attitudes about condoms interfering with sexual pleasure and use of aggressive strategies to obtain unprotected sex would be mediated by the inconsistent use of condoms generally. The hypothesized pathways are depicted in Figure 1.

Figure 1:

Figure 1:

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Hypothesized Model

METHOD

Procedure

Following institutional review board approval, survey advertisements were posted nationwide on Facebook and on Craigslist. Unmarried men between the ages of 18 and 35 who endorsed primarily heterosexual dating experiences and some social drinking were considered eligible to participate. The survey was delivered through the University of Washington's WebQ, an online survey software program. Participants were assured of confidentiality and given the option to decline any question. Participants were compensated with a $40 electronic gift card on survey completion.

A total of 1,164 individuals completed the online screening information form. Of those, 521 were excluded because they were married, reported only homosexual experiences, were over the age cutoff, or were female. Two hundred ninety-nine participants completed the survey. Of these, 10 additional cases were dropped because their answers provided in the survey did not match those given in the screening (for example, screened in as eligible but later reported being married), resulting in a final sample size of 289. The median income bracket of the final sample was $31,000 to $40,999 per year, with 77.6% reporting an annual income under $61,000. Of the sample, 14.8% had a high school diploma or less, 42.6% reported some college, 32.9% had a college degree, and the remainder had a trade school or graduate school degree; 46.0% were currently in school. Of the sample, 57.1% had a full-time job, and 25.3% worked part-time. The sample was moderately ethnically diverse: 11.8% identified as Hispanic or Latino. For racial identification, 13.8% were Asian or Pacific Islanders, 8.3% were African American, 66.1% were white, and 6.6% were multiracial or other. The specific ages of participants were not recorded due to an error in the survey interface, but all were between the ages of 18 and 35.

Measures

Attitudes toward women were measured in three ways. The Adversarial Heterosexual Beliefs Scale (Lonsway & Fitzgerald, 1995) is a mean of 15 items (M = 2.61, SD = 0.98, α = .88) that measures cynicism and suspicion about heterosexual relations in personal and work life (for example, “In the work force, any gain by one sex means a loss for the other”). The revised Hostility to Women Scale, a summed scale with 10 items (M = 33.2, SD = 11.7, α = .87; Lonsway & Fitzgerald, 1995), taps resentment and mistrust toward women, particularly in romantic contexts (for example, “Many times women flirt with men just to tease or hurt them”). Finally, the Rape Myth Attitudes Scale (Lonsway & Fitzgerald, 1995) assesses victim blaming and tolerance for sexual assault with 19 items (M = 2.02, SD = 0.97, α = .93). Answers for all three scales were given on a seven-point Likert-type scale where 1 = strongly disagree and 7 = strongly agree.

The Sexual Sensation Seeking Scale was taken from the sensation-seeking questionnaire (Kalichman & Rompa, 1995). It contains 11 items that assess novelty seeking in sex, desire for variety, and a physical orientation toward sex (M = 2.65, SD = 0.69, α = .88).

The Condom Displeasure Attitudes Scale is a subscale from the Multidimensional Condom Attitudes Scale (Helweg-Larsen & Collins, 1994). The scale contains five items that assessed the effects of condom use on sexual enjoyment and comfort for both partners on a seven-point Likert-type scale (M = 3.10, SD = 1.26, α = .76). In the present study, scores were reversed such that higher values indicate more negative attitudes about the effects of condoms on sexual pleasure.

The number of partners was measured using a mean-based scale assessment of the number of lifetime partners of the opposite sex with whom respondents reported having oral, vaginal, or anal sex (M = 5.38, SD = 3.61, α = .89). This scale is not a count, and the upper tail was truncated to reduce skew (0 partners = 1, 1 partner = 2, 2 partners = 3, 4 partners = 5, 5 partners = 6, 6 partners =7, 7 partners = 8, 9 partners = 10, 10 partners = 11, 11 to 15 partners = 12, 16 to 20 partners = 13, 21 to 25 partners = 14, 26 to 30 partners = 15, 31 to 40 partners = 16, 41 to 50 partners = 17, 51 to 60 partners = 18, and more than 60 partners = 19). Categorizing responses in this way helps to address both skew and recall difficulties for participants.

Inconsistent condom use was measured using a mean-based scale that assessed the number of times respondents reported having sex without a condom in different circumstances, including on a first date, when one was not available, and when a partner did not want to use one (M = 2.36, SD = 1.78, α = .76). Answers were given on a seven-point scale, where 1 = never, 2 = 1 to 5 times, 3 = 6 to 10 times, 4 = 11 to 15 times, 5 = 16 to 20 times, 6 = 21 to 25 times, and 7 = 26 or more times.

The aggressive tactics to avoid condom use measure was based on an updated and revised version of the commonly used Sexual Experiences Survey (Abbey, Parkhill, & Koss, 2005). The measure for sexual aggression reflects two components—acts and tactics—and was designed to assess an increased level of behavioral specificity and to capture the full spectrum of unwanted sex from coercive to forced. For the present study, the tactics from this measure were used in conjunction with a single act: condom avoidance (for example, “Since the age of 14, how many times have you told lies or made promises to a woman that you knew were untrue in order to get her to have sex with you without using a condom?”). Respondents were asked about five tactics: (1) arguments or pressure; (2) lies or false promises; (3) guilt, sulking, or anger; (4) intoxication of the victim; and (5) some degree of physical force. All answers were given as 1 = never, 2 = one time, 3 = two times, 4 = three times, 5 = four times, 6 = five or more times. The average of these were used as a scale (M = 1.59, SD = 1.11, α = .81).

Data Analytic Method

All data were cleaned and prepared using SPSS 15.0. To examine the relations among the variables and to test the hypothesized model, structural equation modeling (SEM) was used with the Mplus statistical package for Windows version 6.1 (Muthén & Muthén, 2007). Because some variables had non-normal distributions, we used maximum likelihood with robust standard errors (Asparouhov & Muthén, 2005). The original model shown in Figure 1 was tested first, and nonsignificant paths were removed. The modification indices were then examined for needed changes.

RESULTS

One hundred participants (35.3% of the sample) reported at least one instance of coercion or aggression to avoid using a condom since age 14; 31.0% (n = 89) of the sample reported using such tactics on multiple occasions. To avoid using condoms, 24.3% (n = 69) had overwhelmed with arguments or pressure, 25.2% (n = 72) had lied or made false promises, 19.2% (n = 55) had used guilt or sulking, 12.3% (n = 35) had taken advantage of the women's intoxication, and 6.3% (n = 18) had used or threatened force. Significant bivariate correlations (see Table 1) were found with aggressive tactics to avoid condom use and all other variables in the predicted directions, with the strongest correlation seen with number of partners (r = 0.50, p <.001).

Table 1:

Correlations among Study Variables

1 2 3 4 5 6 7
1. Condom displeasure attitudes —
2. Hostility toward women .19*** —
3. Adversarial heterosexual beliefs .20*** .60*** —
4. Rape myth attitudes .17*** .44*** .53*** —
5. Sexual sensation seeking .34*** .19*** .20*** .23*** —
6. Inconsistent condom use .26*** .09 .15** .05 .36*** —
7. Number of partners .08 .04 .14* –.09 .40*** .65*** —
8. Condom avoidance through sexual aggression .15* .22*** .33*** .27*** .28*** .50*** .43***
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*p < .05. **p < .01. ***p < .001.

We used SEM with maximum likelihood estimation to test the model shown in Figure 1. The two-way interactions between attitudes toward women and inconsistent condom use and attitudes toward women and number of partners were tested by entering mean-centered multiplicative terms (Cronbach, 1987). The fit statistics for this model were unsatisfactory [χ2(30) = 124.55, p < .001, CFI = 0.76, RMSEA = 0.10, SRMR = 0.09, df = 30, sample size = 289]. However, the latent variable formed through hostility to women, adversarial heterosexual beliefs, and rape myth attitudes was satisfactory (loadings were 0.70, 0.83, and 0.65, respectively, ps < .001). Nonsignificant paths, such as those for the interaction terms, were removed from the model. After examining the modification indices, one additional path was added from sexual sensation seeking to inconsistent condom use.

The fit statistics for the final model (shown in Figure 2) were good [χ2 (15, N = 289) = 30.54, p = .01, CFI = 0.97, RMSEA = 0.06, SRMR = 0.03]. All paths shown are significant at p < .01. This model accounted for 37% of the variance in use of sexual aggression to not use a condom. Three variables had significant direct effects on condom avoidance through use of sexual aggression: inconsistent condom use, number of partners, and attitudes toward women.

Figure 2:

Figure 2:

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Final Model

The significance of the three indirect pathways to condom avoidance through sexual aggression were tested as per Bryan, Schmiege, and Broaddus (2007); all three pathways were significant. Indirect effects from sexual sensation seeking included two pathways: number of partners (β = 0.12, SE = 0.04, p = .005) and inconsistent condom use (β = 0.16, SE = 0.04, p < .001). Finally, the effects of condom displeasure attitudes via inconsistent condom use were also significant, although the magnitude was smaller (β = 0.06, SE = 0.02, p < .001).

DISCUSSION

To our knowledge, this exploratory study represents one of the first examinations of the factors predictive of young men's use of aggressive and coercive tactics to obtain sex without a condom. Based on the confluence model of sexual aggression (Malamuth et al., 1991), findings supported hypotheses regarding the direct and indirect influences of negative attitudes toward women, impersonal sex factors, attitudes about condoms, and sexual sensation seeking on coerced unprotected sex.

We found that just over one-third of young men in this nationwide sample reported having used coercion or aggression to avoid using a condom since the age of 14, with 31.0% of these reporting use of these tactics on multiple occasions. As in studies of sexual assault perpetration (Abbey et al., 2005), verbally coercive tactics such as arguments or false promises were the most commonly used tactics, whereas the use of physical force was the least commonly used tactic. Although other studies have noted a global relationship between young men's sexual violence perpetration and inconsistent condom use (Peterson et al., 2010), these studies have not reported on men's use of coercion or violence specifically to obtain unprotected sex. Laboratory-based studies have noted that some men report intention to use sexually aggressive tactics to obtain unprotected sex (Davis, 2010); our findings extend this work by substantiating that a significant minority of young men actually obtain unprotected sex through the use of coercive or violent tactics.

Our study findings supported our hypotheses, suggesting three primary pathways to young men's use of coercion to engage in unprotected sexual intercourse. In support of the original confluence model, the first pathway indicated that greater endorsement of negative attitudes toward women was directly associated with higher rates of coerced unprotected sex. The second pathway demonstrated that condom displeasure attitudes were related to greater inconsistent condom use, which in turn was related to greater use of aggressive tactics to obtain unprotected sex. Finally, in the third set of pathways, sexual sensation seeking was related to inconsistent condom use and a higher number of sexual partners, each of which was associated with a greater likelihood of using coercion to obtain unprotected sex.

Our hypothesis that the combination of negative attitudes toward women and impersonal sex factors would predict the greatest use of aggression to obtain unprotected sex was not supported. The lack of significance of the interaction terms, which is central to the confluence model, may be due to a number of factors. First, the outcome variable studied here is different than that of the original model; therefore expectation of an interaction may not apply. Instead, aggression to avoid condom use may be used by distinctly different types of men, reflective of the three separate pathways. However, it is possible that having two separate interaction terms may have diluted the predicted effects, although each was tested separately and both were nonsignificant. As others have observed (Parkhill & Abbey, 2008), many of the studies testing the confluence model do not include the interaction term, thus making it difficult to assess its importance.

Our findings show that negative attitudes toward women are directly related to more frequent use of aggression to obtain unprotected sex. These results support prior research in this area (Logan-Greene & Davis, 2011; Malamuth et al., 1991), which also highlights the association between sexual aggression perpetration and misogynistic attitudes. Moreover, traditional gender role attitudes have also been linked to decreased condom use (Marin, Gomez, Tschann, & Gregorich, 1997). Thus, a more traditional masculine ideology that supports more negative attitudes toward women may contribute to men's use of sexual coercion to obtain unprotected sex, thereby increasing women's risk of both sexual victimization and sexual infection transmission. These findings suggest that discussion of gender roles and attitudes should play a prominent role in both STI/HIV and sexual aggression prevention efforts with young heterosexual men.

Men's attitudes about the effects of condoms on sexual pleasure indirectly related to increased engagement in coerced unprotected sex through its association with more inconsistent condom use. As shown in previous work (Conley & Collins, 2005), men who more strongly believe that condoms dampen sexual pleasure reported more infrequent condom use than men with weaker attitudes in this regard. A novel finding in our study is that this infrequent condom use is also associated with the use of coercive tactics to avoid using condoms. This result suggests that prevention programming that targets men's attitudes about condom's effects on sexual pleasure may be an effective means of increasing condom use generally and decreasing the use of aggression and coercion in risky sexual situations. Programs that focus on making safer sex “sexy” by eroticizing condoms and focusing on pleasure rather than disease may be particularly effective in challenging these attitudes (Philpott, Knerr, & Boydell, 2006).

Sexual sensation seeking was significantly related to both inconsistent condom use and greater numbers of sexual partners. The current research expands the work in this area by demonstrating that men who use condoms inconsistently and have more sex partners are also more likely to use coercion and aggression for the purposes of obtaining unprotected sex. These results indicate that focusing prevention efforts toward those with greater sexual sensation seeking tendencies—and then tailoring these programs to meet their specific needs—may ultimately have larger effects on STI transmission than would more general programs (Hendershot et al., 2007).

Limitations

A major limitation of our study was the use of a cross-sectional design, which precludes our ability to make causal statements about the relationships among the variables investigated. Future research examining these constructs in a longitudinal fashion or in an experimental setting to ascertain potential causal relationships is highly warranted. We relied solely on self-reported data, which, although one of the best methods to study sexual aggression given the low rates of reporting (Bureau of Justice, 2002), is nonetheless subject to errors in recall and social desirability biases. That noted, data were provided anonymously, which somewhat reduces this concern, and this bias would have likely resulted in underreporting, not overreporting, of risky sexual behavior and sexual coercion perpetration. Although the sample size was not large, the significant effects observed suggest that it was sufficiently powered. In addition, algorithms that have been developed to predict minimum sample size requirements suggest that our sample size was adequate to test this model (Westland, 2010). Although the sample was moderately diverse on a number of demographic characteristics, recruitment through online venues may select for certain segments of the population, even though almost 90% of people in this age group have Internet access and use the Internet on a regular basis (Pew Internet & American Life Project, 2009). Moreover, as with any study involving a sample of convenience, self-selection bias may occur. Generalizing these findings to other groups should thus be done cautiously. Finally, our measure of condom use avoidance does not allow for the disentangling of situations that culminated in a sexual assault from those that involved the woman's consent. Future research should explore the interplay of men's condom use avoidance tactics with women's provision (or refusal) of sexual consent.

Conclusion

Just over one-third of young heterosexual men in this sample reported use of aggressive tactics to avoid use of condoms with their female sexual partners, and the majority of those reported multiple incidents. Men high in sexual sensation seeking, with more negative attitudes about women and with stronger beliefs that condoms reduce sexual pleasure, were the most likely to engage in this type of behavior. These findings suggest that, despite prevention efforts directed at reducing sexual aggression and sexual risk, many young men continue to engage in both of these behaviors, often within the same sexual incident. A woman who has been coerced into having unprotected sexual intercourse has not only experienced a violation of her sexual autonomy, but also may subsequently be at increased risk for unwanted pregnancy and STI transmission. The successful application of a theoretical model for sexual assault suggests significant overlap with risk factors and pathways to aggressive tactics to avoid condom use. Prevention and intervention programs for sexual assault are thus well positioned to address these problems simultaneously by addressing the pathways illustrated in the confluence model.

As this exploratory study makes clear, further empirical research that advances our understanding regarding the intersection of sexual aggression and sexual risk are imperative for informing sexual health prevention efforts. There are several critical avenues for future research. First, given the selection bias of this study, these findings should be replicated with other samples in other settings, ideally using prospective methods. Although this model explained a robust 37% of variance in the outcome, there are other important factors that are not included in these analyses, which could be addressed in future research. For example, a significant omission from the confluence model is alcohol consumption, which has a complicated and substantial association with sexual aggression (Parkhill & Abbey, 2008) and would likely be similarly associated with aggression to avoid condom use. Second, future research could address the roles of relationship factors like type and length, as well as partner characteristics, because these factors may have implications for the perceived importance of condom use to some men. Finally, women's perceptions of sexual encounters involving men's use of aggressive tactics to avoid use of condoms would also be an important area for future research.

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