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. Author manuscript; available in PMC: 2018 Oct 1.
Published in final edited form as: Psychol Violence. 2016 Aug 8;7(4):593–601. doi: 10.1037/vio0000069

The Effects of Men's Hostility Toward Women, Acute Alcohol Intoxication, and Women's Condom Request Style on Men's Condom Use Resistance Tactics

Rhiana Wegner 1, Kelly Cue Davis 2, Cynthia A Stappenbeck 3, Kelly F Kajumulo 4, Jeanette Norris 5, William H George 6
PMCID: PMC5724380  NIHMSID: NIHMS795938  PMID: 29242755

Abstract

Objective

To extend previous research demonstrating that intoxicated men high in hostility toward women report stronger intentions to use coercive condom use resistance (CUR) tactics to have unprotected sex by examining the role of women's condom request style.

Methods

Community, non-problem drinking men, ages 21-30 (N = 296) completed standard alcohol administration procedures and read an eroticized story of a casual sexual interaction. Following the woman's request to use a condom, intentions to engage in coercive CUR tactics were assessed. Generalized linear models with gamma distributions assessed the 3-way interaction of men's hostility toward women, beverage condition (alcohol or sober), and the woman's condom request style (indirect, direct, or insistent).

Results

The 3-way interaction between hostility toward women, beverage condition, and indirect condom request (vs. direct) significantly predicted men's coercive CUR intentions. Men high in hostility toward women reported stronger CUR intentions after experiencing an indirect condom request, when sober or intoxicated, and after a direct condom request when intoxicated. Men high in hostility toward women reported the weakest CUR intentions when sober following an insistent or direct condom request.

Conclusions

Men high in hostility toward women pose a threat to women's sexual safety, particularly when intoxicated or following an indirect condom request. Hostility toward women and alcohol consumption should be addressed in sexual risk prevention programs. Pending further replication, women should be informed of the relative effectiveness of using insistent condom requests.

Keywords: condom use resistance, unprotected sex, hostility toward women, acute intoxication, alcohol, reproductive coercion, condom sabotage, physical force

Introduction

Men's sexually coercive and violent behavior toward women is a topic of national public health concern. Although the use of coercion in sexual situations is typically considered in relation to non-consensual sex, research suggests that some men also use coercion to obtain unprotected but consensual sex (Davis & Logan-Greene, 2012). A form of reproductive coercion (Chamberlain & Levinson, 2012; Katz, Poleschuck, Beach & Olin, 2015), coercive condom use resistance (CUR) tactics include the use of lies, manipulation, threats, and physical force in order to have unprotected sexual intercourse with a partner who wants to use a condom. Coercive CUR involves situations in which the woman has consented to sexual intercourse, but it is predicated on the use of a condom, thus differentiating these behaviors from those which meet the legal definition of sexual assault. However, similar to sexual assault, coercive CUR behaviors threaten women's sexual safety and take away women's ability to protect themselves from STI/HIV infection and unplanned pregnancy (Teitelman, Tenille, Bohinski, Jemmott, & Jemmott, 2011; Thiel de Bocanegra, Rostovtseva, Khera, & Godhwani, 2010). The goal of the current research is to identify how men's intentions to use coercive CUR tactics differ based on individual (e.g., hostility toward women) and situation-specific risk factors (beverage condition: alcohol vs. sober control), and different condom use requests styles.

Research on men's CUR tactics focused initially on identifying the types and prevalence of CUR behaviors that men report using in their relationships. Davis and colleagues (2014b) found nearly one-third of young men (30.8%) have successfully used emotional manipulation tactics (e.g., telling partner how upset or angry they would be if they had to use a condom) with a partner in order to have unprotected sex when their partner wanted to use a condom. Almost a quarter (23.4%) of men in their sample reported successfully using deception (e.g., lying about a vasectomy or saying they will “pull out” prior to ejaculation, but not doing so), 9% reported condom sabotage (e.g., taking off or intentionally breaking the condom), and 1.6% successfully used the threat of or actual physical force (e.g., threatening to hurt or physically hold down partner so they cannot use a condom).

Identifying risk factors for men's coercive CUR behaviors is essential for informing prevention and intervention programs aimed at reducing these behaviors and promoting condom use among men. The small body of research that has examined men's CUR behaviors has identified men's hostility toward women and alcohol use as key risk factors (Abbey, Parkhill, Jacques-Tiura, & Saenz, 2009; Davis & Logan-Greene 2012; Davis et al., 2014a; 2014b; 2016). These risk factors have been well-established as contributing to other forms of sexually risky, coercive, and violent behavior that men use with women (see Abbey, Wegner, Woerner, Pegram & Pierce, 2014; Cooper, 2002; George & Stoner, 2002; Tharp et al., 2013; Weinhardt & Carey, 2000 for reviews).

Hostility Toward Women

Men who are high in hostility toward women express general distrust, anger, and ill will toward women (Lonsway & Fitzgerald, 1995; Malamuth, Linz, Heavey, Barnes, & Acker, 1995). They feel insecure and defensive toward women and find gratification in being able to control and dominate them (Malamuth, Heavey & Linz, 1996; Malamuth et al., 1995; Malamuth, Sockloskie, Koss & Tanaka, 1991). One way in which men who are hostile toward women can exert power over them is to resist using a condom during sex when their partner wants to use one. Two separate studies have identified men's hostility toward women as a key risk factor for CUR behavior. Davis and Logan-Greene (2012) used a modified version of the Sexual Experiences Survey (Koss et al., 1987) to assess the number of coercive acts men reported perpetrating in order to have unprotected sex. In their SEM analysis, men's hostile attitudes toward women emerged as a direct predictor of coercive CUR tactic use. In another study by Davis and colleagues (2014b), latent profile analysis was used to identify constellations of risk factors related to men's self-reported CUR tactics (Davis et al., 2014a). Men with moderate or high levels of hostility toward women and negative condom use attitudes reported engaging in CUR tactics more frequently than men low in hostility toward women and with more positive attitudes towards condoms. Mean values suggested that men with the highest level of hostility toward women were especially likely to use coercive CUR tactics including deception, condom sabotage, and physical force, although these means did not significantly differ from men with moderate levels of hostility toward women (Davis et al., 2014b).

Acute Alcohol Intoxication

There is a well-established link between alcohol consumption and risky sexual intentions and behavior (Cooper, 2002). Intoxicated men perceive fewer potential negative consequences associated with condom nonuse, report a greater willingness to engage in sex without a condom, and endorse greater justifications for having unprotected sex than sober men (Davis et al., 2007; Fromme, D'Amico, & Katz, 1997; George et al., 2009; MacDonald, Fong, Zanna, & Martineau, 2000a; MacDonald, MacDonald, Zanna, & Fong, 2000b). As well, experimental alcohol administration research has shown that intentions to engage in unprotected sexual intercourse increase linearly with blood alcohol content (BACs from .00 mg/ml to .10 mg/ml; see Rehm, Shield, Joharchi, & Shuper, 2012; Scott-Sheldon, Carey, Cunningham, Johnson, Carey, & MASH research Team (2016) for meta-analyses).

Recent research focusing specifically on CUR intentions has found that acute alcohol intoxication is directly associated with stronger justifications for using CUR and stronger CUR intentions (Abbey et al., 2009; Davis et al., 2016). Using methods similar to the current study, Davis and colleagues (2016) found that intoxicated men report significantly stronger intentions to engage in CUR behaviors than do sober men. As well, Davis and colleagues demonstrated that group differences could be explained by a significant increase from baseline to post-beverage consumption in intentions among intoxicated men, but not sober men.

Synergistic Effects of Hostility and Acute Alcohol Intoxication

Abbey and colleagues (2009) hypothesized that acute alcohol intoxication would increase men's justifications for using coercive CUR in response to a direct condom request from a woman, but only for men high in hostility. Men with greater hostility have a lower threshold for engaging in hostile and aggressive behaviors, and acute alcohol intoxication has been shown to further reduce inhibitions for engaging in aggressive behavior among men who are high in hostility and hostile rumination (Bailey & Tailor, 1993; Borders & Giancola, 2011). In support of their hypothesis, men's hostility was significantly positively related to men's justifications for engaging in CUR tactics for intoxicated, but not sober, men. The current study extends this previous research by examining the synergistic effects of hostility toward women, rather than general hostility, and acute alcohol intoxication on men's intentions to engage in coercive CUR behaviors. The current study also considers how intoxicated men high in hostility toward women respond differently to varying types of condom request, compared to men without these risk factors.

Women's Condom Use Requests

Condom use negotiation is a complex process, often involving verbal and nonverbal communication tactics from both partners. Women self-report that they are most likely to use direct and insistent condom request tactics with their partners and that these tactics are highly effective at persuading a resistant partner to use a condom during sexual intercourse (Bird et al., 2001; DeBro et al., 1994; Edgar et al., 1992; Lam, Mak, Lindsay, & Russell, 2004; Noar, Morokoff, & Harlow, 2004; Tschann et al., 2010). In support of this assertion, most women report that their direct and insistent requests are met with compliance (Edgar et al., 1992). However, we know relatively little about how men perceive and respond to women's condom use requests (see Peasant, Parra, & Okuwumabua, 2014, for review). The prevalence of men's coercive CUR suggests that a subset of those women who reported their partner was compliant unfortunately may have been lied to, manipulated, or deceived by their partner. In one of a few studies to examine men's perceptions of women's condom requests, Edgar and colleagues (1992) found that the majority of their male sample said they would comply with a direct condom request. However, a subset of their sample reported they would likely become upset and/or violent if their partner directly asked them to use a condom. Indeed, it is not uncommon for victims of intimate partner violence to report that they have experienced physical and/or sexual abuse in response to making a direct condom request (Davila & Brackley, 1999; Kalichman, Williams, Cherry, Belcher, & Nachimson, 1998). In laboratory analogue experiments (George et al., 2016; Masters et al., 2014), women with sexual victimization histories anticipate that a potential partner will react negatively (e.g., become angry, force you to have sex) to a direct condom request.

Brehm's Reactance Theory (Brehm, 1966) offers a theoretical explanation for such retaliatory behavior. According to Reactance Theory, when an individual's perceived freedoms are threatened or eliminated (e.g., ability to have unprotected sex), a state of psychological reactance motivates individuals to behave in ways that will allow them to regain these freedoms (e.g., coercive CUR tactics; Miron & Brehm, 2006). The magnitude of reactance depends on 1) the strength of the threat to the individual freedom or 2) the individual's propensity for reactance, but most likely the combination of the two (i.e., interaction). In the current study, the strength of threat is experimentally manipulated through the type of condom use request (insistent, direct, and indirect), and hostility toward women serves as an indicator of the individual's propensity for reactance.

The Current Study

The current study utilizes survey and experimental methods to examine how men's hostility toward women and acute alcohol intoxication predict their intentions to engage in coercive CUR tactics (i.e., emotional manipulation, deception, condom sabotage, and physical force), in response to varying types of condom use request.

  • Hypothesis 1: Men with higher hostility toward women will report stronger CUR intentions than men with lower hostility toward women.

  • Hypothesis 2: Intoxicated men will report stronger CUR intentions than sober men.

  • Hypothesis 3: Finally, we hypothesize a 3-way interaction between hostility toward women, beverage condition and condom request condition on men's CUR intentions. Consistent with Abbey and colleagues' (2009) findings and Reactance Theory, we hypothesize that, following a direct or insistent condom request from the woman, intoxicated men high in hostility toward women will report stronger coercive CUR intentions, than intoxicated men low in hostility toward women or sober men high or low in hostility toward women. Also, within the hypothesized three-way interaction, we expected – based on Reactance Theory – men low in hostility toward women and men in the indirect condom request condition to report weaker intentions to engage in coercive CUR tactics.

Method

Participants

Participants included 320 men, ages 21 to 30 years old. Men were eligible if they were non-problem drinkers, had at least one instance of unprotected vaginal or anal sex with a woman in the past year, and were not in a long-term monogamous relationship. Consistent with the National Institute on Alcohol and Alcohol Abuse (NIAAA) guidelines for ethical administration of alcohol to humans in research settings (NIAAA, 2005), men were excluded if they reported medical condition(s) or prescription drug use contraindicated with alcohol consumption, typically consumed fewer than 3 drinks per week, or had a history of negative reactions to alcohol or problem drinking, as assessed by the Brief Michigan Alcohol Screening Test (BMAST; Pokorny, Miller, & Kaplan, 1972).

Procedure

Men were recruited from an urban community using online and print advertisements targeted toward younger audiences. The advertisement sought single male drinkers of all ethnicities, aged 21-30, to participate in a research study on male-female social interactions. Interested individuals called the laboratory to complete a screening survey over the telephone to assess their eligibility for the study. When eligible participants arrived at the laboratory, a trained male experimenter checked their photo ID to verify their age and made sure that their blood alcohol concentration (BAC) was 0.00, using a handheld breathalyzer (Alco-Sensor IV, Intoximeters, Inc.). The experimenter asked if they adhered to the following pre-visit requirements: a) not driving to the laboratory; b) not consuming a caloric beverage or food in the past 3 hours; and c) not consuming alcohol or using recreational or over-the-counter drugs in the past 24 hours. Once verified, the experimenter administered informed consent. Afterward, participants completed the survey measures in a private room by entering their responses into a computer (Datstat Illume, version 4.7). All procedures and measures were approved by the university's Human Subjects Division institutional review board prior to data collection.

Background questionnaire

Prior to the alcohol administration experiment, participants completed background questionnaires, which included demographics and the assessment of hostility toward women. The background questionnaire took approximately one hour to complete.

Hostility toward women

Participants completed a revised version of Lonsway and Fitzgerald's (1995) 10 item Hostility Toward Women Scale. Example items included, “I think that most women would lie just to get ahead” and “Sometimes women bother me by just being around.” Response options ranged from 1 (strongly disagree) to 7 (strongly agree). A mean of the 10 items was computed. Cronbach's alpha for this sample = .86.

Beverage administration

Following the background measures, participants were randomly assigned to a beverage condition: 1) an alcohol dose (.82 ml ethanol per pound of body weight; Friel, Logan, O'Malley, & Baer, 1999) intended to yield a peak BAC of 0.08%; or 2) a control condition in which participants did not receive alcohol and were told they did not receive alcohol. Alcoholic beverages consisted of one part 100-proof vodka to three parts orange juice, and breathalyzer tests were administered every 4 minutes until a target BAC of .05% was reached. This target was selected so that participants read the experimental story and experienced the experimental manipulation while on the ascending limb of the BAC curve. A yoked control design in which each control participant completed the same number of breathalyzer tests as a matched alcohol participant was used to reduce error variance in time between beverage consumption and experimental manipulation (Giancola & Zeichner, 1997; Schacht, Stoner, George, & Norris, 2010).

Experimental story

After reaching the target BAC, participants read a sexually explicit scenario which was written in the second person. Participants were instructed to project themselves into the story. The first part of the story introduced a relationship with “Erica” by describing two previous sexual encounters. In the first sexual encounter, the protagonist meets Erica at a party where they have consensual casual sexual intercourse using a condom. In the second sexual encounter a couple of nights later, the protagonist runs into Erica at a local bar. After the bar, they go back to his place where they again have consensual sexual intercourse, but on this occasion they do not use a condom.

In the current interaction, Erica invites him to her apartment to watch a movie. Participants are told to project themselves into the story at their current level of intoxication; thus, to be consistent, during this encounter he is offered either a soda or a mixed drink of soda and alcohol matched to his assigned beverage condition (i.e., control condition participants were offered soda and alcohol condition participants were offered an alcoholic beverage). The action progresses from kissing to removing their clothes, becoming increasingly erotic and describing consensual explicit sexual activity. Erica then makes a request to use a condom (Condom Request 1), and the protagonist realizes that he does not have one. The story continues with Erica suggesting that she go search for a condom. Once she finds a condom, she and the protagonist continue to engage in consensual explicit sexual activities, including genital fondling but not intercourse. At this point, Erica once again makes a condom use request (Condom Request 2). The final part of the story includes more explicit, erotic sexual activity, leading up to but not including penetration, and a final request from Erica to use a condom (Condom Request 3). The scenario ends with only consensual sexual activity having occurred between the participant and the woman.

Condom request style manipulation

Upon arriving in the lab, participants were randomly assigned to one of three condom request conditions: Indirect, Direct, or Insistent. Based on research suggesting that using a combination of verbal and nonverbal tactics is common (Lam et al., 2004), verbal and nonverbal tactics were used by the woman in each condom request condition. The indirect request condition included the woman asking her partner if he thinks they should use a condom, making nonverbal gestures toward the condom, and subtly suggesting they should use a condom. The direct request condition included an explicit verbal request to use a condom and handing the condom to the man. Finally, the insistent request condition included the woman making a statement that there will be no sex unless a condom is used while she opens the condom package and hands it to the man. See Table 1 for a detailed description of the verbal and nonverbal cues.

Table 1. Outline of Escalation of Condom Use Requests by Experimental Condition.
Condom Request Style
Indirect Direct Insistent
Condom Request 1 “What do you think about using a condom?” “I think we should use a condom this time.” “You have to use a condom this time.”
Condom Request 2 “Should I look for one?” “I probably have one. I'll go look.” “I know I have one. Come with me.”
Condom Request 3 Erica sits up a bit and glances over at the condom, saying “What do you think?” Erica pulls away a bit and looks at the condom saying, “I think you should put it on now.” Erica pushes you off of her and starts to reach for the condom, saying “No condom, no sex.”
Condom Request 4 Erica looks over at the condom on the table and says “I really want you to fuck me, but maybe we should, you know…” then stops and doesn't say anything else. Erica reaches for the condom on the table, hands it to you, and says, “I really want you to fuck me, but I don't want to have sex without a condom this time.” Erica grabs the condom, opens it and says “I really want you to fuck me. But if you want to fuck me, you have to wear this. No condom means no sex – got it?”
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Coercive CUR tactics

Intentions to use coercive CUR tactics were assessed after the final condom use request made by Erica, using 13 items from the emotional manipulation (e.g., “Tell Erica how angry you would be if she insists on using a condom.”), deception (e.g., “Lie and tell her you will pull-out before you ejaculate but actually plan on ejaculating inside her.”), condom sabotage (e.g., “Agree to use a condom, but remove the condom before or during sex without telling her.”), and physical force (e.g., “Use physical force to get Erica to have sex with you without a condom.”) subscales of the Condom Use Resistance Tactics Survey (Davis et al., 2014). Items asked participants to rate how likely they would be to employ a CUR tactic at this point in the situation in order to get Erica to have sex without a condom. Response options ranged from 1 (very unlikely) to 7 (very likely). All items were averaged to create an average coercive CUR intentions score (α = .90). Demonstrating construct validity for this experimental paradigm, participants' coercive CUR intentions in the experimental scenario were significantly positively correlated with past coercive CUR behavior (assessed at baseline using the same scale as described above, but asking men to indicate the number of times they had used these tactics ‘since the age of 14’), r = .19, p < .001.

After completing the dependent measures, control participants were debriefed and paid $15 per hour. Participants who received alcohol were debriefed and then released once their BAC dropped to below.03%.

Results

Missing Data and Data Cleaning

Two participants withdrew from the study after they arrived at the lab. Five participants were removed from the data set because they provided unreliable data. Four men felt ill after consuming the alcoholic beverage and did not complete the dependent measures. An additional participant was removed because he was missing responses on the outcome measure.

Manipulation Checks

Condom request style condition

At the end of the experiment, participants were asked to rate the woman's behavior in terms of how it aligned with their experimentally assigned condom request style condition. Participants (n = 12) whose ratings of the woman's behavior were incongruent with their experimentally assigned condition were removed from analyses. The final sample size for current study analyses is N = 296. Approximately one third of participants were in each of the three condom request style conditions: 32.4% (n = 96) indirect, 33.1% (n = 98) direct, and 34.5% (n = 102) insistent.

Alcohol condition

One hundred and fifty (50.7%) participants were assigned to the alcohol condition and 146 (49.3%) to the sober condition. Participants in the alcohol condition had an average BAC of .061% (SD = .01%) at the time they started reading the experimental story (approximately 45 minutes post-beverage administration). After completing the experimental story and all post-story questionnaires, participants' average BAC was .070% (SD = .01%).

Experimental realism

All of the following items had response options ranging from 1 (strongly disagree) to 7 (strongly agree). On average, participants strongly agreed that the scenario depicted a realistic situation that might happen to other men their age, M = 6.22, SD = 1.12, that the scenario depicted a realistic situation that might happen to them, M = 5.87, SD = 1.53, and that it was easy to project themselves into the scenario (i.e., imagine the scenario was happening to them), M = 5.73, SD = 1.51. Participants rated the woman in the story as highly attractive, M = 6.41, SD = .99, and indicated that at the end of the scenario they were sexually aroused, M = 5.52, SD = 1.30. Each of these values was significantly greater than the midpoint of the scale (midpoint = 4), t's ranged from 9.02 to 41.69, ps all < .001.

Descriptive Information

Demographics

Participants were on average 25 years old (M = 24.65, SD = 2.68). A quarter (25.1%, n = 74) were currently enrolled as students. Sixty-five percent (65.2%) self-identified as White/Caucasian, 9.5% as Black/African American, 10.1% as Multi-racial, 5.1% as Asian/South Asian, 1.0% as Native Hawaiian/Pacific Islander, 1.0% as Native American/Alaskan Native, and 7.8% indicated Other or did not reply. Across all participants, 8.1% identified as Hispanic/Latino.

Hostility toward women

On average, participants were relatively low in hostility toward women (M = 2.95, SD = 1.00). Although low, these levels are comparable to those observed in Abbey et al.'s (2009) study (i.e., range across beverage conditions 2.09 to 2.49, SD = .66 to .72). Participants did not significantly differ in their pre-existing hostility toward women across beverage condition, F (1, 294) = .58, p = .45, or condom request condition, F (2, 293) = .09, p = .91.

Condom use resistance

On average, men reported that they would be very unlikely to unlikely to use coercive CUR tactics (M = 1.21, SD = .55, skew = 6.23). Although the mean was low, the full range of scores was endorsed. The distribution was significantly and strongly positively skewed.

Generalized Linear Modeling

To account for the non-normal distribution of the dependent variable, generalized linear modeling (GzLM) with gamma distributions and log link function was used to examine the relationships among hostility toward women, beverage condition, and condom request condition with coercive CUR intentions. The gamma distribution was selected because it can account for the nonlinear, significantly positively skewed distribution (McCullagh & Nelder, 1989; Neal & Simmons, 2007). To ensure that the gamma distribution was an appropriate distribution for the data, a model with a linear distribution was compared to a model using the gamma distribution. Based on the AIC and BIC value, it was determined that the gamma distribution substantially improved model fit. In the GzLM analysis, beverage condition was coded 1 = alcohol and 0 = sober, and the condom request condition was coded as 3 = insistent, 2 = indirect, 1 = direct, with the direct condom request condition used as a referent comparison group. Hostility toward women was mean-centered prior to being entered into the models. Table 2 includes the Wald X2 statistics for the main and interaction effects from the GzLM analyses. Whereas linear regressions use F and t-tests to assess the significance of the model and predictors, GzLMs use z and Wald X2 tests of significance.

Table 2. GzLM Parameter Estimates of Main and Interactive Effects of Experimental Condition and Hostility Toward Women on Coercive Condom Use Resistance Tactics.

Model 1 Model 2 Model 3
B Wald X² Sig. B Wald X² Sig. B Wald X² Sig.
Hostility Toward Women (HTW) 0.11 41.16 <.001 0.09 6.50 <.05 0.03 0.46 0.50
Insistent Condom Request 0.04 0.93 0.34 0.05 0.67 0.41 0.04 0.40 0.53
Indirect Condom Request 0.11 7.51 <.01 0.17 8.75 <.01 0.16 7.59 <.01
Beverage Condition 0.09 7.01 <.01 0.14 5.45 < .05 0.13 5.25 < .05
Insistent Condom Request × HTW -0.02 0.24 0.62 0.06 0.79 0.37
Indirect Condom Request × HTW 0.04 0.88 0.35 0.13 5.27 <.05
Beverage Condition × Insistent Condom Request -0.02 0.08 0.78 -0.02 0.07 0.80
Beverage Condition × Indirect Condom Request -0.12 2.26 0.13 -0.12 2.15 0.14
Beverage Condition × HTW 0.02 0.30 0.58 0.14 5.11 0.14
Beverage × HTW × Insistent Condom Request -0.15 3.09 0.08
Beverage × HTW × Indirect Condom Request -0.19 5.33 <.05
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Note. For Beverage Condition 1 = alcohol condition, 0 = sober condition. For Condom Request Condition, the referent group was the direct condom request condition.

Main effects

When only main effects were entered into the model (Table 2, Model 1), there was a significant positive main effect of hostility toward women on men's coercive CUR intentions, providing support for Hypothesis 1. There was a significant main effect of beverage condition, indicating intoxicated men reported stronger coercive CUR intentions than sober men. Thus, Hypothesis 2 was also supported. The condom request condition contrast, with the direct condom request condition as a referent group, indicated that men had stronger coercive CUR intentions following an indirect condom request than following a direct request. Men's coercive CUR intentions did not significantly differ following an insistent versus direct condom use request.

Two-way and three-way interactions

All two-way interactions were not significant (see Table 2, Model 2). As shown in Table 2, Model 3, the three-way interaction between beverage condition, indirect (vs. direct) condom request, and hostility toward women was significant. Although the three-way interaction among hostility toward women, beverage condition, and insistent (vs. direct) condom request condition only approached significance, we included these regression lines in Figure 1 and discuss estimated marginal mean differences below as points of comparison.

Figure 1. Relationship between Men' Hostility toward Women and Coercive CUR Intentions Based on Beverage Condition and Woman's Condom Request Style Condition.

Figure 1

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Note. The simple slopes for the Direct Alcohol and Indirect Sober groups significantly differ from zero, ps < .05.

Simple slopes analyses

The significant interaction was probed by plotting the simple regression lines for participants' beverage condition (alcohol vs. sober) at different levels of hostility toward women (1 SD above and below the mean) for each of the three condom request conditions. Simple slopes analyses were conducted to determine if the slopes for beverage condition and condom request style significantly differed from zero (Aiken & West, 1991). For men in the indirect condom request condition, the slope for the sober condition significantly differed from zero, t(284) = 4.34, p < .001; however, the slope for the alcohol condition did not significantly differ from zero, t(284) = 1.04, p = .30. For men in the direct condom request condition, the slope for the sober condition did not significantly differ from zero, t(284) = .67, p =.50; however, the slope for the alcohol condition did significantly differ from zero, t(284) = 3.84, p < .001. Thus, men with greater hostility toward women reported significantly stronger CUR intentions when sober following an indirect request and when intoxicated following a direct request.

Pairwise comparisons of estimated marginal means

Pairwise comparisons of estimated marginal means were used to test for mean differences in CUR intentions for the alcohol and sober conditions separately by condom request condition at low and high levels of hostility toward women. As can be seen in Table 3, among men low in hostility toward women, pairwise comparisons indicated no significant differences in strength of coercive CUR intentions across condom request style condition.

Table 3. Estimated Marginal Means for Men Low and High in Hostility toward Women Based on Beverage Condition and Condom Request Style Condition.
Sober Intoxicated
Insistent Direct Indirect Insistent Direct Indirect
Low Hostility Toward Women 1.03 (.06) 1.05 (.07) 1.08 (.06) 1.16 (.06) 1.04 (.06) 1.15 (.06)
High Hostility Toward Women 1.22 (.08)a 1.12 (.06)a,c 1.49 (.08)b 1.36 (.07)d 1.47 (.10)b 1.44 (.08)b
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Note. Estimated marginal means and contrasts were examined across experimental groups, separately at 1 SD below and above the mean for men's hostility toward women. Means are presented with standard errors in parentheses. a < b and c < d, p < .05.

Among men high in hostility toward women, pairwise comparisons indicated that intoxicated men who experienced a direct or indirect request and sober men who experienced an indirect request reported significantly stronger CUR intentions than sober men who experienced a direct or insistent condom request. Additionally, intoxicated men who experienced an insistent condom request reported significantly stronger CUR intentions than sober men who experienced a direct condom use request. Pairwise comparisons also indicated that sober men who experienced a direct or an insistent condom request did not significantly differ from each other.

Discussion

The current study extends the literature on men's condom use avoidance behavior by examining how hostility toward women and acute intoxication impact men's responses to women's different condom use request styles. Overall, men's intentions to use coercive CUR tactics were quite low on average, which is to be expected when examining combined intentions for very low base rate behaviors, such as physical force and condom sabotage, with more commonly reported coercive CUR behaviors, such as emotional manipulation (Davis et al., 2014b). Although most men reported little intention of using coercive CUR tactics in response to this specific sexual scenario, some men reported that they were very likely to use such tactics, indicating a need for greater understanding of the factors predictive of coercive CUR intentions.

In support of Hypothesis 1, men with greater hostility toward women reported stronger intentions to use coercive CUR tactics. This is consistent with the previous research (Davis & Logan-Green, 2012; Davis et al., 2014b) and reiterates that men who are hostile toward women pose a greater threat to women's sexual safety than men without such attitudes. Hostility toward women has long been considered an individual level risk factor for men's sexually coercive and aggressive behavior (see Tharp et al., 2013 for review). However, such hostility has received less attention as a potential moderator of in-the-moment perceptions of women's behavior and a catalyst for intentions to engage in coercive condom-related behaviors (c.f. Abbey et al., 2009). Current findings indicate that hostility toward women is indeed a risk factor for the use of coercion around condom negotiation, suggesting that sexual risk prevention programs should also consider men's attitudes about women in their programming.

In support of Hypothesis 2, intoxicated men reported stronger intentions to use coercive CUR tactics when compared to sober men. These findings corroborate previous studies (e.g., Davis et al., 2016) in which acute alcohol intoxication increased men's CUR likelihood relative to sober states and are also commensurate with alcohol-related findings regarding other types of increased sexual risk intentions (Rehm et al., 2012; Scott-Sheldon et al., 2016), as well as sexual coercion intentions (see Abbey et al., 2014 for review). Because of the consistency of these findings, interventions targeting coercive CUR would be well-served to address the role of alcohol in these behaviors.

A significant 3-way interaction between hostility toward women and beverage condition with indirect (vs. direct) condom request condition provides partial support for Hypothesis 3. As hypothesized, men with low levels of hostility toward women reported weak intentions to use coercive CUR tactics; these did not significantly differ based on beverage condition or the woman's condom request style. Among men with high levels of hostility toward women, and consistent with previous research (Abbey et al., 2009), after experiencing a direct condom request from a woman, intoxicated men reported stronger intentions to use coercive CUR tactics than sober men high in hostility toward women. Unexpectedly, there was a significant positive relationship between hostility toward women and coercive CUR intentions among men who experienced an indirect condom request when sober. Because this pattern of results was somewhat unexpected, it will be important to replicate these results in future studies. Importantly, regardless of the woman's condom request style, intoxicated men high in hostility toward women had the strongest coercive CUR intentions relative to almost all other groups, suggesting that men with these combined individual and situation-specific risk factors pose greater sexual risk to their female partners.

Strengths and Limitations

A strength of the current study is the use of an experimentally rigorous design with high internal validity. Random assignment to beverage condition increases our confidence in the causal role of acute intoxication in the etiology of condom avoidance behaviors. As well, random assignment to condom request condition allowed us to explore how men prone to react negatively to women's assertion of sexual power respond differently to varying types of condom requests. However, results from the current study may not generalize to men not included in the current sample, such as problem drinkers and abstainers or those who always use condoms. The current research focused on a casual sexual relationship in which the individuals have an inconsistent condom use history. Additional research is needed to examine how men's responses might differ within a committed relationship. In the current experiment, participants were not provided with a rationale for why the woman wanted to use a condom on this occasion when she had previously agreed to have sex without a condom. Because previous work has demonstrated that the reasons for requesting condom use may influence a partner's response to such requests (Bird et al., 2001; Otto-Salaj et al., 2008; Neighbors, O'Leary & Labouvie, 1999), future research should consider examining the intersection of condom use rationale and directness of message. Finally, the sexual scenario presented a situation in which the couple's history of condom use was inconsistent; thus, findings may not generalize to situations in which condoms were consistently used or not used in the couple's prior sexual activities.

Research Implications

The limitations of this study suggest areas for future research. Studies that examine the use of coercive CUR in real-world situations with a more diverse sample of men are needed. Future research should examine men's patterns of CUR tactic use across a single condom use negotiation event. It seems likely that men who do not want to use a condom may utilize multiple tactics throughout a sexual encounter if their first CUR tactic or preferred CUR tactic did not succeed. Moreover, additional research is needed to better understand how men who are high risk for coercive CUR differentially perceive and respond to women's rationale (e.g., pregnancy, STI/HIV, infidelity concerns) when making condom use requests. Hostile attitudes toward women and alcohol intoxication are risk factors for sexual coercion generally as well as coercion regarding condom non-use. Future research identifying other common and disparate risk and protective factors for coercive CUR and other sexually coercive behaviors would be highly useful for informing prevention and intervention efforts targeting these behaviors.

Clinical and Prevention Implications

The majority of men reported a low likelihood of coercive CUR. However, some men reported that they would be highly likely to engage in these tactics indicating a need to address these behaviors in prevention and intervention programs targeting high risk men, particularly those high in hostility toward women. Alcohol's role in increasing the use of these tactics should also be addressed in these programs. Pending replication of the current results, prevention programs may eventually consider informing women of the ways in which men react to certain condom request styles in specific high risk situations. Our results support previous work (e.g., Edgar et al., 1992) demonstrating that women's direct/insistent condom use requests may be the most effective approach for condom negotiation generally, but also extend previous work by demonstrating that women's condom request style is not differentially influential with intoxicated men high in hostility toward women. These findings thus suggest that prevention programs should not only focus on ways in which to request condom use, but also address situational and partner risk factors when instructing women in these techniques. Although women are in no way accountable for men's coercive CUR behaviors, it is important to provide women with information that could help them to protect themselves from sexually coercive behavior. A two-pronged approach to these efforts – targeting men's risk of engaging in coercive CUR while also teaching women ways to potentially reduce their risk of experiencing coercive CUR – may ultimately be the most effective method for improving the sexual health of young men and women.

Acknowledgments

Research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under award numbers R01AA017608 (PI: Kelly Cue Davis) and T32AA007455 (PI: Mary Larimer). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Contributor Information

Rhiana Wegner, Department of Psychiatry and Behavioral Sciences, University of Washington

Kelly Cue Davis, School of Social Work, University of Washington

Cynthia A. Stappenbeck, Department of Psychiatry and Behavioral Sciences, University of Washington

Kelly F. Kajumulo, Department of Psychology, University of Washington

Jeanette Norris, Alcohol and Drug Abuse Institute, University of Washington

William H. George, Department of Psychology, University of Washington

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