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Abusive Experiences and Young Women's Sexual Health Outcomes: Is Condom Negotiation Self‐Efficacy a Mediator?
Author(s) -
Jones Kelley A.,
Cornelius Marie D.,
Silverman Jay G.,
Tancredi Daniel J.,
Decker Michele R.,
Haggerty Catherine L.,
De Gentacha M.,
Miller Elizabeth
Publication year - 2016
Publication title -
perspectives on sexual and reproductive health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.818
H-Index - 93
eISSN - 1931-2393
pISSN - 1538-6341
DOI - 10.1363/48e8616
Subject(s) - unintended pregnancy , sexual coercion , condom , domestic violence , reproductive health , coercion (linguistics) , odds , population , sexual partner , family planning , psychology , sexual violence , odds ratio , medicine , poison control , clinical psychology , injury prevention , human immunodeficiency virus (hiv) , family medicine , environmental health , logistic regression , criminology , linguistics , philosophy , syphilis , gonorrhea , pathology , research methodology
CONTEXT Intimate partner violence and reproductive coercion are associated with unintended pregnancies and STDs . Greater condom negotiation self‐efficacy among young women may mediate these associations.METHODS A sample of 841 female adolescents (aged 16–19) and 1,387 young adult women (aged 20–24) recruited from 24 family planning clinics in western Pennsylvania in 2011–2012 reported on intimate partner violence, reproductive coercion, condom negotiation self‐efficacy and sexual health outcomes at baseline and four‐ and 12‐month follow‐ups. Mixed models were used to test associations of intimate partner violence and reproductive coercion with unintended pregnancy and STD diagnosis. The Sobel test of mediation was used to measure indirect effects of condom negotiation self‐efficacy.RESULTS At baseline, 15% of adolescents and 11% of young adults reported recent intimate partner violence victimization; 7% and 6%, respectively, reported recent reproductive coercion. For both age‐groups, intimate partner violence and reproductive coercion were associated with a reduced level of condom negotiation self‐efficacy (coefficients, −0.27 to −0.13) and increased odds of STD diagnosis (odds ratios, 1.03–1.1). However, only reproductive coercion was associated with unintended pregnancy (odds ratios, 1.1 for each group). The only association that condom negotiation self‐efficacy mediated was between reproductive coercion and unintended pregnancy among young adults (17% of total effect).CONCLUSIONS Targeting condom negotiation self‐efficacy alone in abusive relationships would likely not translate into improved sexual health outcomes in this population. Other strategies are needed to prevent unintended pregnancy and STDs .