TY - JOUR
T1 - Abusive Experiences and Young Women's Sexual Health Outcomes
T2 - Is Condom Negotiation Self-Efficacy a Mediator?
AU - Jones, Kelley A.
AU - Cornelius, Marie D.
AU - Silverman, Jay G.
AU - Tancredi, Daniel J
AU - Decker, Michele R.
AU - Haggerty, Catherine L.
AU - De Genna, Natacha M.
AU - Miller, Elizabeth
PY - 2016/6/1
Y1 - 2016/6/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85028027905&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028027905&partnerID=8YFLogxK
U2 - 10.1363/48e8616
DO - 10.1363/48e8616
M3 - Article
C2 - 27077497
AN - SCOPUS:85028027905
VL - 48
SP - 57
EP - 64
JO - Perspectives on Sexual and Reproductive Health
JF - Perspectives on Sexual and Reproductive Health
SN - 1538-6341
IS - 2
ER -