Trauma, condom negotiation, and mental health: Configurations of risk

Background: Sexual assault (SA) and intimate partner violence (IPV) are related to an increased risk of engaging in unprotected sex and contracting HIV. This relation may be explained by deficits in condom negotiation or psychological sequelae associated with these traumas. However, little research has examined how SA and IPV, condom negotiation, and psychological factors interact to form configurations of risk that are related to unprotected sex. This study identifies these configurations among college students in the context of casual sex partnerships. Methods: Participants were a diverse sample of 275 college students (M_age = 20.05; 20% men). Twenty four percent and 47% of the sample reported experiencing SA or IPV, respectively. Condom negotiation was measured using the Condom Influence Strategy Questionnaire. Psychological variables examined were depression, anxiety, and stress; posttraumatic stress; relationship avoidance and anxiety; and sexual sensation seeking. Latent profile analyses were conducted to identify risk profiles among participants. Results: Based on fit indices, a seven-class solution was considered the best model. This solution included a “Traumatized” group. This group had a 34% and 76% probability of experiencing SA or IPV, respectively. They reported higher levels of psychological distress and the lowest rate of condom negotiation compared to the other groups. Additional analyses will be conducted to compare rates of condom use across groups. Conclusions: Results indicate that the relations between these constructs are nuanced. Public health professionals must take into account a constellation of factors when addressing HIV prevention efforts for those who have experienced SA and IPV.