(021) STEALTHING IS ASSOCIATED WITH NEGATIVE SEXUAL HEALTH OUTCOMES AMONG COLLEGE WOMEN, REGARDLESS OF WOMEN’S SEXUAL COMMUNICATION
Authors: Bogen K , Lorenz T 
Published: June 2024

Abstract

Introduction
Non-consensual condom removal (“stealthing”) occurs when a perpetrator either says that they will put on a condom but begins intercourse before doing so, or removes a condom before or during intercourse without their partner’s consent. Up to one third of women report experiencing stealthing (Latimer et al., 2018). Stealthing is associated with greater lifetime recreational drug use and sexual shame, as well as positive sexual outcomes like pleasure, desire, arousal, lubrication, and feelings of pleasure deservingness (blinded for review). Preliminary research on the gynecological and reproductive health outcomes of stealthing reveals that experiences of stealthing significantly predict gynecological infections, lifetime pregnancy, and condom use barriers (blinded for review). Intervention research highlights the necessity of prevention programming enhancing women’s sexual communication skills to increase agency in condom use and to prevent SV. However, stealthing is a deliberate choice of non-communication by a perpetrator, and thus it is unclear if women’s sexual communication can play a role in preventing negative health sequelae.

Objective
The present study examined if sexual communication comfort explains associations between stealthing experiences and a series of sexual outcomes (vaginal infection, ever pregnant, times pregnant, age pregnant, contraceptive use, condom use barriers and motivators, genital self-image, pleasure deservingness, pleasure assertiveness self-efficacy, and female sexual functioning) among a sample of college women.

Methods
A sample of 440 women (Mage = 20.3, SD = 2.24) from an online pool at a large Midwestern US university completed an online survey regarding sexual violence and sexual health. Measures included single items regarding lifetime history of vaginal infections, number of lifetime pregnancies (including parity and gravidity), age at first pregnancy, and current contraceptive use. Participants completed well-validated measures of condom use barriers and motivators, genital self-image, pleasure deservingness and assertiveness, and overall sexual functioning. We tested associations between stealthing and outcome of interest via linear regressions controlling for other forms of SV (force, coercion, intoxication) as well as lifetime number of sexual partners. We ran mediation models using the Hayes PROCESS Macro (Model 4). All analyses were completed in R version 4.2.

Results
Approximately one-third of participants (30.2%, n = 133) reported stealthing experiences. Stealthing was independently associated with a history of vaginal infection, ever having been pregnant, and condom use barriers related to partner pressure. Sexual communication skills did not significantly mediate associations between stealthing and any outcome variables of interest.

Conclusions
Despite SV prevention work emphasizing the utility of sexual communication skills in protecting women against both SV and negative sexual health outcomes, we found that sexual communication comfort did not mediate associations between stealthing and sexual wellbeing outcomes. Findings indicate that intervention resources would be better spent on preventing stealthing perpetration. Given findings relevant to pregnancy, addressing stealthing perpetration is particularly important following the repeal of Roe vs. Wade and new restrictions to abortion access in the United States.

Disclosure
No.