Vanbaelen T, Rotsaert A, Van Landeghem E, Nöstlinger C, Vuylsteke B, Scheerder G, Verhoeven V, Reyniers T
Department of Clinical Sciences, Institute of Tropical Medicine.
Department of Public Health, Institute of Tropical Medicine.
J Sex Res. 2025 Feb;62(2):245-251. doi: 10.1080/00224499.2023.2235330. Epub 2023 Jul 24.
Non-consensual sex poses a threat not only to sexual health but also to mental and physical health in general. HIV pre-exposure prophylaxis (PrEP) users might be particularly vulnerable to non-consensual sex because of interplaying factors such as mental health disorders, a high number of sex partners, engagement in chemsex, and the widespread use of dating apps. The objectives of this study were to assess the occurrence of non-consensual sex, its associated factors, and related help-seeking behavior among PrEP users. We analyzed data from an online survey among PrEP users in Belgium (09/2020-02/2022). Almost one in five participants (34/187, 18.2%) reported having ever experienced non-consensual sex. The most reported form was having sex against one's will, followed by having been given drugs against one's will, and having had sex without a condom against one's will. The vast majority of those who had experienced non-consensual sex (29/34, 85.3%) did not seek help afterward, mostly due to a lack of perceived need (21/29, 72.4%). Reported barriers to seeking help were shame (6/29, 20.7%) and lack of awareness of help services (3/29, 10.3%). Having experienced non-consensual sex in the past five years was associated with younger age and suicidal ideation in a multivariable logistic regression model. We conclude that addressing barriers to non-consensual sex help services is crucial to maximize their use and minimize the consequences of non-consensual sex experiences. PrEP consultations also represent an opportunity to offer such help given PrEP users are already familiar with these PrEP services and engaged in care.
非自愿性行为不仅对性健康构成威胁，总体上还对身心健康构成威胁。由于存在诸如心理健康障碍、性伴侣数量多、参与性药滥用以及约会应用广泛使用等相互作用的因素，艾滋病毒暴露前预防（PrEP）使用者可能特别容易遭受非自愿性行为。本研究的目的是评估PrEP使用者中非自愿性行为的发生率、其相关因素以及相关的求助行为。我们分析了比利时PrEP使用者在线调查（2020年9月至2022年2月）的数据。近五分之一的参与者（34/187，18.2%）报告曾经历过非自愿性行为。报告最多的形式是违背意愿发生性行为，其次是被违背意愿下药，以及违背意愿在无保护措施的情况下发生性行为。绝大多数经历过非自愿性行为的人（29/34，85.3%）事后没有寻求帮助，主要原因是缺乏感知到的需求（21/29，72.4%）。报告的求助障碍包括羞耻感（6/29，20.7%）和对帮助服务缺乏认识（3/29，10.3%）。在多变量逻辑回归模型中，过去五年经历过非自愿性行为与较年轻的年龄和自杀意念有关。我们得出结论，解决非自愿性行为帮助服务的障碍对于最大限度地利用这些服务并将非自愿性行为经历的后果降至最低至关重要。鉴于PrEP使用者已经熟悉这些PrEP服务并接受护理，PrEP咨询也代表了提供此类帮助的一个机会。
