Impact of a College Sexual Violence Prevention Program on Condom Use: A Mediation Analysis.

ABSTRACT

College-age students are disproportionately impacted by sexually transmitted infections. Campus programs that reduce sexual violence have received recent investment, are increasingly common, and may offer a platform to increase condom use, but this has not yet been investigated. We explore this novel question through a secondary analysis of a randomized control trial of RealConsent, a web-based, sexual assault program for college women, on three college campuses. By estimating single and multiple-mediator models we examine the relationships between study assignment, the hypothesized mediators self-efficacy to discuss safer sex, and clarity and assertiveness in sexual communication, and consistent condom use at follow-up. In the single mediator models, self-efficacy for safer sex communication (aOR 1.11, 95% CI 1.03-1.19, p = .004), assertiveness in sexual communication (aOR 1.06, 95% CI 1.02-1.11, p =.004), and clarity in sexual communication (aOR 1.03, 95% CI 1.00-1.05, p = .026) demonstrated significant direct effects on condom use. No statistically significant relationships between RealConsent and the mediators, nor indirect effects were found. In the multimediator model, there were no statistically significant associations identified. Self-efficacy, assertiveness, and clarity in communication about sex may have a positive impact on condom use but we did not find evidence that RealConsent impacted these mediators and thus no mediated effect was identified. Additional research is needed to develop and assess college-based sexual violence prevention programs that include an additional focus on skills specifically related to condom negotiation and use to understand if these widespread programs offer an efficient and effective platform to reduce the impact of sexually transmitted infections (STIs) among this high-risk population.