"Stealthing": Factors Associated With Young Men's Nonconsensual Condom Removal

Objective: The purpose of this study was to investigate the rates, predictors, and associated sexual risk indices of young men's nonconsensual condom removal (also known as stealthing). Methods: Participants were 626 male inconsistent condom users aged 21-30 years recruited from an urban area in the Pacific Northwest. Participants completed survey measures assessing sexual aggression history, sexual aggression-related attitudes, sexually transmitted infection history, unplanned pregnancies, and nonconsensual condom removal experiences. Results: Almost 10% of the participants (n = 61) reported engaging in nonconsensual condom removal since the age of 14 years, with an average of 3.62 times (SD = 3.87) and range of 1-21 times (maximum possible). After controlling for condom use self-efficacy, men with greater hostility toward women (odds ratio = 1.47) and more severe sexual aggression history (odds ratio = 1.06) had significantly higher odds of engaging in nonconsensual condom removal behavior. chi(2) analyses demonstrated that men who had a history of nonconsensual condom removal were significantly more likely to have had a sexually transmitted infection diagnosis (29.5% vs. 15.1%) or have had a partner who experienced an unplanned pregnancy (46.7% vs. 25.8%). Conclusions: Nonconsensual condom removal, which involves elements of both sexual risk and sexual aggression, confers multiple sexual risks to its recipients, thus meriting increased clinical and research attention.