Non-Consensual Sex and Help-Seeking Behavior Among PrEP Users in Belgium: Findings from an Online Survey

ABSTRACT

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.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

¹ Various terms are used in the literature such as non-consensual sex, sexual violence, sexual assault, etc. We have chosen to use non-consensual sex because it reflects a broader range of experiences than, for instance, “sexual assault”. Moreover, we chose this term to stay in line with recent publications on the topic among MSM (e.g., Drückler et al., 2021). However, when citing other studies, we have chosen to preserve the original study terminology.

Additional information

Funding

This work was supported by the Fonds Wetenschappelijk Onderzoek [S004919N].