Sexual Negotiation Research Articles

Online commercial sexual exploitation of children in a national victim survey.

To describe the characteristics and consequences of online commercial sexual exploitation of children using a nationally representative sample. The online survey sample comprised 2,639 respondents aged 18-28 from the KnowledgePanel maintained by the survey research firm Ipsos. Fifty-eight respondents or a weighted 1.7% of the sample described childhood experiences in which they used technology to exchange sexual talks, sexual images, or other sexual activities for money, drugs, or other valuable items. The episodes were very diverse. Sixty-three percent were girls, 30% boys, 7% gender fluid, and 42% sexual minorities. Half were ages 16 or 17, and half were younger at the time of the activity. Many (44%) were involved in offline sexual activity. The purchasers were not exclusively anonymous internet contacts; 19% were current or former intimate partners and another 10% friends or acquaintances. Most of the exchanges (92%) were self-negotiated, and only 8% involved a facilitator. Nonetheless, most reported negative reactions involving embarrassment, anxiety, and feeling afraid. Sexual minority youth reported more exchanging sexual talk, having a facilitator involved, feeling afraid and falling behind in school or work than heterosexual youth. This national survey reveals a high frequency of childhood commercial sex that diverges from descriptions of dynamics based on police and social agency data. Such dynamics suggest the need for alternative approaches to prevention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Advice givers rating the quality of their own advice messages during sex talk: testing Advice Response Theory

ABSTRACT Advice givers are chosen on the basis that they provide valuable information on how to solve problematic issues. In sexual contexts, advice givers are chosen over romantic partners because they provide advice on how to manage sex in supportive environments. However, a lacuna in the sexual communication literature concerns how advice givers’ perceptions influence the quality of their own advice messages. This communication theory-based project examined how advice givers’ relational assessments, disclosure about sex, and perceived advice message features influence their own perceptions of advice quality. A total of 266 participants completed a survey developed based on the theoretical tenets of Advice Response Theory (ART). Data were analyzed using structural equation modeling. Advice givers who perceived themselves as a credible source of information perceived that they gave better quality advice. Additionally, greater disclosures of advice givers’ sexual experiences were positively associated with efficacy, feasibility, few limitations, positive face, and negative face. Theoretical and practical implications are discussed.

Beyond Consent: Exploring Bi+ People’s Experiences of Negotiating Sex Through a Queer Phenomenological Framework

ABSTRACT This article explores sexual negotiation beyond dominant consent frameworks that have centered on heterosexuality, responding to and preventing sexual violence, and the pursuit of autonomous, free choice. Building on the work of feminist theorists, I challenge the prevailing emphasis on individual responsibility and autonomy in understanding sexual violence and consent and urge a deeper consideration of how bodies and choices are shaped by social, cultural, and historical contexts. Drawing on 32 in-depth interviews, I examine how bi+ individuals in Australia negotiate sexual encounters with partners of diverse genders. Using a queer phenomenological framework of comfort and discomfort, I focus on experiences where participants felt they have been able to negotiate sex well. This framework acknowledges the complex interplay between sexual negotiation, gendered norms and sexual scripts, and subjectivity. I argue that hetero and queer norms and scripts both constrain and give possibility to sexual negotiation, and I propose that queer bodies and queer sex can disrupt normative constraints in ways that positively impact sexual negotiation. I conclude by advocating for a deeper understanding of the nuanced ways our choices are shaped during sexual encounters and suggest that we must look beyond heterosexuality and violence prevention going forward.

Evaluating the Performance of Machine Learning Algorithm for Classification of Safer Sexual Negotiation among Married Women in Bangladesh

Evaluating the Performance of Machine Learning Algorithm for Classification of Safer Sexual Negotiation among Married Women in Bangladesh

Dancing around gender expression and sex talk: LGBTQ+ asylum policy in the United States

In this article, I argue that the US Citizenship and Immigration Services’ current guidelines for LGBTQ+ asylum adjudication are both underinclusive and improperly restrictive. They are underinclusive because they are insufficiently attentive to LGBTQ+ applicants’ right to protection from persecution on the basis of gender expression. They also flatten the concept of gender identity by conflating it with transgender identity, thus reconsolidating a transgender/cisgender binary that impedes asylum officers’ ability to find cognizable those gender identities that exceed these two terms. The guidelines are also improperly restrictive because they forbid specific discussions of sex acts during the asylum interview. To be sure, this proscription is a response to widespread recent reports of abuse of applicants around the world. Nevertheless, it overcorrects for the problem and, in turn, hinders asylum officers’ ability to elicit detailed testimonies as well as impedes, in all likelihood, the ability of some applicants to furnish credible testimonials.

Exploring the relationship between mothers' competence and comfort in sexual and reproductive health discourse with adolescent girls and its related factors.

The mothers-adolescent discussion regarding sexual and reproductive health (SHR) issues plays an important role in preventing negative outcome associated with sexual risk behaviors. The present study aimed to explore the relationship between mothers' competence and comfort in SHR discourse with adolescent girls and its related factors. A cross-sectional study was conducted involving 160 mothers from July to September 2020. Data were collected through questionnaires covering demographic characteristics, Mother's Comfort in Sexual Discourse (MCSD), Mother's Interest in Sexual Discourse (MISD), and Parenting Sense of Competence (PSOC). The collected data were analyzed using simple and multiple linear regression models. The mean scores for MCSD, MISD, and PSOC were 45.49±16.15 (13-78), 7.9±4.2 (0-13), and 64.07±9.44 (45-94), respectively. The primary topics of mother-adolescent discourse on SRH were menstruation (5.61±0.98) and the delivery process (4.55±1.57). The mean age for "sex talks" and age-appropriate "sex talks" with daughters was 11.76±1.85 (range: 6-15) and 17.05±1.86 (range: 14-23) years, respectively. Significant associations were found between MCSD and MISD (β=0.482, p<0.0001), PSOC (β=0.223, p<0.005), self-efficacy (β=0.202, p<0.011), mother's job (β=0.185, p<0.019), mother's education (β=0.173, p<0.029), and father's age (β=0.161, p<0.042). After adjusting for other variables, major influencing factors on MCSD included MISD (β=0.487, p<0.0001), self-efficacy (β=0.143, p<0.039), satisfaction (β=0.169, p<0.015), daughter number (β=-0.235, p<0.014), son number (β=-0.219, p<0.024), birth rank (β=0.263, p<0.008), and residency (β=0.172, p<0.014). MISD, PSOC, and certain demographic characteristics emerge as significant factors influencing MCSD in mother-daughter sexual discourse. As such, it is imperative to consider these determinants when devising strategies to maintain and enhance the sexual health of teenage girls.

“GREETINGS FROM HELL (NERAKA KIRIM SALAM)”: A DISCOURSE ANALYSIS OF RELIGIOUS-BASED CYBERBULLYING OF DEHIJABIS

Background and Purpose: Many studies have been conducted on cyberbullying discourse in Malaysia, but religious-based cyberbullying discourse has received comparatively less attention. Malaysia’s second place ranking in cyberbullying practices among Asian countries in 2018 is striking, and it is worth highlighting that many public figures in the country have encountered cyberbullying upon deciding to remove their hijab. This paper examines how the first dehijabed Instagram posts by local celebrities, Uqasha Senrose, Emma Maembong and Liyana Jasmay incited religious-based cyberbullying.&#x0D; &#x0D; Methodology: This paper employs a mixed-methods approach. We examined the initial post-dehijabbing captions, along with a total of 300 comments on these posts. Through a two-tiered coding and categorization process, we identified 168 religious-based comments containing religious-related terminologies, Arabic expressions, Quranic verses, and Hadith. From this subset, 70 of them exhibit cyberbullying characteristics: Defamation, Defense, Encouragement, Exclusion, Sexual Talk, Insult and Threat/Blackmail. The most prevalent categories, Insult (n=29) and Threat/Blackmail (n=18) were further qualitatively analysed using Laclau and Mouffe’s discourse framework and Halliday’s transitivity analysis.&#x0D; Findings: The findings reveal that public figures who have removed their hijab have created a hegemonic intervention that challenges Malay Muslim hegemonic practice. Meanwhile, cyberbullies have created a hegemonic closure to counter the hegemonic intervention created by the dehijabed celebrities through the implementation of “Insult” and “Threat”. Nevertheless, the effects of the hegemonic closure, which involves the stabilization of myths as objective reality and the rearticulation of the transgressors’ identities as the sinners, have reproduced the power imbalance between the dominant group and the antagonists.&#x0D; &#x0D; Contributions: This paper demonstrated that while such practices allow cyberbullies to reinforce their dominance and hegemonic practices by manipulating religion, it is crucial to problematize religious-based cyberbullying discourse as yet another form of hegemonic intervention that appears to be a natural articulation in contemporary discourse.&#x0D; &#x0D; Keywords: Discourse analysis, religious-based cyberbullying, Malay hegemony, dehijabing, Malaysian celebrities.&#x0D; &#x0D; Cite as: Nur Syifaa, R., &amp; Siti Nurnadilla, M. J. (2024). “Greetings from hell (neraka kirim salam)”: A discourse analysis of religious-based cyberbullying of dehijabis. Journal of Nusantara Studies, 9(1), 1-24. http://dx.doi.org/10.24200/jonus.vol9iss1pp1-24

Female Circumcision and Sexual Negotiation Ability of Ethiopian Women.

The following study attempts to assess the link between the circumcision status of Ethiopian women and their ability to negotiate sex. From the 2016 Ethiopian Demographic and Health Survey, we analyzed a subsample of 3,445 women aged 15 to 49. Women's sexual negotiation ability was measured by their ability to ask for condom and their ability to refuse sex. We performed a univariate, bivariate, and multiple logistic regression analysis. In the final analysis, only education, residence, media access, and sexually transmitted infections knowledge were independently associated with the sexual negotiation ability of women. Circumcision status was not associated with sexual negotiation ability.

‘There is a No that means Yes!’ – Coercive and aggressive sexual behaviours in adolescents’ heterosexual relationships in rural KwaZulu-Natal, South Africa

ABSTRACT This qualitative study examined sexual negotiation in heterosexual romantic relationships of rural adolescents in the province of KwaZulu-Natal, South Africa. Participatory visual research methodology alongside focus group discussions were employed with 18 and 19-year-old adolescent boys (n = 10) and girls (n = 12) to understand how sex is negotiated in heterosexual relationships. Findings suggest adolescent boys and girls had little understanding of mutual sexual consent, and lacked the skills for exercising it. Adolescent boys’ coercive and aggressive sexual behaviours in romantic relationships were embedded in hegemonic masculinity characterized by male dominance, hypersexuality and multiple partners; and included boys pleading for sex, buying gifts, threatening to dissolve the relationship if sex is not initiated, screening pornographic films and rape. Sexual violence prevention strategies commencing during early adolescence are needed and should focus on developing adolescents’ understanding of mutual sexual consent, incorporate skills for autonomous sexual negotiation, and emphasize gender transformative and equitable norms.

How Family Sex Talks Can Increase Daughters’ Intentions to Engage in Sexual Health Protective Behavior: Mediating Roles of Parents’ Direct and Indirect Sexual Communication

ABSTRACTThe family environment is essential but underused for promoting sexual and reproductive health protective behaviors (SHPB). However, previous literature had no consistent findings regarding how families can efficiently provide sex education and what aspects of family communication may facilitate SHPB. Based on family communication patterns theory (FCPT) and new research that segments family conformity orientation into four sub-dimensions (i.e., respecting parental authority, experiencing parental control, adopting parents’ values, and questioning parents’ beliefs), we explored the roles that family communication patterns (FCP) and parents’ (direct and indirect) sexual communication play in influencing adult daughters’ intentions to engage in SHPB. Using survey data from 234 female participants, path analysis suggested that daughters’ SHPB intentions were associated with more direct and indirect sexual communication, higher conversation orientation, higher parental control, and less adoption of parental values. Also, parents’ direct sexual communication mediated the impact of conversation orientation on SHPB intentions. Additionally, parents’ indirect sexual communication mediated the path from parental value adoption to SHPB intentions, mitigating the negative direct impact of parental value adoption. Theoretical and practical implications are discussed.

Binge drinking and condom negotiation behaviours among adolescent girls and young women living in Cape Town, South Africa: sexual control and perceived personal power

BackgroundCondom use among young people in South Africa has declined in recent years and adolescent girls and young women continue to bear the highest incidence of HIV in the country. Young women who have dropped out of school may be more at risk because of traditional gender norms that create substantial power imbalances and a lack of power to negotiate condom use with their male partners, especially when using alcohol and other drugs.MethodsThis study presents an analysis of baseline data provided by 500 adolescent girls and young women (AGYW) from Cape Town communities between November 2016 and November 2018 who were reached for a cluster-randomised trial conducted to assess the efficacy of an evidence-based, young woman-focused intervention seeking to reduce HIV risk and substance use behaviours. The analysis focuses on associations between binge drinking, condom use, and sexual negotiation, including impaired sex (any substance use at last sex).ResultsAGYW who reported frequent condom negotiation with their partners were 8.92 times (95% CI: [4.36, 18.24]) as likely to use a condom when alcohol or other drugs were not used at last sex and 5.50 times (95% CI: [2.06, 14.72]) as likely when alcohol or other drugs were used at last sex (p < 0.05). AGYW who reported frequent binge drinking in the past month (n = 177) had significantly reduced odds of condom use at last sex, irrespective of whether the sex was impaired (OR 0.60, 95% CI: [0.49, 0.73]) or not impaired (OR 0.69, 95% CI: [0.60, 0.81]).DiscussionThe findings highlight the need for interventions that reach AGYW in South Africa by specifically aiming to educate AGYW about the effect of binge drinking on negotiating power in their relationships, thus providing them with the knowledge and skills to increase agency regarding condom use.Trial registrationClinicalTrials.gov Identifier: NCT02974998 (recruitment completed). 29/11/2016.

Between banjos, beaches and bending gender: Negotiating the queer rural space in Hannah Montana

This article explores queer and non-heteronormative subtexts in connection with representations of rurality in the Disney family sitcom Hannah Montana (2006-2011). The multi-layered world, which the protagonist Hannah Montana/Miley Stewart inhabits, is shaped by sexual undercurrents closely linked to an imagined rural space. This space is constructed as the ‘sexual other’ in relation to the gender and body politics of the show’s main setting: Mailbu, California. In particular, the protagonist’s original home state of Tennessee forms a cultural repertoire in which dominant norms of gender performativity are ignored or subverted. Certain hints at queer codes and practices become identifiable when the rural space is invoked and contrasted with the perceived, sanitized ‘sexual normativity’ of Southern California. Projecting the non-normative onto the rural allows Disney to protect the show’s image as so-called wholesome family entertainment. The resulting play with queer practices, such as gender-bending and cross-dressing, is shown to connect with Disney’s attempts to queercode characters and spaces in order to facilitate the effective marketing of the show across multiple segments in an increasingly multi-sexual teen market. The role of the extratextual personae of Miley Cyrus and Billy Ray Cyrus complement this strategy, through their functioning as instructive models for ongoing negotiations of sexuality and gender among multi-generational audiences in the early twenty-first century.

"I Just Want to Feel Good Without Making You Feel Bad": Sexual Assertiveness Negotiation in Adolescent Romantic Relationships.

Sexual assertiveness is often conceptualized as an individual's ability to express one's own sexual needs, desires, and limits. Given that sexual assertiveness is embedded in interactions and can affect not only both partners' sexual well-being but also relationship satisfaction, dyadic approaches are needed to investigate sexual assertiveness negotiation within adolescent romantic relationships. This qualitative study aimed to document adolescents' ability to negotiate their sexual needs, desires, and limits with their partners during interactions where they discussed their sexual concerns. A directed content analysis, based on the life positions of the transactional analysis theory, was conducted on the interactions of 40 adolescent romantic dyads aged 14-19years (M = 16.65; SD = 1.49). The results revealed four categories of strategies: (1) mutual assertiveness: negotiation of one's own sexual needs, desires, and limits with those of the partner; (2) singular passiveness: repression of one's own sexual needs, desires, and limits to privilege those of the partner; (3) singular aggressiveness: prioritization of one's own sexual needs, desires, and limits over those of the partner; and (4) mutual lack of negotiation skills: neglecting both partners' sexual needs, desires, and limits. Among other things, adolescents' ability to be sexually assertive was hindered by anticipations, including assumptions leading to disregarding one's own sexual needs, desires, and limits or fearing to ignore the partner's. To promote mutually rewarding sexual activities and prevent sexual violence, sexual education initiatives should support adolescents' ability to assertively negotiate their sexuality with their partner and avoid passiveness, aggressiveness, and lack of negotiation.

Considering Communication Theory in Health Education and Behavior: Applying the Integrated Model of Advice-Giving in Friendship Sex Talks.

Individuals may find it challenging and discomforting to communicate about sex because they may lack the skills and efficacy necessary to communicate their sexual desires. When individuals do have opportunities to have such discussions about sex in open and comfortable settings, they may seek informational support (i.e., advice) from a close friend because of knowledge sharing and past experiences navigating sex-related concerns. This research study used a communication theory-based quantitative analysis to examine how advice givers' prosocial behaviors influence their advice outcome messages during conversations about sex. A total of 264 participants completed a survey developed based on the Integrated Model of Advice-Giving (IMA). Data were analyzed using structural equation modeling. Advice givers reported that their emotional supportive messages elicited better quality advice. Additionally, advice givers indicated that being attentive and understanding to others' feelings elicited better disclosures about their own sexual experiences. Structural equation modeling results suggested a good model fit for the theoretical model (comparative fit index [CFI] = .939, tucker-lewis fit index [TLI] = .931, root mean square error of approximation [RMSEA] = .056, 90% confidence interval: [.049, .063], and standardized root mean square residual [SRMR] = .082). This study highlights the theoretical and pragmatic implications of communication theory in sexual health education interventions.

Condom Use at Last Sex and Sexual Negotiation Among Young African American Women in North Carolina: Context or Personal Agency

African American women are 10.8 times more likely to be diagnosed with HIV compared with White women. This descriptive study fills a gap by examining associations among social and contextual factors and sexual communication, condom use, and safer sex negotiation among African American women. Study participants between 18 and 25 years of age and who reported recent substance use were recruited from three North Carolina counties. A risk behavior survey was administered via audio computer-assisted self-interview, and logistic regression analyses were conducted to assess associations between social and contextual variables and condom use at last sex with a main partner. Education (AOR: 2.078; 95% CI: 1.214, 3.556), sexual communication with a main partner (AOR: 1.079; 95% CI: 1.050, 1.109), and condom use relationship scale (AOR: 1.059; 95% CI: 1.023, 1.098) were positively associated with condom use at last sex, whereas living with a main partner (AOR: 0.447; 95% CI: 0.210, 0.950) and the alcohol and drug problem scale (AOR: 0.971; 95% CI: 0.944, 0.998) were negatively associated with condom use (p < 0.05). The study findings show that among young African American women at risk for HIV, contextual and personal factors may influence condom use. A socio-ecological approach combining personal empowerment, interpersonal, structural, and biobehavioral strategies is necessary in implementing holistic gender-focused HIV prevention programs.

"I Wouldn't Believe Her at First"-A Qualitative Study of Young People's Sexual Consent Perceptions and Negotiation in Nairobi Informal Settlements.

Forced or coerced sexual experiences have serious consequences for young people's health and well-being. Healthy sexual consent communication can foster positive intimate relationships and help prevent unwanted sexual experiences. We aimed to explore how young people in Nairobi's informal settlements construct, communicate, and negotiate sexual consent within heterosexual partnerships, given the limited insight into such experiences from resource-poor, global-south contexts. A qualitative study with young men and women aged 15 to 21 years was conducted among former participants of a school-based sexual violence prevention intervention in four informal settlements (slums) of Nairobi. Twenty-one individual in-depth interviews (n = 10 females, n = 11 males) and 10 focus group discussions (five with n = 6-11 males vs. females, respectively), that is, n = 89 in total were conducted. Data were analysed using thematic network analysis and interpreted using the Sexual script theory. Participants' endorsement of incongruent sexual scripts shaped their perceptions and negotiations of sexual consent. Young men were committed to respecting sexual consent, but promoted male (sexual) dominance, and perceived women's refusals as token resistance. Per traditional scripts of sexual chastity, young women were largely bound by their use of a "soft no" to give consent, so as to not display direct sexual interest. Actual non-assertive refusals thus risked being interpreted as consent. Young women's "actual" refusals had to be more assertive (saying a "hard no") and were described as having been influenced by skills learned during the school-based intervention. Findings highlight the need for sexual consent education to address internalized gendered norms about female token resistance, destigmatize female sexuality, reduce male dominance norms, and encourage young people's respect for both assertive and non-assertive sexual consent communication.

Problematic Integrations of Baptist Mothers’ Nested Identities During Sex Talks with Children

This study examines the identity performance of Baptist mothers during sex talks with children using a problematic integration and nested identities integrated framework. The findings of this study suggest that mothers experienced a tension between their Biblical ontologies of sex and secular treatments of sex, which informed the strategies they used to communicate with their children. Sex talks with children, then, emerged as problematic integrations of ambiguity and dissonance. The findings of this study advance the notion that religious identities bleed into other kinds of identity performances, inform and resolve problematic integrations, and intensify stress associated with ambiguity.

Questioning conceptualizations of openness in family sex communication: Exploring associations between family communication patterns and family sex communication quotient

ABSTRACT Family communication patterns theory (FCPT) and family sex communication research herald openness. However, scholars have begun to question whether openness operates differently when considering the difficult nature of sex talk in families. Therefore, regression analyses were conducted to better ascertain the role of openness amongst young adults’ reports of family communication patterns and reports of family sex talk from the Family Sex Communication Quotient (FSCQ). Analysis revealed conformity orientation to be a greater predictor of family sex talk via the FSCQ, negatively predicting young adults’ reports of the comfort and information dimensions, which conceptually measure openness. However, conversation orientation did not significantly predict either dimension associated with openness, instead negatively predicting the value dimension of the FSCQ, which measures the perceived importance of the family to discuss sex and related topics. No significant interaction effects of family communication patterns were found, yet gender did appear as a constraining factor on the meaning of openness measured. Results signify that openness is operationalized within family sex communication differentially from FCPT, particularly conversation orientation. Implications and directions for future research on family sex communication conclude the paper.

Biomedical bargains: Negotiating “safe sex” on antiretroviral treatment in rural South Africa

Wide-scale availability of antiretroviral treatment (ART) has transformed the global landscape for HIV prevention, shifting emphasis away from a strictly behavioral focus on changing sexual practices towards a biomedical approach. Successful ART management is measured by an undetectable viral load, which helps maintain overall health and prevent onward viral transmission. The latter utility of ART, however, must be understood in the context of its implementation. In South Africa, ART has become easily accessible – yet ART knowledge spreads unevenly, while counseling advice and normative expectations and experiences of gender and aging interact to inform sexual practices. As ART enters the sexual lives of middle-aged and older people living with HIV (MOPLH), a population growing rapidly, how has it informed sexual decisions and negotiations? Drawing on in-depth interviews with MOPLH on ART, corroborated with focus group discussions and national ART-related policies and guidelines, we find that for MOPLH, sexual decisions increasingly feature compliance with biomedical directives and concern for ART efficacy. Seeking consensus regarding the biological risks of sex on ART becomes an important feature of sexual negotiations, and anticipated disagreements can pre-empt sexual relationships altogether. We introduce the concept of biomedical bargains to explain what happens when disagreements arise, and the terms of sex are negotiated using competing interpretations of biomedical information. For both men and women, ostensibly gender-neutral biomedical discourses provide new discursive resources and strategies for sexual decisions and negotiations, yet biomedical bargains are still embedded in gender dynamics—women invoke the dangers of jeopardizing treatment efficacy and longevity to insist on condoms or justify abstinence, while men utilize biomedical arguments in an effort to render condomless sex safe. While the full therapeutic benefits of ART are critical for the efficacy and equity of HIV programs, they will nonetheless always affect, and be affected by, social life.

Association between premarital HIV testing and ability to negotiate sexual relations among married women in Ethiopia: a population-based study

ABSTRACT HIV/AIDS prevalence in sub-Saharan Africa remains an issue of concern and young women are disproportionately affected by the disease. Premarital HIV testing is one of the key strategies used in HIV prevention since heterosexual sex remains the primary mode of HIV transmission in sub-Saharan Africa. This study uses the 2016 Ethiopia Demographic and Health Survey to examine the association between premarital HIV testing and the ability to negotiate sexual relations among married women aged 15 to 49 years (N = 3,672). Women's ability to negotiate sexual relations was measured using two variables: the ability to refuse sex and the ability to ask for a condom during intercourse. Descriptive statistics, bivariate, and multiple logistic regression analyses were performed. Only 24.1% of the women had premarital HIV testing. Approximately 46.5% and 32.3% of women reported that they could refuse sexual intercourse and ask their partner to use a condom, respectively. In the multivariable model, having a premarital HIV test was positively associated with the ability to refuse sex odds ratio (95% confidence interval) 1.82 (1.38, 2.41; p < 0.001) and the ability to ask for a condom 2.30 (1.55, 3.41; p < 0.001). Premarital HIV testing can improve women's sexual negotiation ability and possibly prevent future HIV infection.