title: Intimate partner sexual aggression against Chinese women: a mixed methods study.
abstract: BACKGROUND
  Although intimate partner sexual aggression has been shown to be associated with adverse mental health outcomes, there is scant information about sexual aggression in Chinese intimate relationships in general and about its mental health impact in particular. This article aimed to investigate sexual aggression in Chinese intimate relationships, including the use of force or threat of force and non-physical coercive tactics in unwanted sex.
  
  
  METHODS
  The quantitative and qualitative data used in this paper were drawn from a prospective cohort study conducted in Hong Kong between September 2010 and September 2012. A total of 745 Chinese women aged 18 or older who had been in an intimate relationship in the preceding 12 months were recruited from sites in all districts of Hong Kong. Multiple logistic regression analysis, ordinary linear regression, and t-tests were used in quantitative analysis. Directed content analysis was used to analyze the transcripts of 59 women who revealed experiences of intimate partner sexual aggression in individual in-depth interviews.
  
  
  RESULTS
  Of the 745 Chinese women in the study, 348 (46.7%) had experienced intimate partner physical violence in the past year, and 179 (24%) had experienced intimate partner physical violence and sexual aggression in the past year. Intimate partner sexual aggression significantly predicted PTSD and depressive symptoms after controlling for intimate partner physical violence. Among the 179 women reporting intimate partner physical violence and sexual coercion in the past year, 75 indicated that their partners used force or threat of force to make them have sex, and 104 of them reported that they gave in to sex because of non-physical coercive tactics used by their partners. Qualitative data revealed a variety of non-physical coercive tactics with different degrees of subtlety used to coerce women into unwanted sex with their partners. Chinese women experiencing physically forced sex had significantly more depressive symptoms and PTSD symptoms.
  
  
  CONCLUSIONS
  Our findings indicate that sexual aggression in Chinese intimate relationships has specific mental health consequences over and above those associated with physical violence. Assessment of partner violence in Chinese relationships should include screening for sexual aggression in order to provide appropriate interventions.
  
  
  BACKGROUND
  ClinicalTrials gov NCT01206192.
authors.affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M,W, Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China. afytiwar@hku.hk.
authors.forename: Agnes
authors.initials: A
authors.lastname: Tiwari
authors.forename: Denise Shuk Ting
authors.initials: DS
authors.lastname: Cheung
authors.forename: Ko Ling
authors.initials: KL
authors.lastname: Chan
authors.forename: Daniel Yee Tak
authors.initials: DY
authors.lastname: Fong
authors.forename: Elsie Chau Wai
authors.initials: EC
authors.lastname: Yan
authors.forename: Gloria Ling Lee
authors.initials: GL
authors.lastname: Lam
authors.forename: Debbie Hoi Ming
authors.initials: DH
authors.lastname: Tang
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003068:Coercion; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005069:Evaluation Studies as Topic; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D036301:Qualitative Research; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires