| Issue/Objective |
Non-consensual condom removal (NCCR), commonly referred to as "stealthing," is the removal of a condom during sex without a partner's knowledge or consent. It is increasingly recognised as a form of sexual violence and is associated with risks including sexually transmitted infections (STIs), unintended pregnancy, and psychological harm. Despite growing legal and policy attention, evidence on the prevalence and demographic distribution of NCCR remains fragmented. This systematic review aimed to synthesise quantitative evidence on NCCR prevalence among adults, identify associated risk factors, and examine reported health and behavioural outcomes. |
| Methodology/Approach |
This systematic review followed PRISMA 2020 guidelines. Searches were conducted in MEDLINE (n = 372), CINAHL (n = 23), and APA PsycINFO (n = 77), supplemented by citation tracking and screening of 200 Google Scholar records. Studies were eligible if they were peer-reviewed, published in English, and reported quantitative prevalence estimates of NCCR among adults (≥18 years). Two independent reviewers conducted screening, with EndNote used for de-duplication. Eleven studies met the inclusion criteria and underwent quality appraisal. |
| Results |
The 11 included studies represented six countries, with sample sizes ranging from 96 to 2252 participants, primarily aged 18-30 years. Prevalence of victimisation among women ranged from 5.2% to 32%, while rates among men who have sex with men reached 35%. Male perpetration was reported in three studies, ranging from 1.2% to 19.8%. Risk factors for victimisation included non-heterosexual identity, substance use, gender minority status, higher number of sexual partners, and prior sexual victimisation. Perpetration was associated with binge drinking, drug use, and antisocial traits. Reported outcomes included STIs, unintended pregnancy, and adverse mental health outcomes such as distress, depression, and anxiety. Meta-analysis was not conducted due to heterogeneity in definitions and outcome measures. |
| Discussion/Conclusion |
NCCR is a globally reported phenomenon with substantial prevalence and significant health and psychosocial harms. Inconsistent definitions and measurements limit comparability across studies and hinder effective response. By consolidating fragmented evidence, this review provides an evidence base to inform clinical screening, prevention strategies, and policy responses, supporting more accountable and evidence-informed sexual and reproductive health systems. |
| Presenters and Affiliations |
Mamta Behera Swansea University |
