Risk and protective factors for sexually violent behavior among male medical undergraduates across Vietnam: Prospective cohort study

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Objective: In Asia/Pacific, 24% of men 18-49 years report perpetrating rape. Longitudinal research on sexually violent behavior (SVB) is limited. We assessed risk/protective factors for SVB in a cohort of young men across Vietnam. Methods: 2444 male students attending six Vietnamese universities in 2024 participated in two pre-intervention waves of SCALE, an implementation trial of the GlobalConsent sexual-violence-prevention program. Marginal models with a logit link assessed wave-one risk/protective factors for six-month wave-two SVB. Predicted probabilities were derived for significant factors. Results: Six-month SVB prevalence was 15.5% (wave one) and 15.2% (wave two). Factors associated with wave-two SVB were: depressive symptoms moderate or higher (adjusted odds ratio aOR = 1.70), sexual consent knowledge (aOR = 0.44), prior-to-18 sexually explicit material (SEM) use (aORs = 1.92 non-physically-violent SEM, 6.29 physically-violent SEM once, 7.51 violent SEM more than once), 3-4 childhood-family-dysfunction types (aOR = 4.87), 4-6 child-maltreatment types (aOR = 1.90), and wave-one SVB (aORs = 2.23 non-contact, 4.57 contact). The predicted probability of wave-two SVB was 92.33% (95% confidence interval [CI] 87.58%, 97.07%) for higher-risk/lower-protection students and 0.69% (95%CI 0.07%, 1.32%) for lower-risk/higher-protection students on significant wave-one factors. Conclusions: Efficacious universal sexual-violence prevention programming and risk-reducing psychosocial support in higher-risk/less-protected men may promote healthy sexual behavior among male undergraduates across Vietnam.