Nonvolitional sex and sexual health.

Nonvolitional sex is sexual behavior that violates a person's right to choose when and with whom to have sex and what sexual behaviors to engage in. The more extreme forms of this behavior include rape, forced sex, childhood sexual abuse, sex trafficking, and violence against people with nonconventional sexual identities. More nuanced forms of nonvolitional sex include engaging in sexual behavior that masks one's nonconventional sexual identity, or that protects one's position with peers, or that represents a quid pro quo for the economic support that one obtains within an intimate relationship. The aim of this essay is to highlight the ways in which nonvolitional sex threatens sexual health and to identify strategies for ameliorating this problem. These strategies will have to be as broad in scope as is the problem that they are designed to address. The essay discusses the following strategies to reduce nonvolitional sex: (1) advocacy for sexual rights, gender equality, and equality for individuals with nonconventional sexual identities; (2) primary prevention programs and interventions that offer comprehensive sexuality education that establishes volitional sex and sexual health as basic human rights; (3) health services that routinely ask clients about their experiences with nonvolitional sex in an open and culturally appropriate manner; and (4) secondary prevention programs to meet the needs of victims of nonvolitional sex identified by the "screening" programs.