Exploring the Intersection of gender norms, Mental Health, and Sexual Consent, Among Displaced men of Benue state, Nigeria

Exploring the Intersection of gender norms, Mental Health, and Sexual Consent, Among Displaced men of Benue state, Nigeria | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploring the Intersection of gender norms, Mental Health, and Sexual Consent, Among Displaced men of Benue state, Nigeria Ngwibete Atenchong, Benjamin Mkena, Laadi Swende, David Seidenfeld This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8779024/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Rape rates in Nigeria’s displaced settlements reach 37–50%, yet little is known about how displaced men’s navigation of consent is shaped by gender norms and mental health. This cross-sectional study aimed to predict male sexual consent behavior by examining its interaction between sociodemographic factors, gender-equitable norms (GEM), mental health, and gender-related training in displaced camps in Nigeria Methods A total of 610 males were randomly sampled from three purposively selected displaced camps. A validated instrument was used to collect data on sociodemographic characteristics, gender-equitable norms (GEM scale), mental health indicators for post-traumatic stress disorder, anxiety, and depression (PTSD-8 and PHQ-4), as well as sexual consent behavior. Three constructs of sexual consent were assessed: positive attitudes, indirect approaches, and consent norms. Gamma GLM modelling was used to identify significant predictors of each outcome. Interaction effects between GEM and mental health were examined. Results All constructs of sexual consent behaviors were consistently predicted by a longer stay in the camp. Having some form of social and emotional support, such as living with a family or friend, having a partner, or being self-employed, was associated with higher consent outcomes. Gender-equitable norms did not independently predict sexual consent; however, when combined with mental health, which was a strong predictor, they were associated with improved consent behavior. Attending gender-related training was negatively associated with all consent outcomes. Conclusion Sexual consent behaviors among displaced men are driven by an interaction of different constructs beyond gender norms alone. Their social, economic, and psychological factors play an important role in shaping consent behaviors. Current gender trainings may lack contextual relevance and fail to address practical negotiation skills. Interventions must integrate mental health support, empowerment opportunities, and family/community-based approaches to foster healthy consent dynamics in displacement settings. sexual consent displaced men gender norms mental health humanitarian settings gender training Figures Figure 1 Figure 2 Introduction Sexual violence remains a public health concern in displaced settings in Nigeria 1 . Studies have indicated a prevalence as high as 37–50% and nearly all perpetrators were identified as male 2 , 3 . These alarming rates call for the need for intervention to strengthen sexual consent behavior among men in displaced settings as a fundamental component of ethical and safe sexual relationships. However, male sexual and reproductive health and associated behaviors is often overlooked in both research and intervention design 2 – 4 . Sexual consent entails an individual's ability to recognize boundaries, communicate intentions, and respect the autonomy of others 5 , 6 . The Sexual consent behavior remains poorly understood in many settings, particularly among populations experiencing displacement, instability, and socioeconomic hardship 2 , 4 . In displaced settings across Africa, traditional gender norms and the silence surrounding sexuality often restrict men’s ability to negotiate or respect consent within intimate relationships 7 . These dynamics are shaped by patrilineal structures, exposure to trauma, limited opportunities, and disrupted social systems 8 – 10 . Some studies have highlighted that, due to the breakdown of conventional traditional structures during displacement, there are accompanying stressors that exacerbate harmful masculinities 11 . However, the intersection of gender norms, mental health, and sexual consent behaviors among displaced men remains underexplored. Gender-transformative programming has increasingly been promoted to address gender-based violence and harmful norms among men 12 , 13 . Research shows that employment status, the availability of social support, and living arrangements significantly influence sexual risk‑taking and the negotiation of consent 13 – 15 . Nonetheless, gender-equitable norms alone may not translate into practice, especially when trauma or poor mental health are present. 11,16 Moreover, traditional training approaches may be ineffective if they do not address men’s lived realities or provide practical communication skills for navigating consent 16 . Conceptual Framework Figure 1 : Conceptual Framework examining the intersection between mental health, gender norms, and sexual consent behaviors The integrated socio-ecological, Gender and Power Theory, and Theory of Planned Behavior framework was used to examine the intersection between mental health, gender norms, and sexual consent behaviors among displaced men in Benue State, Nigeria. The social ecological theory explains consent behaviors and individual and household dynamics in relation to their environment 17 . Gender and Power Theory explains how situations of one's environment (displacement) may disrupt gender norms in the environment, creating a masculine identity that manifests in sexual domain behaviors 18 , 19 . The theory of planned behavior differentiates how one's attitudes, contextual norms, and perceived behavioral control can affect consent behaviors. According to these theories, a man's characteristics do not directly affect their sexual consent behaviors. However, these behaviors are determined by interactions with contextual factors such as his psychological states, gender norms, and socio-environmental factors arising from displacement. The model uses three distinct constructs of sexual consent as outcomes 20 : positive attitudes toward consent, perceived consent norms, and indirect behavior. The model proposes that gender norm attitudes and mental health symptoms have a strong direct effect on sexual consent behaviors. Differential pathways to each outcome are hypothesized: gender-equitable norms are posited as the primary driver of positive attitudes, while both gender norms and environmental factors are expected to shape perceived norms. Additionally, mental health symptoms are anticipated to have the strongest direct effect on coercive behaviors. According to the framework, access to health care, once physical health and ever attending gender training are moderating factors to their mental health, gender norm attitude and sexual consent behavioral outcomes. It also suggests that there is a bidirectional pathway between mental health and gender norms. It proposes that poor mental health outcomes could push individuals toward rigid, authoritarian masculine ideologies that create dominance and poor consent behaviors. On the other hand, when inequitable gender norms are internalized, healthy coping strategies and health-seeking behaviors may affect men's mental health negatively. This model thus elaborates the multi-level approach to understanding sexual consent behaviors among displaced men. Method This was a cross-sectional study done in three selected internally displaced persons (IDPs) camps (Otese, Mega, and Daudu camps). These camps were purposefully selected because they were relatively safe to assess. These camps are in a rural-agrarian community affected by farmer-herder conflict. Benue shelters about two million displaced persons, with the majority living in the selected internally displaced camps 21 , 22 . Previous studies have reported a prevalence of sexual violence in Nigeria ranging from 36% to 54%, with Benue State recording a rate of over 53% 22,2324 . Inclusion criteria Men aged 18 to 80 Minimum one year of residence in the settlement. Sexually active in the past 12 months Fluent in Tiv, pidgin, or English Voluntarily agrees to participate Exclusion criteria Severe mental illness or acute illness that impairs consent capacity. Never engaged in a minimum of one sexual relationship. Measures We collected sociodemographic data on displaced males, their attendance at gender training, and measures of gender norms, mental health, and sexual consent. We adapted the Gender-Equitable Men (GEM) Scale for assessing gender norms and their relationship to sexual consent 13 . The GEM is a reliable scale that has been piloted across several African countries, including South Africa, Uganda, and Nigeria (specifically in Benue, Kano, Lagos, and Rivers) 15 , 25 , 26 . It measures gender norms and attitudes, supporting its application in programs addressing gender-based violence, reproductive health, and social norm change. The adapted instrument consisted of a total of 12 items, including three context-specific statements that reflected prevailing beliefs about male authority and sexual entitlement in the setting. These included; If a woman refuses sex, it is acceptable for a man to keep trying until a woman agrees to sex. It is acceptable for a man to expect sex if he has provided money. It is a sign of weakness for a man to ask his partner for permission before sex. We assessed three mental health symptoms: Post Traumatic Stress Disorder (PTSD), depression, and anxiety using the PTSD-8 and PHQ-4 instruments, respectively, which have shown high reliability in the African setting, including Nigeria 8 , 27 , 28 . The traditional PTSD-8 instrument measures intrusion, avoidance, and arousal, while the PHQ4 has depression and anxiety as its constructs. Each item used a Likert scale from 0 to 4, where higher scores showed stronger symptoms. The outcome variable for this analysis was sexual consent behavior, assessed using the Sexual Consent Scale (SCS) with three constructs adapted from the original instrument 6 , 20 . The first construct consisted of 9 items and captured positive attitudes toward establishing consent. The second construct, comprising 6 items, captured indirect behaviors related to consent. The third construct consisted of 5 items and captured consent norms. Items were presented in a yes/no format rather than the original Likert scale, as it ensured clarity and consistent understanding in the local language when compared to the Likert responses. The tool has been applied in studies in Ghana 29 and, though primarily developed outside Africa, has been validated and shows strong potential for adaptation and use in African contexts 30 . All the tools adopted had a Cronbach's alpha of 0.85, demonstrating a good internal consistency of the entire scale. Ethical consideration The study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Benue State Ministry of Health (MOH/STA/204/1/337) and further administrative clearance from the Benue State Emergency Management Agency (ref. BSEMA/OFF/206/v.i/104) prior to data collection. Additional permission was received from the camp leadership overseeing the study populations. Participation was voluntary, and written informed consent was obtained from all participants before enrolment. A translated informed consent form was read aloud in the native language or pidgin English to participants with limited literacy to ensure understanding, and consent was confirmed with a thumbprint. Participants received clear information on the study purpose, procedures, risks, and benefits. They were informed of their right to refuse participation or withdraw at any time without consequences. Confidentiality was maintained, and no personal identifiers were used. All data were stored in password-protected files and accessed only by the research team. Participants received modest compensation to cover transport or time spent, in line with ethical guidance and local standards. Analysis Sociodemographic variables, mental health categories, gender norm attitudes, and sexual consent were summarized using descriptive statistics. Continuous variables were summarized using the median and interquartile range (IQR), while Categorical variables were summarized using frequencies and percentages. Scores on the modified GEM Scale ranged from 12 to 36. Equal divisions of the scores were calculated to categorize the scale into three levels: low equity (12–20), medium equity (21–28), and high equity (29–36). Items of the PTSD-8 and PHQ-4 scales were categorized using a clinical standard. Each symptom group was screened by identifying items with values 3 or 4. Intrusion was marked positive when at least one intrusion item scored 3 or 4. Avoidance was marked positive when at least one avoidance item scored 3 or 4. Hypervigilance was marked positive when at least one hypervigilance item scored 3 or 4 31 . The PHQ was categorized into depression symptoms and anxiety symptoms. Depression was calculated as the sum of the first two items (range 0–6), while anxiety was calculated as the sum of the last two items (range 0–6). A score of ≥ 3 on either subscale suggests possible depression or anxiety. The items of the SCS scale were scored as 1 for "yes" and 0 for "no". Subscale scores were created by summing the items within each section. The positive attitude subscale produced scores from 0 to 9. The indirect behavior subscale yielded scores ranging from 0 to 6, while the consent norms subscale produced a total score of 4. Endorsement levels were categorized using the median as the cut‑off point, A higher magnitude means a stronger endorsement of the construct measured by that subscale. Lower magnitude means weaker endorsement. For the positive attitude participants scoring at or above median score of 8 were classified as having high endorsement. For the indirect behavior participant scoring ≥ 6 indicated high endorsement. For the consent norms subscale participants scoring ≥ 5 was classified as high endorsement. A frequency table compared the distribution of SCS endorsement across sociodemographic factors, GEM categories, and mental health indicators. Chi-square tests assessed differences in categorical variables(supplement 1) An exploratory composite index was created by summing PTSD and PHQ symptom scores to approximate overall mental health burden, with the understanding that it is not a validated measure but is intended to capture overall symptom magnitude. The index was used to test interactions between GEM and SCS scores, with sexual consent behavior examined in relation to gender norms, attitudes, and mental health as a moderator. A linear model was applied using the total scores of all three variables. The interaction was visualized using a moderated regression plot, which displays predicted SCS scores for low, average, and high mental health across the range of GEM Scores. To examine the association between socio-demographic characteristics, mental health scores, gender norm attitudes, and gen sexual consent behaviors and its constructs, we used the Gamma generalized linear model (GLM) with a log link to estimate the relationship between predictors. The Gamma generalized linear model (GLM) was found appropriate for the positively skewed SCS score 32 . Two models were fitted to predict consent behavior construct: positive attitudes towards sexual consent, an indirect approach, and sexual consent norms. Model 1 included all predictors: age, length of stay in camp, number of males, income, Number of females (obtained by subtracting household size from number of of males), settlement type, living arrangements, marital status, education level, main activity, religion, gender training attendance, GEM score, and mental health combined score. Model 2 was a simplified model that included only the strongest predictors identified in Model 1, based on statistical significance and theoretical relevance: length of stay, living arrangements, marital status, education level, main activity, gender, training attendance, GEM score, and a combined mental health score. Model 2 achieved a good balance between model fit and parsimony, with Akaike Information Criterion (AIC) values of 3523 for general consent behaviors, 2522 for positive attitudes toward sexual consent, 2169 for the indirect approach, and 1841 for sexual consent norms. These AIC values were all lower than those for Model 1. All analyses were performed in R Studio, and statistical significance was assessed at α = 0.05. Results Table 1: Descriptive Characteristics of Participants Variable Level Overall n(%) N 610 Age(years) (Median, IQR) 36.00 [27.00, 47.00] Age Group 18–29 178 (29.2) 30–39 154 (25.2) 40–49 138 (22.6) 50plus 140 (23.0) length of stay in camp( years) (Median, IQR) 4.00 [2.00, 5.00] Length of stay category Short (1–2 years) 161 (26.4) Medium (3–5 years) 336 (55.1) Long (6–9years) 113 (18.5) Household size (median, IQR) 6.00 [4.00, 8.00] Household size category Single 13 (2.1) Small (2–3) 119 (19.5) Medium (4–5) 167 (27.4) Large (6+) 311 (51.0) Number of males in household (median IQR) 3.00 [2.00, 4.00] Number of males in household Category ≤1 82 (13.4) 2–3 321 (52.6) 4+ 207 (33.9) total income per month(Niara) (Median IQR) 5000.00 [0.00, 19000.00] income Cat Less than 20k 506 (83.0) 20k–50k 89 (14.6) Over 50k 15 (2.5) Settlement Daudu 1 218 (35.7) Mega camp 191 (31.3) Ortese 201 (33.0) Whom do you live with by yourself/with friend(s) 33 (5.4) with family/relative 577 (94.6) Marital status married/cohabiting 463 (75.9) single/separated/divorced/widowed 147 (24.1) Educational level no formal education/other 181 (29.7) Primary 145 (23.8) Secondary 240 (39.3) university/tertiary 44 (7.2) Employment status employed fulltime 112 (18.4) Other(casual /work) 93 (15.2) Self employed 164 (26.9) Student 82 (13.4) Unemployed 159 (26.1) Religion Christian 601 (98.5) other(Islam/traditional 9 (1.5) ever attended gender related training No 219 (35.9) Yes 391 (64.1) In Table 1 above, the average age of the males was 36 [37, 47] years, with up to 178 (29.2%) between 18 and 29 years. The average length of stay in the camp was 4 [2-5] years. Most of the participants had large household sizes, with an average of 6 [4-8] persons in the household and an average of 3 males. Most of the males were self-employed, at 164 (26.9%), with an average monthly income of 5,000 naira. The majority, 463 (75.5%), were married/cohabiting, and 577 (95.6%) lived with a family member/relative. Up to 392 (64.1%) had ever attended gender-related training. Supplement 2 shows that there was a low endorsement of gender-equal norms among displaced men, with only 4.1% reporting high endorsement. Up to 54.8% of the participants reported at least one mental health symptom. Slightly over half of the respondents had a probable symptom of PTSD (54.3%), with the majority experiencing hypervigilance (24.3%). Anxiety and depression were prevalent among (33.3%)and (32.1% )of the respondents. Endorsement of sexual consent behaviors varied, with 59.3% reporting positive attitudes, 55.2% using indirect behaviors, and 60.8% conforming to consent norm beliefs Supplement 1 presents the Pearson correlations among positive attitudes, individual behaviors, and consent norms, showing consistently strong and statistically significant associations across all three domains. Interaction of GEM and Mental Health in Predicting Total SCS Score Figure 1 illustrates that the overall effect of GEM Score on SCS is moderated by mental health. High mental health predicts higher SCS across GEM levels. For participants with an average mental health score, the GEM Score shows little association with SCS, while for those with low mental health, the GEM Score is negatively related to SCS. The lines intersect around GEM ≈ 15–20, where low mental health, combined with a high GEM Score, yields the lowest SCS. Table2 Gamma GLM: Model 2 Predicting general sexual consent Variable Level Estimate Std. Error z value p value Length of stay in camp -0.021 0.005 -4.230 0.000 Whom do you live with, family/relative 0.104 0.043 2.430 0.015 Marital status: single/separated/divorced/widowed 0.097 0.023 4.260 0.000 Level of education primary -0.048 0.025 -1.910 0.057 Secondary -0.066 0.022 -2.990 0.003 University/tertiary 0.007 0.037 0.180 0.857 Activity Other(non/casual work) -0.088 0.031 -2.860 0.004 Self employed 0.099 0.027 3.600 0.000 student -0.088 0.034 -2.610 0.009 unemployed 0.037 0.029 1.300 0.193 Ever attended gender training yes -0.111 0.022 -4.930 0.000 GEM scores -0.002 0.002 -1.280 0.202 Total mental health score 0.004 0.001 2.760 0.006 Table 2 reveals that several factors are significant predictors of sexual Consent behavior. Length of stay in camp was negatively associated with consent . Living with family or relatives and being in a relationship were associated with higher scores. Secondary education was significantly predicted by lower sexual consent behavior scores. Males who were self-employed had significantly higher scores, whereas males in “other” activities or who were students had lower scores. Participants who had ever attended a gender showed a negative association with consent . Finally, mental health scores were positively associated with consent . Table 3 Gamma GLM: Model 2 Predicting Positive Attitude Toward Establishing Consent Estimate SE Z p 2.05 0.08 26.03 <.001 Variable Level 0 0 -1.83 0.068 Length of stay in camp -0.02 0.01 -3.79 <.001 Whom do you live with, family/relative 0.12 0.04 2.6 0.01 Marital status: single/separated/divorced/widowed 0.1 0.02 4.24 <.001 Level of education primary -0.06 0.03 -2.39 0.017 Secondary -0.08 0.02 -3.29 0.001 University/tertiary 0.01 0.04 0.27 0.787 Activity Other(non/casual work) -0.05 0.03 -1.51 0.132 Self employed 0.1 0.03 3.56 <.001 Student -0.09 0.04 -2.49 0.013 unemployed 0.05 0.03 1.64 0.101 Ever attended gender training Yes -0.12 0.02 -4.93 <.001 GEM scores 0 0 -1.82 0.07 Total mental health score 0 0 2.24 0.025 In Table 3, several demographic, socioeconomic, and psychosocial factors were found to significantly predict positive attitudes toward establishing consent. A longer stay in the camp, being a student, and ever attending gender training were associated with lower attitude scores towards establishing consent. In contrast, living with family or relatives, being single, separated, divorced, or widowed, having primary or secondary education, being self-employed, and higher mental health scores predicted higher attitudes scores toward consent. Table 4 Gamma GLM: Model 2 Predicting Indirect behavioral approach to consent Estimate SE z p 1.59 0.09 17.47 <.001 Variable Level 0 0 -1.48 0.139 Length of stay in camp -0.02 0.01 -2.69 0.007 Whom do you live with, family/relative 0.14 0.05 2.84 0.005 Marital status: single/separated/divorced/widowed 0.11 0.03 3.91 <.001 Level of education primary -0.03 0.03 -0.82 0.41 Secondary -0.06 0.03 -2.17 0.03 University/tertiary 0.03 0.04 0.66 0.509 Activity Other(non/casual work) -0.16 0.04 -4.38 <.001 Self employed 0.11 0.03 3.31 <.001 student -0.1 0.04 -2.35 0.019 unemployed 0.02 0.03 0.57 0.568 Ever attended gender training yes -0.15 0.03 -5.38 <.001 GEM scores 0 0 -0.17 0.863 Total mental health score 0 0 1.72 0.085 Table 4 shows that a longer stay in the camp, having a secondary education, engaging in other non-casual work, being a student, and having ever attended gender training were associated with lower scores for indirect behavioral approaches to consent. In contrast, living with family or relatives, being single, separated, divorced, or widowed, and being self-employed were all predictors of higher indirect behavioral approaches to consent. Table 5 Gamma GLM: Model 2 Predicting Sexual Consent Norms Estimate SE z p 1.51 0.08 18.82 <.001 Variable Level 0 0 -1.99 0.047 Length of stay in camp -0.02 0.01 -4.04 <.001 Whom do you live with, family/relative 0.09 0.04 2.02 0.044 Marital status: single/separated/divorced/widowed 0.09 0.02 3.59 <.001 Level of education Primary -0.05 0.03 -1.81 0.071 Secondary -0.09 0.02 -3.98 <.001 University/tertiary -0.03 0.04 -0.69 0.491 Activity Other(non/casual work) -0.14 0.03 -4.3 <.001 Self employed 0.07 0.03 2.58 0.01 Student -0.16 0.04 -4.5 <.001 Unemployed -0.02 0.03 -0.67 0.501 Ever attended gender training Yes -0.06 0.02 -2.75 0.006 GEM scores 0 0 0.52 0.6 Total mental health score 0 0 1.86 0.063 In Table 5, lower sexual consent norms were predicted by a longer stay in the camp, having secondary education, engaging in other kinds of work, being a student, and ever attending gender training. In contrast, living with family or relatives, being single, separated, divorced, or widowed, and being self-employed predict higher sexual consent norms. Discussion In this study, we examined the relationship between sociodemographic factors, gender norms, mental health, and sexual consent among displaced men in Benue State, Nigeria, using validated scales. Findings indicate that most men residing in the camps were aged 18–29 years, had a partner, lived with their families, and had a monthly income of approximately 5,000 naira. Predictors of sexual consent were measured using three constructs: positive attitudes toward consent, indirect behavioral approaches, and sexual consent norms. Overall, longer stay in the camp consistently predicted lower consent across all outcomes, while living with family/relatives, being single/divorced/widowed, being self-employed, and having poor (high mental health score) mental health predicted higher consent. In contrast, attending gender training and being a student were consistently associated with poorer consent endorsement. Interestingly, GEM scores were not directly associated with any consent outcome, but their effect was moderated by mental health, suggesting that equitable gender beliefs alone are insufficient for consent behavior unless supported by psychological well-being. Surprisingly, the findings reveal a strong correlation between positive attitudes, individual behaviors, and consent norms, suggesting that men in the community regard positive consent orientation as integral to sexual identity and norms. Prior studies found a moderate link between indirect behaviors and norms, but reported a negative correlation with positive consent attitudes 6 , 33 . Our study showed strong correlations across all three constructs. This suggests that, in high-context cultures, positive attitudes, peer norms, and both direct and indirect behaviors are viewed as complementary forms of consent communication rather than opposing dimensions. In our study, participants appeared to internalize positive consent and their personal behaviors towards sex. The males may see consent as a good idea ('attitude') while following different rules in practice ('behavior'). This suggests that effective consent promotion may require moving beyond attitude change to foster the internalization of consent as a fundamental personal standard for ethical sexual conduct The men's sociodemographic characteristics predicted different constructs of male sexual consent behavior. General consent scores, including positive attitudes, indirect behaviors, and sexual consent norms, decreased with longer stays in the camp. This suggests that prolonged displacement likely begins to erode psychosocial stability, leading to fatigue, reduced social engagement, and a lower ability to negotiate consent. According to finding from studies using the SCS scale, good sexual consent behavior is predicted by supportive attitudes toward explicit consent communication, confidence in handling consent situations, respect for autonomy, and adherence to positive social norms 6 , 29 . Studies in displaced settings, including IDP camps in Benue State, highlight the absence of supportive structures 10 , 34 . These camps are often overcrowded and insecure, conditions that facilitate sexual exploitation and coerced sex, underscoring how camp environments hinder positive sexual consent experiences 10 , 34 , 35 . Also, males who lived with their family or a relative consistently predicted higher sexual consent scores across all dimensions, highlighting the role of social support for good sexual health. Studies among young adults and women show that social support reinforces communication norms, promotes relationship stability, and fosters accountability 36 ,37 . However, there is limited evidence of this effect in studies of males in Africa. Males who were single/separated/divorced/widowed had a higher Sexual Consent Score, highlighting that these men have consent behaviors and may have clearer boundaries and communication when having sex. This study found that secondary school education was associated with reduced attitudes toward sexual consent, and, unexpectedly, attending gender training also lowered consent attitudes, suggesting that attitudes do not always align with behavior. Although education is linked to safer sex practices and negotiation skills, people often lack a full understanding of sexual consent, as sex education frequently omits consent or is constrained by cultural taboos, a gap that persists even in school-based programs 38,39 . However, limited evidence exists on how the education of males in Africa affects their ability to consent before sex. Males who were self-employed showed high endorsement for indirect behaviors towards sex in comparison to students and men with casual/other work. This can be due to increased autonomy, financial control, and decision-making confidence, which foster independence but also social conservatism, leading men to prefer indirect approaches to sexual consent. In African contexts, indirect sexual consent behaviors stem from cultural norms that emphasize male assertiveness and female passivity, making direct verbal communication about sex rare and often socially uncomfortable 33 ,38,40 Strong endorsement of traditional masculine autonomy roles is associated with greater reliance on indirect consent and negative attitudes toward direct consent 33 . In this study, gender equitable norm scores were not associated with sexual consent behaviors. However, the interaction model showed that high mental health scores and gender norm scores were associated with higher sexual consent behaviors. This implies that men experiencing mental health challenges but endorsing gender-equitable norms were more likely to demonstrate positive consent behaviors. This highlights the importance of integrating mental health support with gender-equity interventions in displaced settings, as addressing both factors together may foster healthier and more respectful sexual consent practices. This may also explain the fact that ever-attending gender-related training consistently predicted lower consent scores across all outcomes. Studies highlight that such training emphasizes gender roles without adequately addressing mental health or the complexities of consent 12 ,41 . A study by Stryker et.al highlighted that training for mental health professionals often lacks structured, experiential learning about the intersection of gender and mental health, leaving practitioners underprepared to address the unique challenges faced by men 42 . Hence, participants may internalize messages that reinforce indirect or traditional behaviors rather than fostering direct, equitable consent practices. Male mental health predicted general consent behavior and positive attitudes towards sexual consent. This may indicate emotional needs caused by depression, anxiety, and PTSD may lead individuals to establish relationship boundaries, showing how poor mental health can foster greater caution or empathy in sexual interactions. Studies have repeatedly shown that depression, anxiety, and PTSD negatively influence sexual consent and behavior among people in Africa and Nigeria, increasing vulnerability to sexual coercion and risky sexual practices 43,44 . However, these studies have focused mostly on the female population. Studies among men prove that mental health issues affect emotional regulation and self-control, leading men to engage in self-gratifying or maladaptive coping behaviors like unprotected sex to alleviate negative affect 45–47 . Also, males with conditions like PTSD or anxiety may also experience increased fear or avoidance of sexual situations, leading to reduced sexual activity 46 . Our findings suggest that male mental health may foster more cautious and empathetic consent behaviors, yet existing literature emphasizes that men’s mental health suggests impaired communication and emotional regulation, sometimes leading to maladaptive coping or avoidance of sexual activity. However, more direct research on male sexual consent behaviors remains scarce. This underscores the need for more gender-inclusive, context-specific research to clarify how men’s mental health influences sexual consent and behavior, and to inform interventions that promote safer and more equitable sexual relationships. Conclusion This study shows that Sexual consent behaviors among displaced men are driven by an interaction of different constructs and not limited to gender norms alone. Males' mental, social support, economic stability, and contextualized learning experiences form prolonged stay in the displaced setting, educational level, and employment status all shape their ability to seek consent before a sexual encounter. The study also highlights that the traditional gender training in these camps may be insufficient to improve sexual consent behaviors. It may need to be contextualized and integrated with mental health interventions to ensure behavioral change. These men may benefit more from developing practical communication skills around sexual consent than from relying on awareness of norms or peer- and facility-based models. Since communication plays a strong role in predicting consent behavior, such skills could represent a more effective intervention. Study limitation. This study was limited by the following factors. Cross-sectional design limits causality. Self-report data may have introduced social desirability bias. The measure for gender related norms did not capture the unique cultural realities of displaced populations. Additionally, the GEM scale does not account for the intersection of belief systems with trauma or economic hardship. This highlights the need for in‑depth qualitative research to better understand how cultural practices and beliefs shape, and are shaped by, experiences of trauma and broader socioeconomic conditions Declarations Ethics approval and consent to participate : Ethical approval for this study was obtained from the Benue State Ministry of Health, review board MOH/STA/204/1/337. The study also received administrative clearance from the Benue State Emergency Management Agency (ref. BSEMA/OFF/206/v.i/104). Informed consent was obtained from all participants prior to data collection. Consent for publication: All authors consent to the publication of this manuscript. Availability of data and materials: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request. Competing interests : The authors declare that they have no competing interests. Funding: This research was supported by the Union for African Population Studies (UAPS) AFResData Fellowship Program and the American Institutes for Research (AIR). Authors’ contributions: All authors contributed to the conception, design, data collection, analysis, and writing of the manuscript. All authors read and approved the final version. Acknowledgements The authors thank the study participants and the supporting institutions for their contributions. References Biometric Registration Report 7 Benue State_07 January 2025_Final. Achem V. Over 2 million Nigerians are displaced by farmer-herder conflict in Benue State: there are 4 support systems they turn to. Joseph N, ed. Published online October 12, 2023. doi:10.64628/AAJ.RYGPT6WVG Surviving pain and fear: Women harrowing tales from camps in Benue, Nigeria - Nigeria | ReliefWeb. Accessed November 26, 2025. https://reliefweb.int/report/nigeria/surviving-pain-and-fear-womens-harrowing-tales-camps-benue-nigeria Muodumogu CA, Anule PT, C.Madu C, A.Omudu E, Aliegba B. Prevalence and Patternsof Sexual Assault in the Context of Socio-demographic Dynamics in Benue Stateof Nigeria. International Journal of Research in Social Science and Humanities . 2024;05(07):111-120. doi:10.47505/ijrss.2024.7.10 Pulerwitz J, Hughes L, Mehta M, Kidanu A, Verani F, Tewolde S. Changing gender norms and reducing intimate partner violence: Results from a quasi-experimental intervention study with young men in Ethiopia. Am J Public Health . 2015;105(1):132-137. doi:10.2105/AJPH.2014.302214 NIGERIA MEN AND GENDER EQUALITY SURVEY (NiMAGES) Nigeria Country Report 2015 . Sedlander E, Granovsky R, Birabwa C, Amongin D, Wasswa R, Diamond-Smith N, Waiswa P, Holt K, Bingenheimer JB. Adaptation of the G-NORM (Gender norms scale) in Uganda: An examination of how gender norms are associated with reproductive health decision-making. PLoS One . 2024;19(11):e0308249. doi:10.1371/JOURNAL.PONE.0308249 Wesson PD, Lippman SA, Neilands TB, Ahern J, Kahn K, Pettifor A. Evaluating the Validity and Reliability of the Gender Equitable Men’s Scale Using a Longitudinal Cohort of Adolescent Girls and Young Women in South Africa. AIDS Behav . 2021;26(3):775. doi:10.1007/S10461-021-03436-0 Okore AA. PSYCHOTRAUMATOLOGY IN NIGERIA’S POST-CONFLICT ZONES: A CLINICAL STUDY OF INTERNALLY DISPLACED ADOLESCENTS IN ISU TOWN, ABIA STATE. Cognizance Journal of Multidisciplinary Studies . 2025;5(5):563-591. doi:10.47760/cognizance.2025.v05i05.036 Kaiser BN, Ticao C, Anoje C, Minto J, Boglosa J, Kohrt BA. Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria. Global Mental Health . 2019;6:e10. doi:10.1017/GMH.2019.8 Hassem T, Laher S. A systematic review of online depression screening tools for use in the South African context. South African Journal of Psychiatry . 2019;25(1):1-8. doi:10.4102/SAJPSYCHIATRY.V25I0.1373 Humphreys TP, Brousseau MM. The sexual consent scale-revised: development, reliability, and preliminary validity. J Sex Res . 2010;47(5):420-428. doi:10.1080/00224490903151358 Sexual Consent Scale, Revised. Accessed November 24, 2025. https://scales.arabpsychology.com/s/sexual-consent-scale-revised/ Bingenheimer JB, Asante EA, Ahiadeke C. Reliability, Validity, and Associations with Sexual Behavior among Ghanaian Teenagers of Scales Measuring Four Dimensions Relationships with Parents and Other Adults. J Fam Issues . 2013;36(5):647. doi:10.1177/0192513X13497349 Humphreys TP, Brousseau MM. The sexual consent scale-revised: development, reliability, and preliminary validity. J Sex Res . 2010;47(5):420-428. doi:10.1080/00224490903151358 PTSD Symptom Scale: Comprehensive Guide. Accessed November 23, 2025. https://neurolaunch.com/ptsd-symptom-scale/ Ng VKY, Cribbie RA. Using the Gamma Generalized Linear Model for Modeling Continuous, Skewed and Heteroscedastic Outcomes in Psychology. Current Psychology . 2017;36(2):225-235. doi:10.1007/S12144-015-9404-0 Marlow HM, Kunnuji M, Esiet A, Bukoye F, Izugbara C. The Sexual and Reproductive Health Context of an Internally Displaced Persons’ Camp in Northeastern Nigeria: Narratives of Girls and Young Women. Frontiers in Reproductive Health . 2022;3:779059. doi:10.3389/FRPH.2021.779059 Ngwibete A, Ogunbode OO, Mangalu MA, Omigbodun A. Displaced Women and Sexual and Reproductive Health Services: Exploring Challenges Women With Sexual and Reproductive Health Face in Displaced Camps of Nigeria. Journal of Education and Community Health . 2023;10(3):162-172. doi:10.34172/JECH.2612 Iyakaremye I, Mukagatare C. Forced migration and sexual abuse: experience of Congolese adolescent girls in Kigeme refugee camp, Rwanda. Health Psychol Rep . 2016;4(3):261-271. doi:10.5114/HPR.2016.59590 Durevall D, Cowden RG, Beckett S, Kharsany ABM, Lewis L, George G, Cawood C, Khanyile D, Govender K. Associations of Social Support with Sexual Practices, Health Behaviours, and Health Outcomes Among Adolescent Girls and Young Women: Evidence From a Longitudinal Study in KwaZulu-Natal, South Africa. Int J Behav Med . 2023;31(4):620. doi:10.1007/S12529-023-10199-6 Harling G, Gumede D, Shahmanesh M, Pillay D, Bärnighausen TW, Tanser F. Sources of social support and sexual behaviour advice for young adults in rural South Africa. BMJ Glob Health . 2018;3(6):e000955. doi:10.1136/BMJGH-2018-000955 Odimegwu CO, Ugwu NH. A multilevel mixed effect analysis of neighbourhood and individual level determinants of risky sexual behaviour among young people in South Africa. Reproductive Health 2022 19:1 . 2022;19(1):119-. doi:10.1186/S12978-022-01407-9 Jackson F, Haile ZT. Association between educational attainment and risky sexual behaviour among Ghanaian female youth. Afr Health Sci . 2023;23(1):301-308. doi:10.4314/AHS.V23I1.32 De Meyer S, Lau K, Kemigisha E, Cevalllos A, Rost L, Michielsen K, Kågesten A, van Reeuwijk M. ‘If her body responds then you know she wants it’: a qualitative study on how young people in Ecuador and Uganda understand and practice consent. Glob Health Action . 2025;18(1):2465123. doi:10.1080/16549716.2025.2465123 Hermann C, Liang CTH, DeSipio BE. Exploring sexual consent and hostile masculine norms using the theory of planned behavior. Psychol Men Masc . 2018;19(4):491-499. doi:10.1037/MEN0000127 Stewart R, Wright B, Smith L, Roberts S, Russell N. Gendered stereotypes and norms: A systematic review of interventions designed to shift attitudes and behaviour. Heliyon . 2021;7(4):e06660. doi:10.1016/j.heliyon.2021.e06660 Exploring sexual consent and hostile masculine norms using the theory of planned behavior. Accessed November 27, 2025. https://psycnet.apa.org/doiLanding?doi=10.1037%2Fmen0000127 Stryker SD, Pallerla H, Yockey RA, Bedard-Thomas J, Pickle S. Training Mental Health Professionals in Gender-Affirming Care: A Survey of Experienced Clinicians. https://home.liebertpub.com/trgh . 2022;7(1):68-77. doi:10.1089/TRGH.2020.0123 Kaiser BN, Ticao C, Anoje C, Minto J, Boglosa J, Kohrt BA. Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria. Global Mental Health . 2019;6:e10. doi:10.1017/GMH.2019.8 Marlow HM, Kunnuji M, Esiet A, Bukoye F, Izugbara C. The Sexual and Reproductive Health Context of an Internally Displaced Persons’ Camp in Northeastern Nigeria: Narratives of Girls and Young Women. Frontiers in Reproductive Health . 2021;3:779059. doi:10.3389/FRPH.2021.779059/BIBTEX Webb EL, Dietrich JJ, Ssemata AS, Nematadzira TG, Hornschuh S, Kakande A, Tshabalala G, Muhumuza R, Mutonyi G, Atujuna M, Bere T, Bekker LG, Abas MA, Weiss HA, Seeley J, Stranix-Chibanda L, Fox J. Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe. BMC Infect Dis . 2022;22(1):466. doi:10.1186/S12879-022-07430-2 Hill LM, Gottfredson NC, Kajula LJ, Pence BW, Go VF, Moody J, Maman S. Changes in Anxiety and Depression Symptoms Predict Sexual Risk Behaviors Among Young Men Living in Dar es Salaam, Tanzania. AIDS Behav . 2018;22(5):1435-1445. doi:10.1007/S10461-017-1991-3 Hill LM, Gottfredson NC, Kajula LJ, Pence BW, Go VF, Moody J, Maman S. Changes in Anxiety and Depression Symptoms Predict Sexual Risk Behaviors Among Young Men Living in Dar es Salaam, Tanzania. AIDS Behav . 2018;22(5):1435. doi:10.1007/S10461-017-1991-3 Additional Declarations No competing interests reported. Supplementary Files Supplement.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 05 Mar, 2026 Editor invited by journal 09 Feb, 2026 Editor assigned by journal 04 Feb, 2026 Submission checks completed at journal 04 Feb, 2026 First submitted to journal 03 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8779024","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":603925856,"identity":"f2cef651-35ec-48e4-a91a-20b99e8a372f","order_by":0,"name":"Ngwibete Atenchong","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYPACiQQgwfiAgeEAKVrYGJgNSNHCANLCJkGUFv7Z7dcefm2zyOOXbz5WzfPrjhwDe+/jF3hddOdMubFsm0SxZBtb2m3evmfGDDzHzSzwWnMjJ01acptE4oZjPGa3eXsOJzZIpLEZ4NMhD9Oy/xj/t2KglnqCWgxupB+T/AiyhY2HjZnnx+EEBok05gf4tBjeyGGTZvwnUSxxLM1Ycm7DYcM2nmNseL0idyP9meSPM3V5/M2HH3548+ewPD97G/MHvHoYeAyYeWBsxjYGYPyAIwgfYH/A+APO+QMmCdkyCkbBKBgFIwwAAAgwTJUh9F0LAAAAAElFTkSuQmCC","orcid":"","institution":"University of Global Health Equity","correspondingAuthor":true,"prefix":"","firstName":"Ngwibete","middleName":"","lastName":"Atenchong","suffix":""},{"id":603925860,"identity":"55854ce0-1d7f-4928-af44-73bbbcbe1814","order_by":1,"name":"Benjamin Mkena","email":"","orcid":"","institution":"AIDS Healthcare Foundation","correspondingAuthor":false,"prefix":"","firstName":"Benjamin","middleName":"","lastName":"Mkena","suffix":""},{"id":603925862,"identity":"2c3e4bdb-cf9b-46e6-a989-efbd51ea281f","order_by":2,"name":"Laadi Swende","email":"","orcid":"","institution":"Federal Medical Centre","correspondingAuthor":false,"prefix":"","firstName":"Laadi","middleName":"","lastName":"Swende","suffix":""},{"id":603925864,"identity":"3c576e62-7ad7-4567-a179-41b3695acf9a","order_by":3,"name":"David Seidenfeld","email":"","orcid":"","institution":"American Institutes for Research","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"","lastName":"Seidenfeld","suffix":""}],"badges":[],"createdAt":"2026-02-03 17:54:33","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8779024/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8779024/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104808092,"identity":"e5b478b6-5580-43bd-abd9-42b11d10ff8b","added_by":"auto","created_at":"2026-03-17 12:12:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":101505,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eConceptual Framework examining the intersection between mental health, gender norms, and sexual consent\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8779024/v1/fe0574a1cfb7698a4c649c5f.png"},{"id":104396851,"identity":"b61c9ce8-529a-49a9-a580-7059e0181d72","added_by":"auto","created_at":"2026-03-11 11:21:18","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":117336,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFigure 1: Interaction of GEM and Mental Health in Predicting Total SCS Score\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"01.png","url":"https://assets-eu.researchsquare.com/files/rs-8779024/v1/241fedfc54fee0d8f4778817.png"},{"id":105906869,"identity":"ef6dfe24-4f06-44a9-b8cd-f8c54775f4f7","added_by":"auto","created_at":"2026-04-01 10:25:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1258230,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8779024/v1/24935304-0531-4801-836e-167b5a5eea80.pdf"},{"id":105751644,"identity":"ea9d9b30-24c6-4bb7-a4ee-c7086a19ee04","added_by":"auto","created_at":"2026-03-30 15:34:32","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":26906,"visible":true,"origin":"","legend":"","description":"","filename":"Supplement.docx","url":"https://assets-eu.researchsquare.com/files/rs-8779024/v1/352dc498d2aca77fb5c13f9e.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Exploring the Intersection of gender norms, Mental Health, and Sexual Consent, Among Displaced men of Benue state, Nigeria","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSexual violence remains a public health concern in displaced settings in Nigeria\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Studies have indicated a prevalence as high as 37\u0026ndash;50% and nearly all perpetrators were identified as male\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. These alarming rates call for the need for intervention to strengthen sexual consent behavior among men in displaced settings as a fundamental component of ethical and safe sexual relationships. However, male sexual and reproductive health and associated behaviors is often overlooked in both research and intervention design\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Sexual consent entails an individual\u0026apos;s ability to recognize boundaries, communicate intentions, and respect the autonomy of others\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. The Sexual consent behavior remains poorly understood in many settings, particularly among populations experiencing displacement, instability, and socioeconomic hardship\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. In displaced settings across Africa, traditional gender norms and the silence surrounding sexuality often restrict men\u0026rsquo;s ability to negotiate or respect consent within intimate relationships\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. These dynamics are shaped by patrilineal structures, exposure to trauma, limited opportunities, and disrupted social systems\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. Some studies have highlighted that, due to the breakdown of conventional traditional structures during displacement, there are accompanying stressors that exacerbate harmful masculinities\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. However, the intersection of gender norms, mental health, and sexual consent behaviors among displaced men remains underexplored.\u003c/p\u003e\n\u003cp\u003eGender-transformative programming has increasingly been promoted to address gender-based violence and harmful norms among men\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Research shows that employment status, the availability of social support, and living arrangements significantly influence sexual risk‑taking and the negotiation of consent\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. Nonetheless, gender-equitable norms alone may not translate into practice, especially when trauma or poor mental health are present. \u003csup\u003e11,16\u003c/sup\u003eMoreover, traditional training approaches may be ineffective if they do not address men\u0026rsquo;s lived realities or provide practical communication skills for navigating consent\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConceptual Framework\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e: \u003cstrong\u003eConceptual Framework examining the intersection between mental health, gender norms, and sexual consent\u003c/strong\u003e behaviors\u003c/p\u003e\n\u003cp\u003eThe integrated socio-ecological, Gender and Power Theory, and Theory of Planned Behavior framework was used to examine the intersection between mental health, gender norms, and sexual consent behaviors among displaced men in Benue State, Nigeria. The social ecological theory explains consent behaviors and individual and household dynamics in relation to their environment\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. Gender and Power Theory explains how situations of one\u0026apos;s environment (displacement) may disrupt gender norms in the environment, creating a masculine identity that manifests in sexual domain behaviors\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. The theory of planned behavior differentiates how one\u0026apos;s attitudes, contextual norms, and perceived behavioral control can affect consent behaviors. According to these theories, a man\u0026apos;s characteristics do not directly affect their sexual consent behaviors. However, these behaviors are determined by interactions with contextual factors such as his psychological states, gender norms, and socio-environmental factors arising from displacement.\u003c/p\u003e\n\u003cp\u003eThe model uses three distinct constructs of sexual consent as outcomes\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e: positive attitudes toward consent, perceived consent norms, and indirect behavior. The model proposes that gender norm attitudes and mental health symptoms have a strong direct effect on sexual consent behaviors. Differential pathways to each outcome are hypothesized: gender-equitable norms are posited as the primary driver of positive attitudes, while both gender norms and environmental factors are expected to shape perceived norms. Additionally, mental health symptoms are anticipated to have the strongest direct effect on coercive behaviors.\u003c/p\u003e\n\u003cp\u003eAccording to the framework, access to health care, once physical health and ever attending gender training are moderating factors to their mental health, gender norm attitude and sexual consent behavioral outcomes. It also suggests that there is a bidirectional pathway between mental health and gender norms. It proposes that poor mental health outcomes could push individuals toward rigid, authoritarian masculine ideologies that create dominance and poor consent behaviors. On the other hand, when inequitable gender norms are internalized, healthy coping strategies and health-seeking behaviors may affect men\u0026apos;s mental health negatively.\u003c/p\u003e\n\u003cp\u003eThis model thus elaborates the multi-level approach to understanding sexual consent behaviors among displaced men.\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003eThis was a cross-sectional study done in three selected internally displaced persons (IDPs) camps (Otese, Mega, and Daudu camps). These camps were purposefully selected because they were relatively safe to assess. These camps are in a rural-agrarian community affected by farmer-herder conflict. Benue shelters about two million displaced persons, with the majority living in the selected internally displaced camps\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Previous studies have reported a prevalence of sexual violence in Nigeria ranging from 36% to 54%, with Benue State recording a rate of over 53%\u003csup\u003e22,2324\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eInclusion criteria\u003c/p\u003e\u003cul\u003e \u003cli\u003e \u003cp\u003eMen aged 18 to 80\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eMinimum one year of residence in the settlement.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSexually active in the past 12 months\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFluent in Tiv, pidgin, or English\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eVoluntarily agrees to participate\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e\u003cp\u003eExclusion criteria\u003c/p\u003e\u003cul\u003e \u003cli\u003e \u003cp\u003eSevere mental illness or acute illness that impairs consent capacity.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eNever engaged in a minimum of one sexual relationship.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e\u003cp\u003eMeasures\u003c/p\u003e\u003cp\u003eWe collected sociodemographic data on displaced males, their attendance at gender training, and measures of gender norms, mental health, and sexual consent. We adapted the Gender-Equitable Men (GEM) Scale for assessing gender norms and their relationship to sexual consent\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. The GEM is a reliable scale that has been piloted across several African countries, including South Africa, Uganda, and Nigeria (specifically in Benue, Kano, Lagos, and Rivers)\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. It measures gender norms and attitudes, supporting its application in programs addressing gender-based violence, reproductive health, and social norm change. The adapted instrument consisted of a total of 12 items, including three context-specific statements that reflected prevailing beliefs about male authority and sexual entitlement in the setting. These included;\u003c/p\u003e\u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eIf a woman refuses sex, it is acceptable for a man to keep trying until a woman agrees to sex.\u003c/em\u003e \u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eIt is acceptable for a man to expect sex if he has provided money.\u003c/em\u003e \u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eIt is a sign of weakness for a man to ask his partner for permission before sex.\u003c/em\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e\u003cp\u003eWe assessed three mental health symptoms: Post Traumatic Stress Disorder (PTSD), depression, and anxiety using the PTSD-8 and PHQ-4 instruments, respectively, which have shown high reliability in the African setting, including Nigeria\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. The traditional PTSD-8 instrument measures intrusion, avoidance, and arousal, while the PHQ4 has depression and anxiety as its constructs. Each item used a Likert scale from 0 to 4, where higher scores showed stronger symptoms.\u003c/p\u003e\u003cp\u003eThe outcome variable for this analysis was sexual consent behavior, assessed using the Sexual Consent Scale (SCS) with three constructs adapted from the original instrument\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. The first construct consisted of 9 items and captured positive attitudes toward establishing consent. The second construct, comprising 6 items, captured indirect behaviors related to consent. The third construct consisted of 5 items and captured consent norms. Items were presented in a yes/no format rather than the original Likert scale, as it ensured clarity and consistent understanding in the local language when compared to the Likert responses. The tool has been applied in studies in Ghana\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e and, though primarily developed outside Africa, has been validated and shows strong potential for adaptation and use in African contexts\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. All the tools adopted had a Cronbach's alpha of 0.85, demonstrating a good internal consistency of the entire scale.\u003c/p\u003e\u003ch3\u003eEthical consideration\u003c/h3\u003e\u003cp\u003e The study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Benue State Ministry of Health (MOH/STA/204/1/337) and further administrative clearance from the Benue State Emergency Management Agency (ref. BSEMA/OFF/206/v.i/104) prior to data collection. Additional permission was received from the camp leadership overseeing the study populations. Participation was voluntary, and written informed consent was obtained from all participants before enrolment. A translated informed consent form was read aloud in the native language or pidgin English to participants with limited literacy to ensure understanding, and consent was confirmed with a thumbprint. Participants received clear information on the study purpose, procedures, risks, and benefits. They were informed of their right to refuse participation or withdraw at any time without consequences. Confidentiality was maintained, and no personal identifiers were used. All data were stored in password-protected files and accessed only by the research team. Participants received modest compensation to cover transport or time spent, in line with ethical guidance and local standards.\u003c/p\u003e\u003ch2\u003eAnalysis\u003c/h2\u003e\u003cp\u003eSociodemographic variables, mental health categories, gender norm attitudes, and sexual consent were summarized using descriptive statistics. Continuous variables were summarized using the median and interquartile range (IQR), while Categorical variables were summarized using frequencies and percentages.\u003c/p\u003e\u003cp\u003eScores on the modified GEM Scale ranged from 12 to 36. Equal divisions of the scores were calculated to categorize the scale into three levels: low equity (12–20), medium equity (21–28), and high equity (29–36).\u003c/p\u003e\u003cp\u003eItems of the PTSD-8 and PHQ-4 scales were categorized using a clinical standard. Each symptom group was screened by identifying items with values 3 or 4. Intrusion was marked positive when at least one intrusion item scored 3 or 4. Avoidance was marked positive when at least one avoidance item scored 3 or 4. Hypervigilance was marked positive when at least one hypervigilance item scored 3 or 4\u003csup\u003e31\u003c/sup\u003e. The PHQ was categorized into depression symptoms and anxiety symptoms. Depression was calculated as the sum of the first two items (range 0–6), while anxiety was calculated as the sum of the last two items (range 0–6). A score of \u003cb\u003e≥ 3\u003c/b\u003e on either subscale suggests possible depression or anxiety.\u003c/p\u003e\u003cp\u003eThe items of the SCS scale were scored as 1 for \"yes\" and 0 for \"no\". Subscale scores were created by summing the items within each section. The positive attitude subscale produced scores from 0 to 9. The indirect behavior subscale yielded scores ranging from 0 to 6, while the consent norms subscale produced a total score of 4. Endorsement levels were categorized using the median as the cut‑off point, A higher magnitude means a stronger endorsement of the construct measured by that subscale. Lower magnitude means weaker endorsement. For the positive attitude participants scoring at or above median score of 8 were classified as having high endorsement. For the indirect behavior participant scoring ≥ 6 indicated high endorsement. For the consent norms subscale participants scoring ≥ 5 was classified as high endorsement.\u003c/p\u003e\u003cp\u003eA frequency table compared the distribution of SCS endorsement across sociodemographic factors, GEM categories, and mental health indicators. Chi-square tests assessed differences in categorical variables(supplement 1)\u003c/p\u003e\u003cp\u003eAn exploratory composite index was created by summing PTSD and PHQ symptom scores to approximate overall mental health burden, with the understanding that it is not a validated measure but is intended to capture overall symptom magnitude. The index was used to test interactions between GEM and SCS scores, with sexual consent behavior examined in relation to gender norms, attitudes, and mental health as a moderator. A linear model was applied using the total scores of all three variables. The interaction was visualized using a moderated regression plot, which displays predicted SCS scores for low, average, and high mental health across the range of GEM Scores.\u003c/p\u003e\u003cp\u003e To examine the association between socio-demographic characteristics, mental health scores, gender norm attitudes, and gen sexual consent behaviors and its constructs, we used the Gamma generalized linear model (GLM) with a log link to estimate the relationship between predictors. The Gamma generalized linear model (GLM) was found appropriate for the positively skewed SCS score \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. Two models were fitted to predict consent behavior construct: positive attitudes towards sexual consent, an indirect approach, and sexual consent norms. Model 1 included all predictors: age, length of stay in camp, number of males, income, Number of females (obtained by subtracting household size from number of of males), settlement type, living arrangements, marital status, education level, main activity, religion, gender training attendance, GEM score, and mental health combined score. Model 2 was a simplified model that included only the strongest predictors identified in Model 1, based on statistical significance and theoretical relevance: length of stay, living arrangements, marital status, education level, main activity, gender, training attendance, GEM score, and a combined mental health score. Model 2 achieved a good balance between model fit and parsimony, with Akaike Information Criterion (AIC) values of 3523 for general consent behaviors, 2522 for positive attitudes toward sexual consent, 2169 for the indirect approach, and 1841 for sexual consent norms. These AIC values were all lower than those for Model 1. All analyses were performed in \u003cb\u003eR\u003c/b\u003e Studio, and statistical significance was assessed at α = 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable 1: Descriptive Characteristics of Participants\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e610\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eAge(years) (Median, IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e36.00 [27.00, 47.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e18\u0026ndash;29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e178 (29.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e30\u0026ndash;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e154 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e40\u0026ndash;49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e138 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e50plus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e140 (23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003elength of stay in camp( years) (Median, IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e4.00 [2.00, 5.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eLength of stay category\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eShort (1\u0026ndash;2 years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e161 (26.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMedium (3\u0026ndash;5 years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e336 (55.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eLong (6\u0026ndash;9years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e113 (18.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eHousehold size (median, IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e6.00 [4.00, 8.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eHousehold size category\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e13 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eSmall (2\u0026ndash;3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e119 (19.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMedium (4\u0026ndash;5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e167 (27.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eLarge (6+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e311 (51.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNumber of males in household (median IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e3.00 [2.00, 4.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eNumber of males in household Category\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u0026le;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e82 (13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e2\u0026ndash;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e321 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e4+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e207 (33.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003etotal income per month(Niara) (Median IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e5000.00 [0.00, 19000.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eincome Cat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eLess than 20k\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e506 (83.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e20k\u0026ndash;50k\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e89 (14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eOver 50k\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e15 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eSettlement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eDaudu 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e218 (35.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMega camp\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e191 (31.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eOrtese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e201 (33.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eWhom do you live with\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eby yourself/with friend(s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e33 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003ewith family/relative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e577 (94.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003emarried/cohabiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e463 (75.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003esingle/separated/divorced/widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e147 (24.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eno formal education/other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e181 (29.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e145 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e240 (39.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003euniversity/tertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e44 (7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eEmployment status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eemployed fulltime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e112 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eOther(casual /work)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e93 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eSelf employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e164 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e82 (13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e159 (26.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e601 (98.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eother(Islam/traditional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e9 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\n \u003cp\u003eever attended gender related training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e219 (35.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 276px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e391 (64.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn Table 1 above, the average age of the males was 36 [37, 47] years, with up to 178 (29.2%) between 18 and 29 years. The average length of stay in the camp was 4 [2-5] years. Most of the participants had large household sizes, with an average of 6 [4-8] persons in the household and an average of 3 males. Most of the males were self-employed, at 164 (26.9%), with an average monthly income of 5,000 naira. The majority, 463 (75.5%), were married/cohabiting, and 577 (95.6%) lived with a family member/relative. Up to 392 (64.1%) had ever attended gender-related training.\u003c/p\u003e\n\u003cp\u003eSupplement 2 shows that there was a low endorsement of gender-equal norms among displaced men, with only 4.1% reporting high endorsement. \u0026nbsp; Up to 54.8% of the participants reported at least one mental health symptom. Slightly over half of the respondents had a probable symptom of PTSD (54.3%), with the majority experiencing hypervigilance (24.3%). \u0026nbsp;Anxiety and depression were prevalent among (33.3%)and (32.1% )of the respondents. Endorsement of sexual consent behaviors varied, with 59.3% reporting positive attitudes, 55.2% using indirect behaviors, and 60.8% conforming to consent norm beliefs\u003c/p\u003e\n\u003cp\u003eSupplement 1 presents the Pearson correlations among positive attitudes, individual behaviors, and consent norms, showing consistently strong and statistically significant associations across all three domains.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInteraction of GEM and Mental Health in Predicting Total SCS Score\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 1 illustrates that the overall effect of GEM Score on SCS is moderated by mental health. High mental health predicts higher SCS across GEM levels. \u0026nbsp; For participants with an average mental health score, the GEM Score shows little association with SCS, while for those with low mental health, the GEM Score is negatively related to SCS. The lines intersect around GEM \u0026asymp; 15\u0026ndash;20, where low mental health, combined with a high GEM Score, yields the lowest SCS.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 508px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable2 Gamma GLM: Model 2 Predicting general sexual consent\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEstimate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd. Error\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ez value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eLength of stay in camp\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-4.230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eWhom do you live with,\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003efamily/relative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2.430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.015\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMarital status:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003esingle/separated/divorced/widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e4.260\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eLevel of education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-1.910\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.057\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-0.066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-2.990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003eUniversity/tertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eActivity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003eOther(non/casual work)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-2.860\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003eSelf employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e3.600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003estudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-2.610\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003eunemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eEver attended gender training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-4.930\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eGEM scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-1.280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 138px;\"\u003e\n \u003cp\u003eTotal mental health score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 232px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2.760\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2 reveals that several factors are significant predictors of sexual Consent behavior. Length of stay in camp was negatively associated with consent . Living with family or relatives and being in a relationship were associated with higher scores. Secondary education was significantly predicted by lower sexual consent behavior scores. Males who were self-employed had significantly higher scores, whereas males in \u0026nbsp;\u0026ldquo;other\u0026rdquo; activities or who were students had lower scores. Participants who had ever attended a gender showed a negative association with consent . Finally, mental health scores were positively associated with consent . \u0026nbsp;\u003cstrong\u003e\u003cem\u003e\u003cbr\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 3 Gamma GLM: Model 2 Predicting \u0026nbsp;Positive Attitude Toward Establishing Consent\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 157px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 190px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eEstimate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 157px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 190px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e26.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eLength of stay in camp\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-3.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eWhom do you live with,\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003efamily/relative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eMarital status:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003esingle/separated/divorced/widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e4.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eLevel of education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-2.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.017\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-3.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eUniversity/tertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.787\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eActivity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eOther(non/casual work)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eSelf employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e3.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-2.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.013\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eunemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.101\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eEver attended gender training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-4.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eGEM scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-1.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eTotal mental health score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.025\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn Table 3, \u0026nbsp;several demographic, socioeconomic, and psychosocial factors were found to significantly predict positive attitudes toward establishing consent. A longer stay in the camp, being a student, and ever attending gender training were associated with lower attitude scores towards establishing consent. In contrast, living with family or relatives, being single, separated, divorced, or widowed, having primary \u0026nbsp;or secondary education, being self-employed, and higher mental health scores predicted higher attitudes scores toward consent.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4\u0026nbsp;\u003cstrong\u003e\u003cem\u003eGamma GLM: Model 2 Predicting Indirect behavioral approach to consent\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eEstimate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ez\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e17.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-1.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.139\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eLength of stay in camp\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eWhom do you live with,\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003efamily/relative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eMarital status:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003esingle/separated/divorced/widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eLevel of education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-2.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eUniversity/tertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.509\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eActivity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eOther(non/casual work)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-4.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eSelf employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e3.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003estudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-2.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eunemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eEver attended gender training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-5.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eGEM scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eTotal mental health score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 4 shows that a longer stay in the camp, having a secondary education, engaging in other non-casual work, being a student, and having ever attended gender training were associated with lower scores for indirect behavioral approaches to consent. In contrast, living with family or relatives, being single, separated, divorced, or widowed, and being self-employed were all predictors of higher indirect behavioral approaches to consent.\u003c/p\u003e\n\u003cp\u003eTable 5 \u003cstrong\u003e\u003cem\u003eGamma GLM: Model 2 Predicting \u0026nbsp;Sexual Consent Norms\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eEstimate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ez\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e18.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.047\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eLength of stay in camp\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-4.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eWhom do you live with,\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003efamily/relative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.044\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eMarital status:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003esingle/separated/divorced/widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e3.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eLevel of education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-3.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eUniversity/tertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.491\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eActivity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eOther(non/casual work)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eSelf employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.501\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eEver attended gender training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e-2.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eGEM scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003eTotal mental health score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn Table 5, lower sexual consent norms were predicted by a longer stay in the camp, having secondary education, engaging in other kinds of work, being a student, and ever attending gender training. \u0026nbsp;In contrast, living with family or relatives, being single, separated, divorced, or widowed, and being self-employed predict higher sexual consent norms.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we examined the relationship between sociodemographic factors, gender norms, mental health, and sexual consent among displaced men in Benue State, Nigeria, using validated scales. Findings indicate that most men residing in the camps were aged 18\u0026ndash;29 years, had a partner, lived with their families, and had a monthly income of approximately 5,000 naira. Predictors of sexual consent were measured using three constructs: positive attitudes toward consent, indirect behavioral approaches, and sexual consent norms. Overall, longer stay in the camp consistently predicted lower consent across all outcomes, while living with family/relatives, being single/divorced/widowed, being self-employed, and having poor (high mental health score) mental health predicted higher consent. In contrast, attending gender training and being a student were consistently associated with poorer consent endorsement. Interestingly, GEM scores were not directly associated with any consent outcome, but their effect was moderated by mental health, suggesting that equitable gender beliefs alone are insufficient for consent behavior unless supported by psychological well-being. Surprisingly, the findings reveal a strong correlation between positive attitudes, individual behaviors, and consent norms, suggesting that men in the community regard positive consent orientation as integral to sexual identity and norms.\u003c/p\u003e \u003cp\u003ePrior studies found a moderate link between indirect behaviors and norms, but reported a negative correlation with positive consent attitudes\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e. Our study showed strong correlations across all three constructs. This suggests that, in high-context cultures, positive attitudes, peer norms, and both direct and indirect behaviors are viewed as complementary forms of consent communication rather than opposing dimensions. In our study, participants appeared to internalize positive consent and their personal behaviors towards sex. The males may see consent as a good idea ('attitude') while following different rules in practice ('behavior'). This suggests that effective consent promotion may require moving beyond attitude change to foster the internalization of consent as a fundamental personal standard for ethical sexual conduct\u003c/p\u003e \u003cp\u003eThe men's sociodemographic characteristics predicted different constructs of male sexual consent behavior. General consent scores, including positive attitudes, indirect behaviors, and sexual consent norms, decreased with longer stays in the camp. This suggests that prolonged displacement likely begins to erode psychosocial stability, leading to fatigue, reduced social engagement, and a lower ability to negotiate consent. According to finding from studies using the SCS scale, good sexual consent behavior is predicted by supportive attitudes toward explicit consent communication, confidence in handling consent situations, respect for autonomy, and adherence to positive social norms\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. Studies in displaced settings, including IDP camps in Benue State, highlight the absence of supportive structures\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. These camps are often overcrowded and insecure, conditions that facilitate sexual exploitation and coerced sex, underscoring how camp environments hinder positive sexual consent experiences\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. Also, males who lived with their family or a relative consistently predicted higher sexual consent scores across all dimensions, highlighting the role of social support for good sexual health. Studies among young adults and women show that social support reinforces communication norms, promotes relationship stability, and fosters accountability\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e,37\u003c/sup\u003e. However, there is limited evidence of this effect in studies of males in Africa. Males who were single/separated/divorced/widowed had a higher Sexual Consent Score, highlighting that these men have consent behaviors and may have clearer boundaries and communication when having sex.\u003c/p\u003e \u003cp\u003eThis study found that secondary school education was associated with reduced attitudes toward sexual consent, and, unexpectedly, attending gender training also lowered consent attitudes, suggesting that attitudes do not always align with behavior. Although education is linked to safer sex practices and negotiation skills, people often lack a full understanding of sexual consent, as sex education frequently omits consent or is constrained by cultural taboos, a gap that persists even in school-based programs\u003csup\u003e38,39\u003c/sup\u003e. However, limited evidence exists on how the education of males in Africa affects their ability to consent before sex.\u003c/p\u003e \u003cp\u003eMales who were self-employed showed high endorsement for indirect behaviors towards sex in comparison to students and men with casual/other work. This can be due to increased autonomy, financial control, and decision-making confidence, which foster independence but also social conservatism, leading men to prefer indirect approaches to sexual consent. In African contexts, indirect sexual consent behaviors stem from cultural norms that emphasize male assertiveness and female passivity, making direct verbal communication about sex rare and often socially uncomfortable\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,38,40\u003c/sup\u003e Strong endorsement of traditional masculine autonomy roles is associated with greater reliance on indirect consent and negative attitudes toward direct consent\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn this study, gender equitable norm scores were not associated with sexual consent behaviors. However, the interaction model showed that high mental health scores and gender norm scores were associated with higher sexual consent behaviors. This implies that men experiencing mental health challenges but endorsing gender-equitable norms were more likely to demonstrate positive consent behaviors. This highlights the importance of integrating mental health support with gender-equity interventions in displaced settings, as addressing both factors together may foster healthier and more respectful sexual consent practices. This may also explain the fact that ever-attending gender-related training consistently predicted lower consent scores across all outcomes. Studies highlight that such training emphasizes gender roles without adequately addressing mental health or the complexities of consent\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,41\u003c/sup\u003e. A study by Stryker et.al highlighted that training for mental health professionals often lacks structured, experiential learning about the intersection of gender and mental health, leaving practitioners underprepared to address the unique challenges faced by men\u003csup\u003e42\u003c/sup\u003e. Hence, participants may internalize messages that reinforce indirect or traditional behaviors rather than fostering direct, equitable consent practices.\u003c/p\u003e \u003cp\u003eMale mental health predicted general consent behavior and positive attitudes towards sexual consent. This may indicate emotional needs caused by depression, anxiety, and PTSD may lead individuals to establish relationship boundaries, showing how poor mental health can foster greater caution or empathy in sexual interactions. Studies have repeatedly shown that depression, anxiety, and PTSD negatively influence sexual consent and behavior among people in Africa and Nigeria, increasing vulnerability to sexual coercion and risky sexual practices\u003csup\u003e43,44\u003c/sup\u003e. However, these studies have focused mostly on the female population. Studies among men prove that mental health issues affect emotional regulation and self-control, leading men to engage in self-gratifying or maladaptive coping behaviors like unprotected sex to alleviate negative affect \u003csup\u003e45\u0026ndash;47\u003c/sup\u003e. Also, males with conditions like PTSD or anxiety may also experience increased fear or avoidance of sexual situations, leading to reduced sexual activity\u003csup\u003e46\u003c/sup\u003e. Our findings suggest that male mental health may foster more cautious and empathetic consent behaviors, yet existing literature emphasizes that men\u0026rsquo;s mental health suggests impaired communication and emotional regulation, sometimes leading to maladaptive coping or avoidance of sexual activity. However, more direct research on male sexual consent behaviors remains scarce. This underscores the need for more gender-inclusive, context-specific research to clarify how men\u0026rsquo;s mental health influences sexual consent and behavior, and to inform interventions that promote safer and more equitable sexual relationships.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study shows that Sexual consent behaviors among displaced men are driven by an interaction of different constructs and not limited to gender norms alone. Males' mental, social support, economic stability, and contextualized learning experiences form prolonged stay in the displaced setting, educational level, and employment status all shape their ability to seek consent before a sexual encounter. The study also highlights that the traditional gender training in these camps may be insufficient to improve sexual consent behaviors. It may need to be contextualized and integrated with mental health interventions to ensure behavioral change. These men may benefit more from developing practical communication skills around sexual consent than from relying on awareness of norms or peer- and facility-based models. Since communication plays a strong role in predicting consent behavior, such skills could represent a more effective intervention.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy limitation.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis study was limited by the following factors.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eCross-sectional design limits causality.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSelf-report data may have introduced social desirability bias.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe measure for gender related norms did not capture the unique cultural realities of displaced populations. Additionally, the GEM scale does not account for the intersection of belief systems with trauma or economic hardship. This highlights the need for in‑depth qualitative research to better understand how cultural practices and beliefs shape, and are shaped by, experiences of trauma and broader socioeconomic conditions\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003cstrong\u003e:\u003c/strong\u003e Ethical approval for this study was obtained from the Benue State Ministry of Health, review board MOH/STA/204/1/337. \u0026nbsp;The study also received administrative clearance from the Benue State Emergency Management Agency (ref. BSEMA/OFF/206/v.i/104). Informed consent was obtained from all participants prior to data collection.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConsent for publication:\u0026nbsp;\u003c/em\u003eAll authors consent to the publication of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAvailability of data and materials:\u0026nbsp;\u003c/em\u003eThe\u0026nbsp;datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCompeting interests\u003c/em\u003e: The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding: This research was supported by the Union for African Population Studies (UAPS) AFResData Fellowship Program and the American Institutes for Research (AIR).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAuthors\u0026rsquo; contributions:\u003c/em\u003e All authors contributed to the conception, design, data collection, analysis, and writing of the manuscript. All authors read and approved the final version.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank the study participants and the supporting institutions for their contributions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBiometric Registration Report 7 Benue State_07 January 2025_Final.\u003c/li\u003e\n \u003cli\u003eAchem V. Over 2 million Nigerians are displaced by farmer-herder conflict in Benue State: there are 4 support systems they turn to. Joseph N, ed. Published online October 12, 2023. doi:10.64628/AAJ.RYGPT6WVG\u003c/li\u003e\n \u003cli\u003eSurviving pain and fear: Women harrowing tales from camps in Benue, Nigeria - Nigeria | ReliefWeb. Accessed November 26, 2025. https://reliefweb.int/report/nigeria/surviving-pain-and-fear-womens-harrowing-tales-camps-benue-nigeria\u003c/li\u003e\n \u003cli\u003eMuodumogu CA, Anule PT, C.Madu C, A.Omudu E, Aliegba B. Prevalence and Patternsof Sexual Assault in the Context of Socio-demographic Dynamics in Benue Stateof Nigeria. \u003cem\u003eInternational Journal of Research in Social Science and Humanities\u003c/em\u003e. 2024;05(07):111-120. doi:10.47505/ijrss.2024.7.10\u003c/li\u003e\n \u003cli\u003ePulerwitz J, Hughes L, Mehta M, Kidanu A, Verani F, Tewolde S. Changing gender norms and reducing intimate partner violence: Results from a quasi-experimental intervention study with young men in Ethiopia. \u003cem\u003eAm J Public Health\u003c/em\u003e. 2015;105(1):132-137. doi:10.2105/AJPH.2014.302214\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eNIGERIA MEN AND GENDER EQUALITY SURVEY (NiMAGES) Nigeria Country Report 2015\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003eSedlander E, Granovsky R, Birabwa C, Amongin D, Wasswa R, Diamond-Smith N, Waiswa P, Holt K, Bingenheimer JB. Adaptation of the G-NORM (Gender norms scale) in Uganda: An examination of how gender norms are associated with reproductive health decision-making. \u003cem\u003ePLoS One\u003c/em\u003e. 2024;19(11):e0308249. doi:10.1371/JOURNAL.PONE.0308249\u003c/li\u003e\n \u003cli\u003eWesson PD, Lippman SA, Neilands TB, Ahern J, Kahn K, Pettifor A. Evaluating the Validity and Reliability of the Gender Equitable Men\u0026rsquo;s Scale Using a Longitudinal Cohort of Adolescent Girls and Young Women in South Africa. \u003cem\u003eAIDS Behav\u003c/em\u003e. 2021;26(3):775. doi:10.1007/S10461-021-03436-0\u003c/li\u003e\n \u003cli\u003eOkore AA. PSYCHOTRAUMATOLOGY IN NIGERIA\u0026rsquo;S POST-CONFLICT ZONES: A CLINICAL STUDY OF INTERNALLY DISPLACED ADOLESCENTS IN ISU TOWN, ABIA STATE. \u003cem\u003eCognizance Journal of Multidisciplinary Studies\u003c/em\u003e. 2025;5(5):563-591. doi:10.47760/cognizance.2025.v05i05.036\u003c/li\u003e\n \u003cli\u003eKaiser BN, Ticao C, Anoje C, Minto J, Boglosa J, Kohrt BA. Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria. \u003cem\u003eGlobal Mental Health\u003c/em\u003e. 2019;6:e10. doi:10.1017/GMH.2019.8\u003c/li\u003e\n \u003cli\u003eHassem T, Laher S. A systematic review of online depression screening tools for use in the South African context. \u003cem\u003eSouth African Journal of Psychiatry\u0026nbsp;\u003c/em\u003e. 2019;25(1):1-8. doi:10.4102/SAJPSYCHIATRY.V25I0.1373\u003c/li\u003e\n \u003cli\u003eHumphreys TP, Brousseau MM. The sexual consent scale-revised: development, reliability, and preliminary validity. \u003cem\u003eJ Sex Res\u003c/em\u003e. 2010;47(5):420-428. doi:10.1080/00224490903151358\u003c/li\u003e\n \u003cli\u003eSexual Consent Scale, Revised. Accessed November 24, 2025. https://scales.arabpsychology.com/s/sexual-consent-scale-revised/\u003c/li\u003e\n \u003cli\u003eBingenheimer JB, Asante EA, Ahiadeke C. Reliability, Validity, and Associations with Sexual Behavior among Ghanaian Teenagers of Scales Measuring Four Dimensions Relationships with Parents and Other Adults. \u003cem\u003eJ Fam Issues\u003c/em\u003e. 2013;36(5):647. doi:10.1177/0192513X13497349\u003c/li\u003e\n \u003cli\u003eHumphreys TP, Brousseau MM. The sexual consent scale-revised: development, reliability, and preliminary validity. \u003cem\u003eJ Sex Res\u003c/em\u003e. 2010;47(5):420-428. doi:10.1080/00224490903151358\u003c/li\u003e\n \u003cli\u003ePTSD Symptom Scale: Comprehensive Guide. Accessed November 23, 2025. https://neurolaunch.com/ptsd-symptom-scale/\u003c/li\u003e\n \u003cli\u003eNg VKY, Cribbie RA. Using the Gamma Generalized Linear Model for Modeling Continuous, Skewed and Heteroscedastic Outcomes in Psychology. \u003cem\u003eCurrent Psychology\u003c/em\u003e. 2017;36(2):225-235. doi:10.1007/S12144-015-9404-0\u003c/li\u003e\n \u003cli\u003eMarlow HM, Kunnuji M, Esiet A, Bukoye F, Izugbara C. The Sexual and Reproductive Health Context of an Internally Displaced Persons\u0026rsquo; Camp in Northeastern Nigeria: Narratives of Girls and Young Women. \u003cem\u003eFrontiers in Reproductive Health\u003c/em\u003e. 2022;3:779059. doi:10.3389/FRPH.2021.779059\u003c/li\u003e\n \u003cli\u003eNgwibete A, Ogunbode OO, Mangalu MA, Omigbodun A. Displaced Women and Sexual and Reproductive Health Services: Exploring Challenges Women With Sexual and Reproductive Health Face in Displaced Camps of Nigeria. \u003cem\u003eJournal of Education and Community Health\u003c/em\u003e. 2023;10(3):162-172. doi:10.34172/JECH.2612\u003c/li\u003e\n \u003cli\u003eIyakaremye I, Mukagatare C. Forced migration and sexual abuse: experience of Congolese adolescent girls in Kigeme refugee camp, Rwanda. \u003cem\u003eHealth Psychol Rep\u003c/em\u003e. 2016;4(3):261-271. doi:10.5114/HPR.2016.59590\u003c/li\u003e\n \u003cli\u003eDurevall D, Cowden RG, Beckett S, Kharsany ABM, Lewis L, George G, Cawood C, Khanyile D, Govender K. Associations of Social Support with Sexual Practices, Health Behaviours, and Health Outcomes Among Adolescent Girls and Young Women: Evidence From a Longitudinal Study in KwaZulu-Natal, South Africa. \u003cem\u003eInt J Behav Med\u003c/em\u003e. 2023;31(4):620. doi:10.1007/S12529-023-10199-6\u003c/li\u003e\n \u003cli\u003eHarling G, Gumede D, Shahmanesh M, Pillay D, B\u0026auml;rnighausen TW, Tanser F. Sources of social support and sexual behaviour advice for young adults in rural South Africa. \u003cem\u003eBMJ Glob Health\u003c/em\u003e. 2018;3(6):e000955. doi:10.1136/BMJGH-2018-000955\u003c/li\u003e\n \u003cli\u003eOdimegwu CO, Ugwu NH. A multilevel mixed effect analysis of neighbourhood and individual level determinants of risky sexual behaviour among young people in South Africa. \u003cem\u003eReproductive Health 2022 19:1\u003c/em\u003e. 2022;19(1):119-. doi:10.1186/S12978-022-01407-9\u003c/li\u003e\n \u003cli\u003eJackson F, Haile ZT. Association between educational attainment and risky sexual behaviour among Ghanaian female youth. \u003cem\u003eAfr Health Sci\u003c/em\u003e. 2023;23(1):301-308. doi:10.4314/AHS.V23I1.32\u003c/li\u003e\n \u003cli\u003eDe Meyer S, Lau K, Kemigisha E, Cevalllos A, Rost L, Michielsen K, K\u0026aring;gesten A, van Reeuwijk M. \u0026lsquo;If her body responds then you know she wants it\u0026rsquo;: a qualitative study on how young people in Ecuador and Uganda understand and practice consent. \u003cem\u003eGlob Health Action\u003c/em\u003e. 2025;18(1):2465123. doi:10.1080/16549716.2025.2465123\u003c/li\u003e\n \u003cli\u003eHermann C, Liang CTH, DeSipio BE. Exploring sexual consent and hostile masculine norms using the theory of planned behavior. \u003cem\u003ePsychol Men Masc\u003c/em\u003e. 2018;19(4):491-499. doi:10.1037/MEN0000127\u003c/li\u003e\n \u003cli\u003eStewart R, Wright B, Smith L, Roberts S, Russell N. Gendered stereotypes and norms: A systematic review of interventions designed to shift attitudes and behaviour. \u003cem\u003eHeliyon\u003c/em\u003e. 2021;7(4):e06660. doi:10.1016/j.heliyon.2021.e06660\u003c/li\u003e\n \u003cli\u003eExploring sexual consent and hostile masculine norms using the theory of planned behavior. Accessed November 27, 2025. https://psycnet.apa.org/doiLanding?doi=10.1037%2Fmen0000127\u003c/li\u003e\n \u003cli\u003eStryker SD, Pallerla H, Yockey RA, Bedard-Thomas J, Pickle S. Training Mental Health Professionals in Gender-Affirming Care: A Survey of Experienced Clinicians. \u003cem\u003ehttps://home.liebertpub.com/trgh\u003c/em\u003e. 2022;7(1):68-77. doi:10.1089/TRGH.2020.0123\u003c/li\u003e\n \u003cli\u003eKaiser BN, Ticao C, Anoje C, Minto J, Boglosa J, Kohrt BA. Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria. \u003cem\u003eGlobal Mental Health\u003c/em\u003e. 2019;6:e10. doi:10.1017/GMH.2019.8\u003c/li\u003e\n \u003cli\u003eMarlow HM, Kunnuji M, Esiet A, Bukoye F, Izugbara C. The Sexual and Reproductive Health Context of an Internally Displaced Persons\u0026rsquo; Camp in Northeastern Nigeria: Narratives of Girls and Young Women. \u003cem\u003eFrontiers in Reproductive Health\u003c/em\u003e. 2021;3:779059. doi:10.3389/FRPH.2021.779059/BIBTEX\u003c/li\u003e\n \u003cli\u003eWebb EL, Dietrich JJ, Ssemata AS, Nematadzira TG, Hornschuh S, Kakande A, Tshabalala G, Muhumuza R, Mutonyi G, Atujuna M, Bere T, Bekker LG, Abas MA, Weiss HA, Seeley J, Stranix-Chibanda L, Fox J. Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe. \u003cem\u003eBMC Infect Dis\u003c/em\u003e. 2022;22(1):466. doi:10.1186/S12879-022-07430-2\u003c/li\u003e\n \u003cli\u003eHill LM, Gottfredson NC, Kajula LJ, Pence BW, Go VF, Moody J, Maman S. Changes in Anxiety and Depression Symptoms Predict Sexual Risk Behaviors Among Young Men Living in Dar es Salaam, Tanzania. \u003cem\u003eAIDS Behav\u003c/em\u003e. 2018;22(5):1435-1445. doi:10.1007/S10461-017-1991-3\u003c/li\u003e\n \u003cli\u003eHill LM, Gottfredson NC, Kajula LJ, Pence BW, Go VF, Moody J, Maman S. Changes in Anxiety and Depression Symptoms Predict Sexual Risk Behaviors Among Young Men Living in Dar es Salaam, Tanzania. \u003cem\u003eAIDS Behav\u003c/em\u003e. 2018;22(5):1435. doi:10.1007/S10461-017-1991-3\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"sexual consent, displaced men, gender norms, mental health, humanitarian settings, gender training","lastPublishedDoi":"10.21203/rs.3.rs-8779024/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8779024/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eRape rates in Nigeria\u0026rsquo;s displaced settlements reach 37\u0026ndash;50%, yet little is known about how displaced men\u0026rsquo;s navigation of consent is shaped by gender norms and mental health. This cross-sectional study aimed to predict male sexual consent behavior by examining its interaction between sociodemographic factors, gender-equitable norms (GEM), mental health, and gender-related training in displaced camps in Nigeria\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 610 males were randomly sampled from three purposively selected displaced camps. A validated instrument was used to collect data on sociodemographic characteristics, gender-equitable norms (GEM scale), mental health indicators for post-traumatic stress disorder, anxiety, and depression (PTSD-8 and PHQ-4), as well as sexual consent behavior. Three constructs of sexual consent were assessed: positive attitudes, indirect approaches, and consent norms. Gamma GLM modelling was used to identify significant predictors of each outcome. Interaction effects between GEM and mental health were examined.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAll constructs of sexual consent behaviors were consistently predicted by a longer stay in the camp. Having some form of social and emotional support, such as living with a family or friend, having a partner, or being self-employed, was associated with higher consent outcomes. Gender-equitable norms did not independently predict sexual consent; however, when combined with mental health, which was a strong predictor, they were associated with improved consent behavior. Attending gender-related training was negatively associated with all consent outcomes.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eSexual consent behaviors among displaced men are driven by an interaction of different constructs beyond gender norms alone. Their social, economic, and psychological factors play an important role in shaping consent behaviors. Current gender trainings may lack contextual relevance and fail to address practical negotiation skills. Interventions must integrate mental health support, empowerment opportunities, and family/community-based approaches to foster healthy consent dynamics in displacement settings.\u003c/p\u003e","manuscriptTitle":"Exploring the Intersection of gender norms, Mental Health, and Sexual Consent, Among Displaced men of Benue state, Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-11 11:21:13","doi":"10.21203/rs.3.rs-8779024/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-03-05T15:39:13+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-09T08:16:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-04T22:58:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-04T22:57:10+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-02-03T17:38:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4201021b-a04c-4b99-b0e5-b7aae040676c","owner":[],"postedDate":"March 11th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-11T11:21:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-11 11:21:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8779024","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8779024","identity":"rs-8779024","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}