Background Vaccination may be critical to curtailing the spread of the SARS-CoV-2 virus responsible for the COVID-19 pandemic, but herd immunity can only be realized with high vaccination coverage. There is a need to identify empirically supported strategies to increase uptake, especially among young adults as this subpopulation has shown relatively poor adherence to physical distancing guidelines. Social norms – estimates of peers’ behavior and attitudes – are robust predictors of health behaviors and norms-based intervention strategies may increase COVID vaccine uptake, once available. This study examined the extent that vaccination intentions and attitudes were associated with estimated social norms as an initial proof-of-concept test. Method In November of 2020, 647 undergraduate students (46.21% response rate) completed online surveys in which they reported intentions to get COVID and influenza vaccines, perceived importance of these vaccines for young adults, and estimated social norms regarding peers’ vaccination behaviors and attitudes. Results Students reported significantly greater intentions to get a COVID vaccine (91.64%) than an influenza vaccine (76.04%), and perceived COVID vaccination as significantly more important than influenza vaccination. The sample generally held strong intentions to receive a COVID vaccine and thought that doing so was of high importance, but participants, on average, perceived that other young adults would be less likely to be vaccinated and would not think vaccination was as important. Multiple regression models indicated that estimated social norms were positively associated with participants’ own intentions and perceived importance of getting a COVID vaccine. Conclusions These significant associations highlight the potential value in developing and testing norms-based intervention strategies, such as personalized normative feedback, to improve uptake of forthcoming COVID vaccines among young adults .

Background Alcohol and marijuana are psychoactive substances commonly used by young adults and are independently associated with numerous acute and long‐term consequences. Many young adults engage in simultaneous alcohol and marijuana (SAM) use to cross‐fade (i.e., to enhance the effects of intoxication), although the extent to which alcohol use and alcohol‐related consequences increase on SAM occasions compared to alcohol‐only occasions is unclear. This study examines daily data among a sample of SAM users comparing SAM days to other days when young adults only used alcohol. Methods A sample of 409 young adults (age 18 to 25; Mage = 21.6, SD = 2.2; 50.9% women) who reported SAM use in the past month completed 2 bursts of 14 days of daily surveys (28 days in total) assessing alcohol use, alcohol‐related consequences, and SAM use. Results Multilevel models based on alcohol‐only and SAM days (n = 3,016 days; 391 individuals) indicated young adults drank more alcohol on SAM days compared to alcohol‐only days (with no marijuana use). Similarly, days with SAM use were associated with more alcohol‐related positive and negative consequences. The daily association between SAM use and positive consequences was statistically significant, after accounting for the amount of alcohol consumed; in contrast, the association between SAM use and negative consequences was diminished and nonsignificant. Conclusions Among young adult SAM users, days with SAM use were associated with more alcohol use and positive consequences compared to days they only drank alcohol. Further examination of the motivational context for engaging in SAM use, as well as potential physiological interactions between alcohol and marijuana use on alcohol’s effects, is warranted. Alcohol interventions might benefit from addressing increased alcohol use and alcohol‐related consequences as risks associated with SAM use.

This experiment examined the effects of women's relationship motivation, partner familiarity, and alcohol consumption on sexual decision making. Women completed an individual difference measure of relationship motivation, then were randomly assigned to partner familiarity condition (low, high), and to alcohol consumption condition (high dose, low dose, no alcohol, placebo). Then women read and projected themselves into a scenario of a sexual encounter. Relationship motivation and partner familiarity interacted with intoxication to influence primary appraisals of relationship potential. Participants' primary and secondary relationship appraisals mediated the effects of women's relationship motivation, partner familiarity, and intoxication on condom negotiation, sexual decision abdication, and unprotected sex intentions. These findings support a cognitive mediation model of women's sexual decision making, and identify how individual and situational factors interact to shape alcohol's influences on cognitive appraisals that lead to risky sexual decisions. This knowledge can inform empirically-based risky sex interventions.

This experimental study examined effects of alcohol consumption and sexual sensation seeking on unprotected sex intentions, taking into account sexual arousal, indirectly discouraging sex, and condom insistence. Women (N=173; M age = 25.02) were randomly assigned to a control, placebo, low dose (target blood alcohol level = .04), or high dose (target blood alcohol level = .08) beverage condition. Participants projected themselves into a hypothetical sexual interaction with a man in which no condom was available. Structural equation modeling demonstrated that both sexual sensation seeking and alcohol dose directly increased sexual arousal early in the interaction, but later sexual arousal indirectly increased unprotected sex intentions by decreasing endorsement of indirect discouragement and, in turn, condom insistence. These findings help to clarify the role of alcohol consumption and sensation seeking in women's sexual decision making and point to the importance of examining it as a multi-stage process. KeywordsAlcohol Consumption; Sensation Seeking; Sexual Arousal; Risky Sex; Condom NegotiationThe proportion of AIDS cases in the US composed of women has increased dramatically over the last two decades, rising from 8% of the total in 1985 to 27% in 2005. Approximately 80% of new HIV cases in women are attributable to heterosexual transmission (Centers for Disease Control and Prevention, 2008). Because consistent use of the male condom is still the most effective preventive strategy, intervention efforts have focused on ways to increase its use. However, for a woman to "use" a male condom, she must be able to insist on using one, and ultimately refuse to have sex if her male partner refuses to use one.Sexual decision making is a multi-stage process, involving a series of interactions with and responses to one's partner. When a woman wants to use a condom with a man, she may engage in a series of strategies, such as discouraging him from continuing to pursue sex if one is not available and insisting on using one before ultimately deciding whether or not to have unprotected sex. Contributing to the complexities of these interactions is likely to be concurrent Correspondence concerning this article should be addressed to Jeanette Norris, Alcohol and Drug Abuse Institute, University of Washington, 1107 NE 45th St., Suite 120, Seattle, WA 98105. Email: norris@u.washington.edu. NIH Public Access Author ManuscriptPsychol Addict Behav. Author manuscript; available in PMC 2010 March 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript sexual arousal. To obtain a full understanding of how sexual decisions are made, it is necessary to study both situational and predispositional influences on this process. Alcohol consumption and sensation seeking are two such influences that have jointly been associated with risky sexual behavior (Hendershot, Stoner, George, & Norris, 2007;Kalichman & Cain, 2004;Kalichman, Simbayi, Jooste, Cain, & Cherry, 2006). However, little research has addressed the ne...

Research on substance use motivestypically examines each substance separately. However, simultaneous alcohol and marijuana (SAM) use-thatis, using alcohol andmarijuanaatthe same timesothattheireffects overlap-iscommonamongyoungadults. This study examines day-today fluctuations in motivesfor using alcohol and/ or marijuana among young adult substance users as predictors of alcohol, marijuana, and SAM use across days. Method: Data were from a community sample of young adults whoreported SAM use in the past month (analytic sample: N =399,mean[SD]age =21.63 [2.17];50.9% women). Participants reported alcohol, marijuana, and SAM use, and also motives"for alcohol and/or marijuanause" for14consecutive days. Results: Multilevelmodels showedthat elevated enhancement motives were associated withheavy episodic drinking, drinkingmore, and more hours high from marijuana. Elevated social motiveswere associated with heavy episodic drinking and drinking more, and also with fewerh ours high.Elevated conformity motives were associated with drinking more. SAM usewas more likely:onalcohol days and on marijuana days with elevated enhancement and conformity motives, on alcohol days with elevatedc oping motives, and on marijuana days with elevated social motives. Conclusions: SAM useonagiven daywas primarily associated with enhancement and conformity motives. Social motivesw ere more stronglylinked to alcohol use, and to some extent coping motivesw ere linked to marijuana use in this young adult sample.Further examination of situation-specific motivesa nd contexts of use is needed to inform development of real-time interventions for SAM use and consequences.