Condom use with a casual partner: What distinguishes college students' use when intoxicated?

Abstract

Determining alcohol's precise role in sexual risk taking has proven to be an elusive goal. Past research has produced mixed results, depending on characteristics of individuals, their partners, and the situation, as well as how the link between alcohol consumption and sexual behavior was assessed. In this study, cross-sectional predictors of the frequency of condom use were examined for 298 heterosexual college students at a large urban university. In hierarchical multiple regression analyses that controlled for frequency of condom use when sober, alcohol expectancies regarding sexual risk taking and self-efficacy regarding condom use when intoxicated were significant predictors of frequency of condom use when intoxicated. These findings highlight the importance of targeting beliefs about alcohol's disinhibiting effects in STD-and HIV-prevention programs. Keywordsrisky sexual behavior; condom use; alcohol; STD and HIV prevention; college students Approximately 19 million STD infections are diagnosed annually in the United States, and almost half occur among individuals between the ages of 15 and 24 (Weinstock, Berman, & Cates, 2004). At least half of all new HIV infections in the United States are estimated to occur among people under the age of 25, with African Americans disproportionately affected (Centers for Disease Control and Prevention, 2004). Rates of heterosexual transmission have been increasing, particularly among young women (Centers for Disease Control and Prevention, 2004).Nationally representative surveys of college students suggest that many engage in high-risk sexual behaviors. Approximately 80% of college students have engaged in sexual intercourse, yet only about one third report that they regularly use condoms (Douglas et al., 1997;Wechsler et al., 2000). About one quarter of college students report having had six or more lifetime sexual partners (Douglas et al., 1997), and 6% report having had more than one partner in the past 30 days (Wechsler et al., 2000). Self-reported lifetime rates of STD infections range from 12% to 25% among sexually experienced students (Cooper, 2002) HHS Public Access Mixed Evidence Regarding the Relationship Between Intoxication and Risky Sexual BehaviorAcute alcohol consumption impairs higher-order cognitive processing and activates relevant expectancies (Curtin & Fairchild, 2003;Fillmore & Blackburn, 2002;Fromme, D'Amico, & Katz, 1999;George & Stoner, 2000). Thus, sexual encounters that take place when individuals are intoxicated are expected to involve more high-risk sexual behavior because of drinkers' diminished decision-making capacities, coupled with their beliefs that intoxication reduces their sexual inhibitions. Despite the large body of theory and research that supports this hypothesis, delineating alcohol's role in risky sexual behavior has been more challenging than originally anticipated (for reviews see Cooper, 2002; HalpernFelsher, Millstein, & Ellen, 1996;Weinhardt & Carey, 2000). Personality traits, such as impulsivity and sensation seek...

Alcohol Mixed with Energy Drink Use and Sexual Risk-Taking: Casual, Intoxicated, and Unprotected Sex

“…Gender differences in self-protective sexual behavior may reflect dyadic power imbalances that limit women's ability to negotiate safer sex, 54 particularly in drinking situations that undermine self-protective strategies. 46,52 While some previous studies have failed to find a significant link between alcohol use and unprotected sex, 17 others have found that the connection between drinking and condom use is to some extent conditioned by gender. 19,54,59 However, in the present analysis, no gender/ AmED interaction was found for any of the three sexual risktaking outcomes; the relationships between AmED use and sexual risk-taking were robust across gender.…”

“…3,11 Drinking increases the likelihood of indiscriminate sexual activity, including sex with a casual, unplanned, and/or high-risk partner. [12][13][14][15][16] Although the relationship between drinking and condom use is complex, 12,17,18 alcohol use may in some instances reduce the odds of using barrier protection against pregnancy or STIs. 19 In 2011, fewer than two-thirds of sexually active college students reported condom use during their most recent intercourse, and one in six alcohol-using students reported having had unprotected sex as a consequence of his or her drinking in the past 12 months.…”

Predictors of Risky Sexual Behavior With New and Regular Partners in a Sample of Women Bar Drinkers

“…However, in a study of women only, Cooper and Orcutt (2000) found that drinking and condom use were more common with casual partners. In a recent study of college students' risky sexual behavior with casual partners, Abbey et al (2007) found that condom use when sober was the strongest predictor of condom use when drinking.…”

HIV Information and Behavioral Skills Moderate the Effects of Relationship Type and Substance Use on HIV Risk Behaviors Among African American Youth

“…59 Finally, a study of college students found that those who were higher in self-efficacy were more likely to use condoms while drunk than those lower on this domain. 52 The purpose of the current manuscript is to explore how established cognitive predictors of risky sexual behavior may moderate the association between situational factors and unprotected sex using a cross-sectional Partner-Level Model (PLM); if moderation is found, it suggests that approaches to positively influence cognitions may help sever the association between situational factors and unhealthy outcomes. In our sample of very low-income, African American adolescents, we used the sexual partnership, rather than the individual, as the unit of analysis.…”

“…15 The IMB Model draws on the tenets of Social Cognitive Theory 49 and Theory of Reasoned Action, 50 and it asserts that the fundamental determinants of engaging in behaviors that prevent HIV acquisition are the combined effects of having: (a) HIV-related information and prevention knowledge, (b) motivation to become/stay safer, and (c) necessary skills to engage in prevention behaviors, including self-efficacy to use condoms. 51 The literature on heterosexual youth and adults generally supports the association between the components of the IMB model and sexual risk behavior in both observational studies 16,[51][52][53][54][55][56] and tests of interventions. 57,58 However, evidence suggests that motivation and behavioral skills may play a more proximal role in influencing sexual risk than HIVrelated information.…”