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)
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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...