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George WH, Blayney JA, Davis KC. Impact of Acute Alcohol Consumption on Sexuality: A Look at Psychological Mechanisms. Annu Rev Clin Psychol 2024; 20:307-331. [PMID: 38346294 DOI: 10.1146/annurev-clinpsy-080921-075423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Alcohol's link with sexuality is long-standing and prominent. While research continues to document robust associations between drinking and sexual behavior, scientific attention now centers primarily on evaluating mechanisms and attendant theoretical frameworks to advance our understanding of how alcohol exerts a causal impact. We describe four domains with reliable evidence of alcohol effects: sexualized social perceptions, sexual arousal, sexual risk taking, and sexual assault. We consider three contextual frames: distal factors associated with encountering opportunities for alcohol-involved sex, proximal factors associated with alcohol's acute effects, and distal-proximal interactions. We then examine the empirical support for mechanisms embedded within four theoretical frameworks: alcohol disinhibition, alcohol expectancy, alcohol myopia, and emotion regulation. Support for disinhibition mechanisms is evident with sexual arousal only. Expectancy and myopia mechanisms enjoy support across domains and make up bases for integrative expectancy-myopia causal explanations. Emotion regulation mechanisms evidence preliminary support in risk taking and sexual assault. Implications and future directions are considered.
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Affiliation(s)
- William H George
- Department of Psychology, University of Washington, Seattle, Washington, USA;
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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2
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Jaffe AE, Blayney JA, Jones HR, Stappenbeck CA, George WH, Davis KC. Sexual Decision Making When Intoxicated: Women's Reasons for and Against Having Sex in a Laboratory-Based Scenario. JOURNAL OF SEX RESEARCH 2024; 61:767-782. [PMID: 37651745 PMCID: PMC10902182 DOI: 10.1080/00224499.2023.2249774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Young adult women report high condom use intentions, but inconsistent condom use. Cognitive appraisals during sexual encounters are important determinants of condom use decisions, but a nuanced understanding of what cognitions emerge during women's "hot states" (e.g., sexual arousal, alcohol intoxication) remains lacking. To address this gap, we examined women's heat of the moment cognitions in their own words using mixed methods. Young adult women (N = 503; Mage = 25.01, SDage = 2.66) were randomized to a beverage condition (alcohol or control), then read and responded to questions about an eroticized sexual scenario. The nature and strength of reasons for and against having sex were reported before and after learning no condom was available. Multilevel models revealed intoxicated participants were more likely to let the partner decide how far to go sexually than sober participants at both timepoints, but the strength of cognitive appraisals (reasons for, reasons against, and feeling conflicted) only differed between beverage conditions after knowledge of no condom. These results suggest alcohol myopia was evident in the presence of inhibition conflict. Content analysis of these reasons revealed multifaceted cognitions that changed upon learning there was no condom. Findings highlight cognitions to target through interventions and underscore the importance of both alcohol and situational context in decision making.
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Affiliation(s)
- Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Harper R Jones
- Department of Psychology, University of Nebraska-Lincoln
| | | | | | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University
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3
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Luehring-Jones P, Fulford D, Palfai TP, Simons JS, Maisto SA. Alcohol, Sexual Arousal, and Partner Familiarity as Predictors of Condom Negotiation: An Experience Sampling Study. AIDS Behav 2024; 28:854-867. [PMID: 37751109 DOI: 10.1007/s10461-023-04189-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
Numerous contextual factors contribute to risky sexual decision-making among men who have sex with men (MSM), with experimental laboratory-based studies suggesting that alcohol consumption, sexual arousal, and partner familiarity have the potential to impact condom negotiations during sexual encounters. The purpose of the current study was to extend this line of inquiry outside of the laboratory and into the everyday lives of MSM. We collected six weeks of daily data on alcohol consumption and sexual behaviors from 257 moderate- and heavy-drinking MSM to examine the within- and between-subjects effects of alcohol consumption, average daily sexual arousal, and partner familiarity on condom negotiation processes during sexual encounters. We hypothesized that alcohol consumption, higher levels of average daily sexual arousal, and greater partner familiarity would all contribute to a reduced likelihood of condom negotiation prior to sexual activity, and that they would also affect the difficulty of negotiations. Contrary to hypotheses, none of these three predictors had significant within-subjects effects on condom negotiation outcomes. However, partner familiarity and average daily sexual arousal did exert significant between-subjects effects on the incidence of negotiation and negotiation difficulty. These findings have important implications for risk-reduction strategies in this population. They also highlight the challenges of reconciling results from experimental laboratory research and experience sampling conducted outside of the laboratory on sexual risk behavior.
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Affiliation(s)
- Peter Luehring-Jones
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA.
| | - Daniel Fulford
- Department of Occupational Therapy and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Tibor P Palfai
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Stephen A Maisto
- Department of Psychology, Syracuse University, Syracuse, NY, USA
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4
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Stappenbeck CA, Jaffe AE, Blayney JA, Kirwan M, George WH, Davis KC. An event-level evaluation of women's self-medicated drinking: The role of sexual assault severity, affect, and drinking motives. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:110-120. [PMID: 35617256 PMCID: PMC10914019 DOI: 10.1037/tra0001278] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Women with sexual assault (SA) histories report heavier and more frequent drinking. Consistent with the motivational model of alcohol use, women with SA histories may consume alcohol to both downregulate negative emotions and upregulate positive ones. The present event-level study used a Bayesian multilevel moderated mediation approach to examine the extent to which women's alcohol use and intoxication was influenced by coping and enhancement drinking motives to downregulate or upregulate affect, respectively. METHOD Women ages 21-30 were recruited from the community to participate in a larger study that included a 32-day daily diary assessment of affect, drinking motives, and alcohol use. RESULTS We found consistent support for women's tendencies to be motivated to drink to cope or enhance negative or positive affect, respectively, and those drinking motives were associated with indicators of increased drinking. Becoming intoxicated to downregulate negative emotion was common and this pathway was particularly strong for women who reported more severe SA histories. Although women with more severe SA histories were generally more likely to drink more, they were not likely to do so as a way to enhance positive experiences. CONCLUSIONS Alcohol interventions that provide adaptive regulatory strategies are needed for women who experience increased negative or positive affect, with a particular focus on self-medication for young women with more severe SA histories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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5
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Yeater EA, Witkiewitz K, Testa M, Bryan AD. Substance Use, Risky Sex, and Peer Interactions Predict Sexual Assault Among College Women: An Ecological Momentary Assessment (EMA) Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP5094-NP5115. [PMID: 32969282 DOI: 10.1177/0886260520958720] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexual assault is an unfortunately common experience among women in college campuses. This study used ecological momentary assessment (EMA) to gain a better understanding of the contextual determinants of sexual assault among college women. EMA reports inquired about sexual assault experiences, risky sex (sex without a condom and regretted hookups), and substance use (alcohol and cannabis use), as well as what activities participants were engaged in (e.g., pregaming, drinking with peers, and drinking with a casual sexual partner), and whether they experienced peer pressure to engage in casual sex. Participants were 103 freshman undergraduate women (18-24 years old) at a Southwestern university in the United States, who were unmarried, interested in dating opposite-sex partners, engaged in binge drinking (defined as having 3 or more drinks on one occasion) in the past month, and reported at least one experience of sexual intercourse in their lifetime. Participants completed reports (one random and two time-contingent) via EMA three times a day over a 42-day period. Compliance in completing EMA reports was good (84.2% of prompted reports were completed), and time-to-completion of reports once signaled was acceptable (mean = 26 minutes, median = 5.75 minutes). During the 42 days, 40 women (38.8%) reported 75 occasions of sexual assault. The odds of experiencing sexual assault were significantly greater during occasions of regretted hookups and unprotected sex. Additionally, drinking with peers and peer pressure to engage in casual sex were each associated significantly with occasions of sexual assault. Reducing risk for sexual assault among undergraduate women may be possible by targeting these behaviors and contextual features in near real-time via momentary intervention.
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Affiliation(s)
| | | | - Maria Testa
- The State University of New York, Buffalo, NY, United States
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6
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George WH, Blayney JA, Stappenbeck CA, Davis KC. The Role of Alcohol-Related Behavioral Risk in the Design of HIV Prevention Interventions in the Era of Antiretrovirals: Alcohol Challenge Studies and Research Agenda. AIDS Behav 2021; 25:347-364. [PMID: 34244871 DOI: 10.1007/s10461-021-03351-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/29/2022]
Abstract
HIV/AIDS remains a significant health threat and alcohol is a robust contributing factor. After 25 years of alcohol challenge studies investigating alcohol-related behavioral risk (ARBR), much has been learned delineating how drinking influences sexual transmission. We examine this research and consider its relevance for interventions in the era of antiretrovirals. We consider prototypic alcohol challenge methods, illustrative findings, and prevention/intervention implications, noting three perspectives: (a) scale up/extend existing interventions, including identifying under-targeted risk groups and intersecting with PrEP/PEP interventions; (b) modify existing interventions by cultivating psychoeducational content related to alcohol expectancies, alcohol myopia, sexual arousal, risk perception, sexual abdication, and condom use resistance; and (c) innovate new interventions through Science of Behavior Change approaches and repurposing ARBR paradigms. Finally, we suggest research directions concluding that until HIV incidence diminishes significantly, psychosocial interventions addressing the nexus of alcohol use, sexual transmission, and adherence to biomedical protocols will be an important priority.
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Affiliation(s)
- William H George
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195-1525, USA.
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Cynthia A Stappenbeck
- Department of Psychology, Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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7
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Palfai TP, Luehring-Jones P. How Alcohol Influences Mechanisms of Sexual Risk Behavior Change: Contributions of Alcohol Challenge Research to the Development of HIV Prevention Interventions. AIDS Behav 2021; 25:314-332. [PMID: 34148189 DOI: 10.1007/s10461-021-03346-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
This paper examines the contributions of laboratory-based alcohol challenge research (ACR) to the development of HIV prevention interventions. Following a brief overview of HIV prevention interventions and related health behavior change models, we discuss how alcohol may influence mechanisms of behavior change. The paper highlights the value of ACR for: (1) elucidating mechanisms of action through which alcohol affects sexual risk behavior, (2) testing how alcohol may influence mechanisms thought to underlie HIV prevention interventions, (3) clarifying moderators of the causal influences of alcohol, (4) identifying novel intervention targets, and (5) developing strategies to reduce sexual risk among those who consume alcohol. We conclude with a discussion of the importance of using experimental research to identify mechanisms of behavior change that are specific to populations at high risk for HIV and outline some key implications for developing HIV prevention interventions that integrate the role of alcohol.
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8
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Sheinfil AZ, Woolf-King SE. Effects of affective arousal on risky sexual decision-making in US emerging adult college students. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1950202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Alan Z Sheinfil
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Sarah E. Woolf-King
- Department of Psychology, Syracuse University, Syracuse, New York, USA
- University of California, San Francisco, Department of Medicine, Center for AIDS Prevention Studies, San Francisco, California, USA
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9
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Kirwan M, Lanni DJ, Nagy S, Pickett SM. Building a Model to Predict Sexual Assault Victimization Frequency Among Undergraduate Women. Violence Against Women 2021; 28:1925-1946. [PMID: 34229524 DOI: 10.1177/10778012211022777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research has identified several factors, including sexual risk behaviors, alcohol consumption, sexual refusal assertiveness, impulse control difficulties, drinking to cope, and sex to cope, as being associated with sexual assault victimization. Data were collected from 465 adult, undergraduate women, and analyzed using structural equation modeling to determine how these variables related to one another. Results showed that together, these factors predicted 17.1% of the variance in victimization frequency. These findings may help future researchers better understand the etiology of sexual assault victimization on college campuses and prove crucial to the development of future intervention programs which reduce victimization.
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10
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Ménard AD, MacIntosh HB. Childhood Sexual Abuse and Adult Sexual Risk Behavior: A Review and Critique. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:298-331. [PMID: 33403939 DOI: 10.1080/10538712.2020.1869878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/14/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
Childhood sexual abuse (CSA) is a global problem with serious repercussions for survivors in various domains of adult interpersonal functioning, including sexual risk behavior. This review aimed to summarize findings from the recent literature on the connections between CSA and later adult sexual risk behaviors (e.g., unprotected intercourse, sexually transmitted infection [STSI] diagnosis). The sexual risk behaviors consistently associated with CSA were having sex under the influence of alcohol/substances and reports of concurrent sexual partners/infidelity. Notably, studies investigating the links between CSA and history of STI diagnosis and CSA and reports of unprotected sex (with the exception of samples comprised men who have sex with men) produced inconsistent findings. The methodological limitations of existing studies are considered and suggestions for future research are offered.
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11
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Kelley EL, Gidycz CA. Mediators of the Relationship Between Sexual Assault and Sexual Behaviors in College Women. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:4863-4886. [PMID: 29294822 DOI: 10.1177/0886260517718188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Some research shows that sexual assault victimization is associated with increased engagement in risky sexual behavior (e.g., intercourse without use of a condom or contraceptives), whereas other research indicates sexual assault victimization is related to sexual aversion. The purpose of the current study was to examine whether posttraumatic stress symptoms, alcohol use, and sexual assertiveness mediated the relationship between adolescent/emerging adulthood sexual assault (ASA) and risky sexual behavior, and whether posttraumatic stress symptoms mediated the relationship between ASA and sexual aversion, among college women. A sample of 462 women from a Midwestern university completed online questionnaires assessing ASA, child sexual abuse (CSA), posttraumatic stress symptoms (i.e., intrusion, avoidance, hyperarousal, and dissociation), alcohol use, sexual assertiveness, risky sexual behavior, and sexual aversion. CSA was considered as a covariate in the mediation models. Results of mediation analyses showed that the relationship between ASA and risky sexual behavior with a new partner was partially mediated by greater alcohol use and lower sexual assertiveness and that the relationship between ASA and risky sexual behavior with a regular partner was partially mediated by greater alcohol use. Results of a model examining mediators of ASA and sexual aversion detected no significant mediators. Results suggest that college women with a history of ASA would benefit from psychoeducation on the effect of alcohol on sexual decision-making, as well as from sexual assertiveness skills training, to reduce potential risks associated with risky sexual behaviors, particularly with lesser known partners, including sexually transmitted infections and sexual revictimization.
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Affiliation(s)
- Erika L Kelley
- VA Palo Alto Health Care System, Palo Alto, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
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12
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George WH. Alcohol and Sexual Health Behavior: "What We Know and How We Know It". JOURNAL OF SEX RESEARCH 2019; 56:409-424. [PMID: 30958036 DOI: 10.1080/00224499.2019.1588213] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Alcohol, despite salutary associations with sexuality, has been implicated in sexual health problems. This review examines the relationship between alcohol and outcomes related to sexual health. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed, as are advantages of experimental methods. Findings from laboratory experiments are reviewed evaluating causal effects of acute alcohol intoxication on a variety of outcomes, including sexual arousal, sexual desire, orgasm, and sexual risk behaviors related to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Several variables exerting mediating and moderating influences are identified. It is concluded that acute alcohol intoxication is capable of exerting a causal impact on multiple constituent components of sexual responding related to sexual health. Both alcohol expectancy and alcohol myopia theories have been supported as explanations for these causal effects. Furthermore, for sexual risk behavior, noteworthy recent developments include research highlighting the importance of women's sexual victimization history and men's condom use resistance. Limitations and implications associated with this body of research are also discussed.
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13
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Hahn AM, Simons RM, Simons JS, Wiers RW, Welker LE. Can cognitive bias modification simultaneously target two behaviors? Approach bias retraining for alcohol and condom use. Clin Psychol Sci 2019; 7:1078-1093. [PMID: 31890350 DOI: 10.1177/2167702619834570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study tested the effectiveness of a cognitive bias modification (CBM) intervention to simultaneously reduce approach biases toward alcohol and increase approach biases toward condoms among high-risk young adults. Participants (N = 102) were randomly assigned to either a training condition or a sham-training condition. Participants in the training condition were trained to make avoidance movements away from alcohol stimuli and approach movements toward condom stimuli over four training sessions. Approach biases and behavior were assessed at pretest, posttest, and 3-month follow-up. Approach biases changed for both stimulus categories in accordance with training condition. Condom behavior and attitudes also changed as a function of training condition, such that participants in the training condition reported fewer instances of condom nonuse and a more positive attitudes toward condoms at a three-month follow-up. Participants in both conditions had significant reductions in alcohol consumption following the intervention and did not differ by training condition.
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Affiliation(s)
- Austin M Hahn
- Department of Psychology, University of South Dakota
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14
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Berry MS, Johnson MW. Does being drunk or high cause HIV sexual risk behavior? A systematic review of drug administration studies. Pharmacol Biochem Behav 2017; 164:125-138. [PMID: 28843425 DOI: 10.1016/j.pbb.2017.08.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 07/25/2017] [Accepted: 08/21/2017] [Indexed: 01/05/2023]
Abstract
HIV sexual risk behavior is broadly associated with substance use. Yet critical questions remain regarding the potential causal link between substance use (e.g., intoxication) and HIV sexual risk behavior. The present systematic review was designed to examine and synthesize the existing literature regarding the effects of substance administration on HIV sexual risk behavior. Randomized controlled experiments investigating substance administration and HIV sexual risk behavior (e.g., likelihood of condom use in a casual sex scenario) were included. Across five databases, 2750 titles/abstracts were examined and forty-three total peer reviewed published manuscripts qualified (few were multi-study manuscripts, and those details are outlined in the text). The majority of articles investigated the causal role of acute alcohol administration on HIV sexual risk behavior, although one article investigated the effects of acute THC administration, one the effects of acute cocaine administration, and two the effects of buspirone. The results of this review suggest a causal role in acute alcohol intoxication increasing HIV sexual risk decision-making. Although evidence is limited with other substances, cocaine administration also appears to increase sexual risk, while acute cannabis and buspirone maintenance may decrease sexual risk. In the case of alcohol intoxication, the pharmacological effects independently contribute to HIV sexual risk decision-making, and these effects are exacerbated by alcohol expectancies, increased arousal, and delay to condom availability. Comparisons across studies showed that cocaine led to greater self-reported sexual arousal than alcohol, potentially suggesting a different risk profile. HIV prevention measures should take these substance administration effects into account. Increasing the amount of freely and easily accessible condoms to the public may attenuate the influence of acute intoxication on HIV sexual risk decision-making.
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Affiliation(s)
- Meredith S Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States.
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States
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15
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Neilson EC, Eakins DR, Davis KC, Norris J, George WH. Depressive Symptoms, Acute Alcohol Intoxication, and Risk Rationale Effects on Men's Condom Use Resistance. JOURNAL OF SEX RESEARCH 2017; 54:764-775. [PMID: 27547862 PMCID: PMC5526205 DOI: 10.1080/00224499.2016.1217500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the role of depressive symptoms, acute intoxication, and risk rationale in men's use of condom use resistance (CUR) tactics in an experimental study. Participants included 313 heterosexual male, nonproblem drinkers, ages 21 to 30. Participants were randomized to one of four beverage conditions: no alcohol, placebo, low (.04%) alcohol dose, or high (.08%) alcohol dose. They read an eroticized scenario depicting a consensual sexual encounter with a female partner who requested a condom to prevent either pregnancy or sexually transmitted infections (STIs) (risk rationale) and then indicated their intentions to use 10 different CUR tactics. Hypotheses related to the pharmacological, dosage, and expectancy effects of alcohol were tested in a generalized linear model. In intoxicated (.04% and .08%) men who were given a pregnancy risk rationale, depressive symptoms were associated with stronger intentions to use CUR tactics than in sober (control and placebo) men. Men who received a high alcohol dose (.08%) and who were given a pregnancy risk rationale reported higher intentions to use CUR tactics than those who received a lower alcohol dose (.04%). Findings suggest that the pharmacological effects of alcohol on men's likelihood to resist condoms vary by the saliency of the risk rationale and mood-related variables.
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Affiliation(s)
- Elizabeth C. Neilson
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195
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16
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Latack JA, Moyer A, Simon VA, Davila J. Attentional Bias for Sexual Threat Among Sexual Victimization Survivors: A Meta-Analytic Review. TRAUMA, VIOLENCE & ABUSE 2017; 18:172-184. [PMID: 26337573 PMCID: PMC5593786 DOI: 10.1177/1524838015602737] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The current meta-analysis examined the effects of sexual victimization (SV) on attentional bias for sexual threat. This relationship was also examined among victims of SV with and without a current diagnosis of post-traumatic stress disorder (PTSD). The broader aim was to elucidate potential mechanisms operating between SV and negative health outcomes. As hypothesized, the findings supported a positive relationship between SV and attentional bias toward sexual threat stimuli, and subanalyses indicated that PTSD symptomatology significantly contributed to this association.
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Affiliation(s)
| | - Anne Moyer
- Stony Brook University, Stony Brook, NY, USA
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17
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Bountress KE, Metzger IW, Maples-Keller JL, Gilmore AK. Reducing sexual risk behaviors: secondary analyses from a randomized controlled trial of a brief web-based alcohol intervention for underage, heavy episodic drinking college women. ADDICTION RESEARCH & THEORY 2017; 25:302-309. [PMID: 28428737 PMCID: PMC5395250 DOI: 10.1080/16066359.2016.1271416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 12/06/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND Alcohol use and sexual risk behaviors (SRBs) are significant problems on college campuses. College women are at particularly high risk for negative consequences associated with sexually transmitted infections (STIs) and unwanted pregnancy. METHODS The current study (n = 160) examined the effect of a brief, web-based alcohol intervention (n = 53) for college women on reducing SRBs compared to an assessment only control (n = 107) with a randomized controlled trial. Outcome measures included condom use assertiveness and number of vaginal sex partners and data were collected at baseline and three-month follow-up. RESULTS Regression analyses revealed that the alcohol intervention was associated with higher levels of condom use assertiveness at a three-month follow-up. Additionally, more alcohol use was associated with less condom use assertiveness for those with more significant sexual assault histories. CONCLUSIONS These findings suggest that alcohol interventions may impact college women's beliefs but not behavior, and future interventions should more explicitly target both alcohol and sexual risk to decrease risky behaviors.
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Affiliation(s)
- Kaitlin E Bountress
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
| | - Isha W Metzger
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
| | - Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
| | - Amanda K Gilmore
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, USA
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18
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Masters NT, Stappenbeck CA, Kaysen D, Kajumulo KF, Davis KC, George WH, Norris J, Heiman JR. A person-centered approach to examining heterogeneity and subgroups among survivors of sexual assault. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 124:685-96. [PMID: 26052619 DOI: 10.1037/abn0000055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M = 24.78, SD = 2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across 2 cohorts of women using multiple-group LCA: contact or attempted assault (17% of the sample), incapacitated assault (52%), and forceful severe assault (31%). Groups did not differ in their sexual risk/safety behavior. Women in the forceful severe category had higher levels of anxiety, depression, and trauma symptoms; higher proportions of incarceration and transactional sex; and more experiences with controlling and violent partners than did women in the other 2 groups. Women in the forceful severe category also reported a higher frequency of HED than women in the incapacitated category. Different types of assault experiences appear to be differentially associated with negative outcomes. Understanding heterogeneity and subgroups among sexual assault survivors has implications for improving clinical care and contributing to recovery.
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Affiliation(s)
| | | | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | | | | | | | - Julia R Heiman
- The Kinsey Institute Research in Sex, Gender, and Reproduction, Psychological & Brain Sciences, Indiana University
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Wells BE, Starks TJ, Robel E, Kelly BC, Parsons JT, Golub SA. From Sexual Assault to Sexual Risk: A Relational Pathway? JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:3377-3395. [PMID: 25944835 PMCID: PMC4635062 DOI: 10.1177/0886260515584353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Among women and gay and bisexual men, sexual assault is associated with increased rates of sexual risk behavior and negative sexual health outcomes. Although the mechanisms of these effects are potentially myriad, the current analyses examine the role of perceived partner pressure for condomless sex in mediating the association between adult sexual assault (ASA) and recent anal or vaginal sex without a condom. In a sample of 205 young adult women and gay and bisexual men, ASA was indirectly associated with condomless anal and/or vaginal sex via perceptions of partner pressure for condomless sex, χ2(1) = 5.66, p = .02, after controlling for race, age, gender and sexual identity, and relationship status. The elucidation of this relational mechanism points to several potential intervention and prevention strategies that may reduce actual and perceived pressure for sex without a condom, including strategies designed to facilitate the prioritization of health and safety over relational goals and the improvement of partner selection and perceptions of partner pressure.
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Affiliation(s)
- Brooke E Wells
- Hunter College and Graduate Center of the City University of New York, NY, USA
| | - Tyrel J Starks
- Hunter College and Graduate Center of the City University of New York, NY, USA
| | - Erika Robel
- Hunter College and Graduate Center of the City University of New York, NY, USA
| | - Brian C Kelly
- Hunter College and Graduate Center of the City University of New York, NY, USA
- Purdue University, West Lafayette, IN, USA
| | - Jeffrey T Parsons
- Hunter College and Graduate Center of the City University of New York, NY, USA
| | - Sarit A Golub
- Hunter College and Graduate Center of the City University of New York, NY, USA
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20
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Stappenbeck CA, George WH, Staples J, Nguyen H, Davis KC, Kaysen D, Heiman JR, Masters NT, Norris J, Danube CL, Gilmore AK, Kajumulo KF. In-The-Moment Dissociation, Emotional Numbing, and Sexual Risk: The Influence of Sexual Trauma History, Trauma Symptoms, and Alcohol Intoxication. PSYCHOLOGY OF VIOLENCE 2016; 6:586-595. [PMID: 28239507 PMCID: PMC5321660 DOI: 10.1037/a0039978] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Prior research on the effects of sexual trauma has examined dissociation but not emotional numbing during sex and has relied exclusively on retrospective surveys. The present experiment examined associations among distal factors of childhood sexual abuse (CSA), adolescent/adult sexual assault (ASA), and trauma symptoms and the proximal factor of acute alcohol intoxication on in-the-moment dissociation, emotional numbing, and sexual risk intentions. METHOD Young adult female drinkers (N = 436) at elevated sexual risk were randomized to receive alcohol (target peak breath alcohol concentration = .10%) or no alcohol. They then read an eroticized sexual scenario and reported on their dissociation and emotional numbing experiences, unprotected sex refusal self-efficacy, and unprotected sex intentions. RESULTS Path analysis revealed that CSA was indirectly associated with increased unprotected sex intentions through increased ASA severity, increased trauma-related symptoms, increased emotional numbing, and decreased unprotected sex refusal self-efficacy. Further, alcohol intoxication was indirectly associated with increased unprotected sex intentions through increased emotional numbing and decreased unprotected sex refusal self-efficacy. CONCLUSIONS Emotional numbing, but not dissociation, was associated with unprotected sex intentions and may be one potential target for interventions aimed at reducing HIV/STI-related risk among women with a history of sexual trauma.
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Affiliation(s)
| | | | | | - Hong Nguyen
- Department of Psychology, University of Washington
| | | | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Julia R Heiman
- Department of Psychological and Brain Sciences, Indiana University
| | | | | | - Cinnamon L Danube
- Department of Psychiatry and Behavioral Sciences, University of Washington
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21
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Staples JM, Eakins D, Neilson EC, George WH, Davis KC, Norris J. Sexual Assault Disclosure and Sexual Functioning: The Role of Trauma Symptomatology. J Sex Med 2016; 13:1562-9. [PMID: 27590187 DOI: 10.1016/j.jsxm.2016.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 07/25/2016] [Accepted: 08/03/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Previous research has demonstrated that a history of adult sexual assault (ASA) is associated with negative outcomes, including trauma symptomatology and fear of sexual intimacy. Disclosing sexual assault might be protective against such negative outcomes. AIM To examine the indirect effect of trauma symptomatology on the association between disclosing ASA and current sexual functioning. METHODS Participants included 652 women 21 to 30 years old with a history of ASA recruited from the community. Participants completed self-report measurements on a computer. MAIN OUTCOME MEASURES Separate models were performed, with sexual functioning divided into sexual desire, orgasm, and pain during sex. RESULTS ASA disclosure was indirectly associated with sexual orgasm and pain during sex by trauma symptomatology. However, there was no indirect effect of trauma symptomatology on the relation between ASA disclosure and sexual desire. CONCLUSION Disclosing experiences of ASA could serve a protective function by lessening trauma symptomatology, thereby mitigating impacts on aspects of sexual functioning, such as orgasm and pain.
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Affiliation(s)
| | - Danielle Eakins
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - William H George
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Kelly Cue Davis
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Jeanette Norris
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA
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22
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Johnson PS, Sweeney MM, Herrmann ES, Johnson MW. Alcohol Increases Delay and Probability Discounting of Condom-Protected Sex: A Novel Vector for Alcohol-Related HIV Transmission. Alcohol Clin Exp Res 2016; 40:1339-50. [PMID: 27129419 PMCID: PMC4968206 DOI: 10.1111/acer.13079] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/28/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol use, especially at binge levels, is associated with sexual HIV risk behavior, but the mechanisms through which alcohol increases sexual risk taking are not well-examined. Delay discounting, that is, devaluation of future consequences as a function of delay to their occurrence, has been implicated in a variety of problem behaviors, including risky sexual behavior. Probability discounting is studied with a similar framework as delay discounting, but is a distinct process in which a consequence is devalued because it is uncertain or probabilistic. METHODS Twenty-three, nondependent alcohol users (13 male, 10 female; mean age = 25.3 years old) orally consumed alcohol (1 g/kg) or placebo in 2 separate experimental sessions. During sessions, participants completed tasks examining delay and probability discounting of hypothetical condom-protected sex (Sexual Delay Discounting Task, Sexual Probability Discounting Task) and of hypothetical and real money. RESULTS Alcohol decreased the likelihood that participants would wait to have condom-protected sex versus having immediate, unprotected sex. Alcohol also decreased the likelihood that participants would use an immediately available condom given a specified level of sexually transmitted infection (STI) risk. Alcohol did not affect delay discounting of money, but it did increase participants' preferences for larger, probabilistic monetary rewards over smaller, certain rewards. CONCLUSIONS Acute, binge-level alcohol intoxication may increase sexual HIV risk by decreasing willingness to delay sex in order to acquire a condom in situations where one is not immediately available, and by decreasing sensitivity to perceived risk of STI contraction. These findings suggest that delay and probability discounting are critical, but heretofore unrecognized, processes that may mediate the relations between alcohol use and HIV risk.
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Affiliation(s)
- Patrick S Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary M Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan S Herrmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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23
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Hahn AM, Simons RM, Simons JS. Childhood Maltreatment and Sexual Risk Taking: The Mediating Role of Alexithymia. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:53-62. [PMID: 26318149 PMCID: PMC6555481 DOI: 10.1007/s10508-015-0591-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 03/23/2015] [Accepted: 05/01/2015] [Indexed: 06/04/2023]
Abstract
Childhood maltreatment is a significant predictor of sexual risk taking. The nature of this relationship is not fully understood; however, emotion dysregulation may play an important role. We tested the role of difficulty identifying and describing feelings (i.e., alexithymia) on the relationship between childhood maltreatment and sexual risk taking. Specifically, we hypothesized two mechanisms, one in which alexithymia is related to sexual risk taking via negative urgency and alcohol use and a second one in which alexithymia is related to sexual risk taking via neediness. The participants for this study were 425 sexually active college undergraduates (303 females, 122 males) between the ages of 18 and 25 years. The results of a structural equation model indicated that alexithymia accounted for a significant part of the relationship between child maltreatment and sexual risk behavior. Moreover, the relationship between alexithymia and sexual risk taking was fully accounted for by two separate paths. First, negative urgency and subsequent alcohol use partially mediated the relationship, and the second effect was accounted for by needy interpersonal style. Adverse experiences during childhood can impair emotional functioning and contribute to behavioral and interpersonal dysregulation.
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Affiliation(s)
- Austin M Hahn
- Department of Psychology, University of South Dakota, 414 East Clark St., Vermillion, SD, 57069, USA.
| | - Raluca M Simons
- Department of Psychology, University of South Dakota, 414 East Clark St., Vermillion, SD, 57069, USA
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, 414 East Clark St., Vermillion, SD, 57069, USA
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24
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Scott-Sheldon LAJ, Carey KB, Cunningham K, Johnson BT, Carey MP. Alcohol Use Predicts Sexual Decision-Making: A Systematic Review and Meta-Analysis of the Experimental Literature. AIDS Behav 2016; 20 Suppl 1:S19-39. [PMID: 26080689 DOI: 10.1007/s10461-015-1108-9] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alcohol is associated with HIV and other sexually transmitted infections through increased sexual risk-taking behavior. Establishing a causal link between alcohol and sexual behavior has been challenging due to methodological limitations (e.g., reliance on cross-sectional designs). Experimental methods can be used to establish causality. The purpose of this meta-analysis was to evaluate the effects of alcohol consumption on unprotected sex intentions. We searched electronic bibliographic databases for records with relevant keywords; 26 manuscripts (k = 30 studies) met inclusion criteria. Results indicate that alcohol consumption is associated with greater intentions to engage in unprotected sex (d +s = 0.24, 0.35). The effect of alcohol on unprotected sex intentions was greater when sexual arousal was heightened. Alcohol consumption is causally linked to theoretical antecedents of sexual risk behavior, consistent with the alcohol myopia model. Addressing alcohol consumption as a determinant of unprotected sex intentions may lead to more effective HIV interventions.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA.
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA.
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown School of Public Health, Providence, RI, USA
| | - Karlene Cunningham
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - Blair T Johnson
- Department of Psychology, University of Connecticut, Storrs, CT, USA
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
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Partner Pressure, Victimization History, and Alcohol: Women's Condom-Decision Abdication Mediated by Mood and Anticipated Negative Partner Reaction. AIDS Behav 2016; 20 Suppl 1:S134-46. [PMID: 26340952 DOI: 10.1007/s10461-015-1154-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Highly intoxicated versus sober women were evaluated using multi-group path analyses to test the hypothesis that sexual victimization history would interact with partner pressure to forgo condom use, resulting in greater condom-decision abdication-letting the man decide whether or not to use a condom. After beverage administration, community women (n = 408) projected themselves into a scenario depicting a male partner exerting high or low pressure for unprotected sex. Mood, anticipated negative reactions from the partner, and condom-decision abdication were assessed. In both control and alcohol models, high pressure increased anticipated negative partner reaction, and positive mood was associated with increased abdication. In the alcohol model, victimization predicted abdication via anticipated negative partner reaction, and pressure decreased positive mood and abdication. In the control model, under high pressure, victimization history severity was positively associated with abdication. Findings implicate condom-decision abdication as an important construct in understanding how women's sexual victimization histories may exert sustained impact on sexual interactions.
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26
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Townsend JM, Wasserman TH, Rosenthal A. Gender difference in emotional reactions and sexual coercion in casual sexual relations: An evolutionary perspective. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2015.04.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jacques-Tiura AJ, Norris J, Kiekel PA, Davis KC, Zawacki T, Morrison DM, George WH, Abdallah DA. Influences of acute alcohol consumption, sexual precedence, and relationship motivation on women's relationship and sex appraisals and unprotected sex intentions. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2015; 32:197-221. [PMID: 25755302 PMCID: PMC4351473 DOI: 10.1177/0265407514528101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Guided by the cognitive mediation model of sexual decision making (Norris, Masters, & Zawacki, 2004. Cognitive mediation of women's sexual decision making: The influence of alcohol, contextual factors, and background variables. Annual Review of Sex Research, 15, 258-296), we examined female social drinkers' (N = 162) in-the-moment risky sexual decision making by testing how individual differences (relationship motivation) and situational factors (alcohol consumption and sexual precedence conditions) influenced cognitive appraisals and sexual outcomes in a hypothetical sexual scenario. In a path model, acute intoxication, sexual precedence, and relationship motivation interactively predicted primary relationship appraisals and independently predicted primary sex appraisals. Primary appraisals predicted secondary appraisals related to relationship and unprotected sex, which predicted unprotected sex intentions. Sexual precedence directly increased unprotected sex intentions. Findings support the cognitive mediation model and suggest that sexual risk reduction interventions should address alcohol, relationship, sexual, and cognitive factors.
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28
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Gilmore AK, George WH, Jacques-Tiura AJ, Granato HF, Davis KC, Norris J, Heiman JR. Men's Intentions to Have Sex With a New Partner: Sexual and Emotional Responding, Alcohol, and Condoms. JOURNAL OF SEX & MARITAL THERAPY 2015; 42:165-77. [PMID: 25529527 PMCID: PMC4938155 DOI: 10.1080/0092623x.2014.985350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Findings regarding the relation between alcohol and intentions to have sex have been mixed, and little research has examined the role of condom availability on intentions to have sex. Sexual and emotional responding may influence subsequent sexual decisions. Thus, a better understanding of sexual and emotional responding combined with situational factors such as condom presence could help explain the discrepancies in findings regarding alcohol's effect on intentions to have sex. The effects of alcohol and condom presence on men's intentions to have sex were examined using an experimental paradigm involving an alcohol administration study and a second-person eroticized scenario. The effects of sexual and emotional responding were also examined in relation to intentions to have sex. It was found that alcohol increased positive mood, which was associated with higher intentions to have sex. In addition, condom presence was directly associated with higher intentions to have sex. More sexual desire was related to increased likelihood of sexual intentions. These findings increase understanding of mechanisms underlying the relation between alcohol and intentions to have sex.
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Affiliation(s)
- Amanda K Gilmore
- a Department of Psychology , University of Washington , Seattle , Washington , USA
| | - William H George
- a Department of Psychology , University of Washington , Seattle , Washington , USA
| | - Angela J Jacques-Tiura
- b Pediatric Prevention Research Center , Wayne State University , Detroit , Michigan , USA
| | - Hollie F Granato
- c Department of Psychology , University of Washington , Seattle , Washington , USA
| | - Kelly Cue Davis
- d School of Social Work , University of Washington , Seattle , Washington , USA
| | - Jeanette Norris
- e Alcohol and Drug Abuse Institute , University of Washington , Seattle , Washington , USA
| | - Julia R Heiman
- f The Kinsey Institute , Psychological and Brain Sciences, Indiana University , Bloomington , Indiana , USA
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29
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Gilmore AK, Koo KH, Nguyen HV, Granato HF, Hughes TL, Kaysen D. Sexual assault, drinking norms, and drinking behavior among a national sample of lesbian and bisexual women. Addict Behav 2014; 39:630-6. [PMID: 24360780 DOI: 10.1016/j.addbeh.2013.11.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 11/18/2013] [Accepted: 11/18/2013] [Indexed: 11/25/2022]
Abstract
Childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) are strongly associated with women's alcohol use and the rates of both alcohol use and sexual assault history are higher among lesbian and bisexual women than heterosexual women. Although descriptive drinking norms are one of the highest predictors of alcohol use in emerging adults, this is the first study to examine the relationship between sexual assault history, drinking norms, and alcohol use in lesbian and bisexual women. We found that CSA severity was associated with a higher likelihood of experiencing more severe alcohol-involved ASA, more severe physically forced ASA, and was indirectly associated with more drinking behavior and higher drinking norms. Additionally, more severe alcohol-involved ASA was associated with higher drinking norms and more drinking behavior, but physically forced ASA was not. These findings help explain previous contradictory findings and provide information for interventions.
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30
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Andrasik MP, Otto JM, Nguyen HV, Burris LD, Gilmore AK, George WH, Kajumulo KF, Masters T. The potential of alcohol "heat-of-the-moment" scenarios in HIV prevention: A qualitative study exploring intervention implications. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:1487-99. [PMID: 23740468 PMCID: PMC4089951 DOI: 10.1007/s10508-013-0125-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 03/16/2013] [Accepted: 03/25/2013] [Indexed: 05/24/2023]
Abstract
Scenarios simulating real-world risk situations have proven effective for substance use intervention methods and could potentially prove useful as an HIV-prevention method. This study explored qualitatively the development and use of such "in-the-moment" methods. We interviewed 97 moderate-drinking women (50 % Caucasian) after participation in an experiment requiring that they project themselves into a risky-sex scenario. Most participants (58 %) reported experiencing the scenario as a reflective tool characterized by two primary themes: (1) increased awareness of risk and (2) contemplation of behavior change. Findings suggest that "in-the-moment" methods depicting real-world risk situations and providing opportunities to reflect about behavioral choices and subsequent outcomes could prove a useful adjunct to HIV/AIDS-prevention interventions. Such methods could potentially augment existing prevention protocols.
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Affiliation(s)
- Michele Peake Andrasik
- Department of Psychiatry, School of Medicine, University of Washington, 1100 Fairview Avenue N, LE-500, Box 358080, Seattle, WA, 98109-1024, USA,
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