The Complexities of Sexual Consent Among College Students: A Conceptual and Empirical Review

Development of a sexual consent intervention for adolescents with intellectual and developmental disabilities

BACKGROUND

Tailored sexuality education for adolescents with intellectual and developmental disabilities is a crucial, yet unmet, need as this population is particularly at risk for sexual abuse and victimisation. However, there are no evidence-based interventions to specifically address this need. This paper presents the development of an intervention framework to address equity in sexuality education and support adolescents with intellectual and developmental disabilities to understand and provide sexual consent, a foundational aspect of sexuality education and sexual health.

METHODS

The Sexual Health Equity Project team used a Community-Based Participatory Research approach to develop a four-module sexual consent intervention for adolescents with intellectual and developmental disabilities. We leveraged a diverse, interdisciplinary team in a suburban Midwestern school district, and used Backward Design to create objectives and assessments which were rooted in findings from qualitative data by special education teachers.

RESULTS

The resulting sexual consent intervention, Ask Me First-Choices, is comprised of four modules covering topics including definition of sexual consent; decision-making strategies and practice; communicating consent and refusal, identifying situations of consent and non-consent; and legal issues surrounding consent. Each module is divided into five components for content delivery: (1) introduction, (2) lecture, (3) supplemental activity, (4) assessment, and (5) conclusion. We detail the intervention's unique aspects, emphasising areas where we used Universal Design for Learning principles to support teachers' instruction and students' learning.

CONCLUSION

Our efforts to create a sexual consent intervention directly address sexuality education equity issues. We offer commentary on our design process and decisions, as well as recommendations for future groups who want to develop sexual health interventions in similar contexts for students with intellectual and developmental disabilities. Next steps include further testing and validation of the sexual consent intervention to build the evidence-base of sexuality education for adolescents with intellectual and developmental disabilities.

Reporting Rape: Stigmatizing Reactions to Survivors Who Seek Accountability

Rape survivors face stigma when disclosing their experiences. We hypothesized that a rape survivor who formally reports their rape would experience more stigma than one who does not, and that this effect will be stronger when the perceiver is a man or low in support for sexual consent. Across two studies using self-report, observational, and psychophysiological measures, we found that a reporting survivor was seen more negatively than an identical survivor who did not report their rape. Men and those low in support for sexual consent also responded more negatively to the survivor. Implications of these findings are discussed.

"I Think You Covered the Three Levels of Drugs and Consent": Qualitatively Testing Different Operationalizations of an Alcohol and Other Drugs-Involved Sexual Violence

Substance-involved rape is increasing among college students, particularly women (Koss et al., 2022). Addressing rape requires first measuring it accurately in surveys to understand its true scope and nature. We used cognitive interviews with 40 young adults to qualitatively test the construct validity of an alcohol- and other drugs (AOD)-involved rape item in the Sexual Experiences Survey by asking participants to comment on different operationalizations of this construct. Our findings revealed that different phrasings elicited different interpretations of the items by participants. Specifically, the results indicated that (1) respondents viewed the different operationalizations as a sequence of events with varying severity; (2) some participants focused on the intentionality and responsibility of the perpetrator as opposed to opportunistic perpetration; and (3) study participants consistently chose one of the operationalizations as describing "being roofied" (being drugged without consent). Participants also contributed additional scenarios not described in the questionnaire and shared their interpretations of the items. The results underscore the importance of refining survey language to properly measure AOD-involved rape and allow us to understand how to tailor appropriate questions for best comprehension. The findings indicate the benefit in including several items about AOD-involved rape in questionnaires such as the Sexual Experiences Survey, with each item addressing different scenarios of victim intoxication. The results could also have important implications for sexual violence prevention programs, which should discuss consent, intentions, and responsibility specifically in the context of AOD consumption.

Myths of trauma memory: on the oversimplification of effects of attention narrowing under stress

The present article addresses claims commonly made by prosecution witnesses in sexual assault trials: that attention narrows under stress, and that these attended aspects of the event are encoded in a way that ensures accuracy and resistance to fading and distortion. We provide evidence to contradict such claims. Given that what is encoded is largely the gist of one's interpretation of experience, we discuss the way in which attention and emotion can bias the interpretation of experience. We illustrate with issues of memory reports in cases of acquaintance rape, where the primary issue is the presence or absence of consent. We provide some specific illustrations concerning effects of emotion on interpretation of sexual consent. Finally, based on what is known regarding priming effects on memory retrieval and judgment, we conclude with discussion of the potential of some "trauma-informed" interviewing strategies to promote false memories (such as FETI: Forensic Experiential Trauma Interview).

Let's just do it: sexual arousal's effects on attitudes regarding sexual consent

Misperception of others' sexual willingness or consent is widely considered to contribute to sexual coercion. Sexual arousal is commonly present among those in situations with potential to result in sexual assault. The current research tests the effects of sexual arousal on related attitudes: including those toward token resistance, assertive sexual strategies, and affirmative consent. Sexual arousal was primed through a narrative writing paradigm. Results indicate sexual arousal led all participants to be more likely to endorse belief in female token resistance, and led women to more strongly endorse men's assertive sexual strategies. Implications for research on sexual consent are discussed.

Camsites as a Context for Sexual Consent Education: User Experiences

Understanding sexual consent is essential for the promotion of healthy sexual relationships and the prevention of sexual violence. Emerging sexual technologies can provide opportunities for users to learn about and potentially practice navigating sexual consent with partners, but this field of research is still nascent. In this study, we surveyed 5,828 erotic camsite users to determine whether they learned something new about sexual consent from their use of the site. Participants mostly identified as heterosexual white men, aged 18 to 99. Our results showed that 12% (n = 699) reported learning something new about sexual consent from their camsite use. Those who reported learning something new were prompted to provide a qualitative report of what they had learned; 36% (n = 252) did so. Users reported learning about the importance of respecting boundaries; how consent can change or differ based on the person, context, or time; the implicit and explicit forms of sexual consent, and the need to explicitly communicate about sexual consent; and how consent norms apply to commercial sexual contexts. Our findings show that people are learning about sexual consent from camsites, but the obtained knowledge is complex and sometimes negative. This study sheds light on the potential of emerging sexual technologies as sources for sexual education, and highlights the need for further research exploring the ways in which understandings of digital sexual consent translate to broader contexts.

Yes, No, Maybe So: The Effects of Relationship Status on Perceptions of Inferred Consent

Despite the notion that sexual consent is either granted or refused, its communication can sometimes be ambiguous. This uncertainty stems from the tendency to rely on implicit, nonverbal cues to indicate consent. Without clear, explicit communication, people might be encouraged to rely upon contextual information when assessing whether a sexual encounter was consensual. Perceived levels of intimacy and familiarity in a relationship might influence these perceptions, such that prior intimacy might lead to ambiguously communicated consent being interpreted as more consensual. Gender roles can dictate the behaviors expected in a sexual encounter, with female-initiated sexual violence against men potentially being perceived as more consensual than the inverse. The current study examined how relationship type (Experiments 1 and 2) and gender pairing (Experiment 2) influenced participants' perceptions of how consensual various sexual encounters were. Participants read a series of vignettes in which sexual consent was verbally granted, verbally rejected, or inferred using nonverbal cues. Additionally, the dyads' relationships were either described as dating, friends, or strangers. Following vignette presentation, participants provided judgments regarding how consensual the interactions were. Experiment 2 expanded upon this by manipulating the gender of the initiators and targets. When consent was not clearly indicated, more established relationships were associated with higher ratings of perceived consent. Male targets were attributed more responsibility for sexual interactions, and they were also believed to want nonconsensual sex more than female targets. These findings highlight the importance of contextual information in instances where sexual consent is unclear.

Words Can Hurt: A Taxonomy of Verbally Pressured Sexual Exploitation in the SES-V

This article describes the development of the Verbally Pressured Sexual Exploitation module of the Sexual Experiences Survey (SES)-Victimization (introduced by Koss et al., 2024). This module assesses the use of verbal or nonphysical, paraverbal pressure to obtain sexual acts without freely given permission. An interdisciplinary team of seven sexual exploitation researchers collaborated to create this module, with consultation from the full 15 member SES-V revision collaboration team. In this paper, we describe our process for developing this module. We briefly review empirical literature and theoretical frameworks (e.g., rape scripts, normative sexual scripts, intersectionality, and sex-positivity) that informed this work. Summary tables compare the SES-V items to verbal pressure items in prior versions of the SES and to other existing measures of violence. The comprehensive taxonomy developed herein includes six domains of Verbally Pressured sexual exploitation across 11 item stems. The components of the taxonomy include: positive verbal pressure, neutral verbal pressure, negative verbal pressure, substance-related pressure, postural violence, and threats to critical resources. The paper concludes with suggestions for future research, with priority on intersectional research that can illuminate the phenomenology and contexts of sexual exploitation against marginalized groups.

The Revised Sexual Experiences Survey Victimization Version (SES-V): Conceptualization, Modifications, Items and Scoring

The Sexual Experiences Survey [SES] is considered the gold standard measure of non-consensual sexual experiences. This article introduces a new victimization version [SES-V] developed by a multidisciplinary collaboration, the first revision since 2007. The 2024 SES-V is designed to measure the construct of sexual exploitation since the 14th birthday. Notable revisions are adoption of a freely given permission standard for non-consent, introduction of new tactics and acts, including made to perform or to penetrate another person's body, tactics-first wording order, and emphasis on gender and sexual orientation inclusivity. The SES-V is modularized to allow whole or partial administration. Modules include Non-contact, Technology-facilitated, Illegal (largely penetrative), and Verbally pressured sexual exploitation. Tables provide item text, multiple scoring approaches, module follow-up, specific incident description and demographics. Future plans include developing a scoring algorithm based on weighting our hypothesized dimensions of sexual exploitation severity: invasiveness, pressure, and norm violation combined with frequency. This article is the first in a special issue on the SES-V. Subsequent articles focus on the taxonomies and literature that informed each module. The issue concludes with two empirical papers demonstrating the feasibility and validity of the SES-V: (1) psychometric comparison with the 2007 SES-SFV; and (2) prevalence data from a census-matched adult community sample.

Pilot randomized controlled trial using the theory of planned behavior to promote sexual consent of undergraduates in Greek-letter organizations

OBJECTIVE

Sexual assault is prevalent among undergraduates in Greek-letter organizations (GLO). Prevention efforts promote sexual consent, though few explicitly employ theoretical constructs known to positively influence behavior. This study evaluated theory-informed educational posters promoting sexual consent seeking.

PARTICIPANTS

Forty undergraduate GLO students (20 female, 20 male) were recruited through in-person, email, and social media solicitation. Data collection was completed March-November 2019 during the spring and fall semesters.

METHODS

A double-blind randomized controlled trial was conducted. Intervention participants viewed theory-informed educational posters promoting sexual consent.

RESULTS

The intervention group demonstrated more favorable consent intention (p = .024; η2 = 0.131) and consent subjective norms (p = .040; η2 = 0.109). Intervention group males showed a greater improvement in one of four consent attitudes (p = .045; η2 = 0.211).

CONCLUSIONS

Brief exposures to theory-informed messaging may help to improve subjective norms and behavioral intent to seek sexual consent among undergraduate GLO members.

Intimate Partner Sexual Violence in Emerging Adulthood: Exploring Sexual Consent Attitudes as a Target for Sexual Coercion Prevention

While intimate partner violence is now recognized as a major societal and international issue, sexual violence between partners remains understudied despite its significant prevalence rates and the specific contexts in which it occurs. The aim of this study was to analyze the links between different dimensions of sexual consent and sexual coercion experienced within intimate relationships in order to identify targets for prevention campaigns. The study was carried out during a time of transition in the sociopolitical and legislative context in Belgium linked to the implementation of a reform to the sexual criminal law, which has made the expression of sexual consent central to the qualification of sexual offenses. A total of 431 young adults (88.40% female; Mage = 22.19 years; SDage = 1.79) were recruited from the general population through an online survey to analyze the links between attitudes and beliefs toward sexual consent, attachment style, mental health, and sexual victimization between partners. Results showed that a lack of perceived behavioral control over establishing sexual consent, as well as the avoidance of intimacy, predicted sexual victimization. The clinical implications of these findings are discussed and potential public policy responses for prevention and awareness are suggested. Future research should further investigate and conceptualize sexual consent as it relates to sexual coercion in a more representative sample from an intersectional perspective.

Quantifying Criminal Sexual Acts: The Illegal Sexual Exploitation Module of the Revised Sexual Experiences Survey-Victimization (SES-V) Measure

Since the initial development of the Sexual Experiences Survey (SES) four decades ago, the SES has been designed to measure a range of forms of sexual exploitation, including acts that are coercive but not legally sanctioned as well as acts that legally qualify as crimes. That feature was retained in the revised Sexual Experiences Survey-Victimization (SES-V) measure. This article reviews the theoretical and empirical literature that guided the development of the Illegal Sexual Exploitation module of the SES-V, which measures experiences of nonconsensual exploitation resulting in sexual contact and which is designed to correspond to legal definitions across multiple jurisdictions. This article addresses research and applied contexts in which the distinction between legal and illegal sexual exploitation is important and the challenges and limitations involved in writing survey items that correspond to legal definitions. It also discusses revisions made to the items that make up the Illegal Sexual Exploitation module of the SES-V as compared to the illegal items in prior versions of the SES, including a new operationalization of non-consent and an expansion of the sexual acts and exploitative tactics that are included. Finally, the article discusses directions for future research on the Illegal Sexual Exploitation module of the SES-V.

Sexual Victimization, Emotion Dysregulation, and Sexual Consent Feelings and Communication During a Recent Sexual Encounter

Sexual consent has been a major focus of campus campaigns to reduce sexual violence (SV). However, these campaigns often educate students about consent with little attention to the complex ways consent can be experienced, expressed, and interpreted by others. Further, little research has focused on the consent feelings and communication cues of students who have a history of SV, nor have studies examined how the ability to attend to and regulate emotions relates to internal feelings or external communication of consent. This secondary analysis examined SV histories, emotion dysregulation, and internal and external consent cues in a sample of 610 college students (72% women) who completed an online self-report survey. Findings revealed that students with SV histories (n = 257) reported greater emotion dysregulation, lower internal consent, and greater use of passive external consent cues compared to students without SV histories; greater emotion dysregulation was associated with lower internal consent. In a path model, SV history was indirectly related to use of direct nonverbal and passive consent cues through greater emotion dysregulation and lower internal consent. Contrary to expectations, higher internal consent was associated with greater use of passive external consent cues. Consent programming could be augmented to encourage attention to and regulation of emotions in sexual situations to improve communication and sexual well-being.

Considering the Impact of High School Sexual Education on Past Sexual Victimization and Rape Myth Acceptance in a College Sample

Sexual victimization is a serious public health crisis affecting college students, with high rates reported among both women and men. Sexual consent education is crucial as it defines sexual assault and is linked to reduced risk of victimization. Rape myths and stereotyped beliefs shifting blame to survivors are established risk factors for sexual violence. Comprehensive sexual education can mitigate these attitudes, fostering a supportive environment for survivors. However, most high school students in the United States receive abstinence-based or abstinence-plus education, which uses unstandardized protocols and often lacks information about sexual consent. The following study explores the influence of high school sexual education on past sexual victimization and rape myth acceptance in college students. Six hundred sixty-four undergraduate students participated in an online survey through a university participant pool. Results show that those who received comprehensive sexual education were more likely to understand sexual consent and were less likely to endorse past sexual victimization. In contrast, students without comprehensive sexual education reported lower satisfaction with their sexual education and greater acceptance of rape myths. Despite limitations in the study's sample and reliance on self-reporting, this research highlights the importance of implementing comprehensive sexual education, including consent education, in high schools. Policymakers and educators must recognize the influence of comprehensive sexual education in promoting healthy relationships and combating sexual assault. As a significant public health concern, incorporating standardized sexual consent education into high school curricula can equip students with the knowledge and skills to make informed decisions about their sexual health and relationships. Future research should explore diverse populations and the mediating role of related factors that may further influence these relationships. These efforts will contribute to fostering a safer environment within educational institutions and combating sexual assault.

Uncovering young people's situational construction of sexual consent

Aim: To investigate how young Danes construct sexual consent generally, but also specifically in relation to heavy alcohol intoxication. Methods: Drawing on 30 qualitative in-depth interviews with young people, aged 19-25 years, and adopting a critical discursive psychological framework, we explored the interpretative repertoires that the participants made use of to construct sexual consent and the subject positions those repertoires enabled. Results: The participants made use of three interpretative repertoires that we named as follows: (1) sexual consent as an agreement between rational individuals; (2) sexual consent as a heteronormative practice; and (3) intoxicated sexual consent. Discussion: Young people draw on different repertoires when discussing sexual consent in general, sexual consent in relation to gendered practices and expectations, and sexual consent in relation to heavy alcohol intoxication. Conclusion: It is vital to keep the situational nature of young people's constructions of sexual consent in mind if we wish to understand and eventually reduce the number of non-consensual sexual experiences.

UK and Australian University Students' Perceptions of the Nature of Sexual Assault and Intervening Behavior

Sexual assault is a global problem, with the risk highest among university students. Bystander intervention preventing sexual assaults has primarily been researched using quantitative methods to understand what factors influence it. However, both sexual assault and bystander intervention are complex with many subtle and overlapping issues that, when analyzed qualitatively, can offer new insights. The current study aimed to explore and develop a nuanced and comprehensive understanding of students' perceptions of sexual assault and bystander intervention across two universities, one in the United Kingdom and one in Australia. Thirty-nine university students (19 in the United Kingdom; 20 in Australia) took part in one-to-one semistructured interviews. Using inductive thematic analysis, two overarching themes were identified: (a) navigating the complex dynamics of sexual assault; and (b) decisions to intervene or not to intervene. Findings suggest that the complexity and ambiguity around sexual assault can forestall bystander intervention. As such, increasing education, awareness, and discussions around sexual assault and bystander intervention is vital to increase awareness of the problem and mobilize action from bystanders to prevent sexual assault.

Effectiveness of a Comprehensive School-Based Sex Education Program for Young Adolescents in the Netherlands

Most sexual education programs traditionally focused on providing sexual information regarding the risks of sex. However, current studies on sexual behavior in youth show a need for truly comprehensive sex education approaches with a sex-positive focus on sexuality, that effectively improve sexual competence. Therefore, in the current study the effectiveness of "Love is…", a four lesson school-based program based on the Sexual Interactional Competence model and Attitude-Social-Influence-Self-Efficacy-model was studied. A cluster-randomized controlled trial on the effectiveness of "Love is…" was conducted in 2018-2020. The sample consisted of 1160 adolescents in grades 8 and 9 from nine schools in the Netherlands. The sample was 48% female, 34% Dutch/Caucasian, 41% none-religious and 50% higher educated. They were randomized at class level into a program group [n = 32 classes; 567 students (Mage = 13.74 (SD = 0.74))] and a control group [n = 31 classes; 593 students (Mage = 13.86 (SD = 0.73))]. Results showed that "Love is…" increased sexual knowledge, that adolescents in the program group showed less cyber victim blaming attitudes and increased in communications skills after the program. In conclusion, the current study shows that "Love is…" was effective not only on the knowledge level, but also regarding sexual attitudes and competences. However, due to the developmental process of sexuality, there is a necessity to continue lessons in following grades through booster sessions by reinforcing competences as communicating comfortably about sexuality.On 12 November 2019 the study design and hypotheses were registered in the Dutch Trial Registration, number NL8150. ( https://onderzoekmetmensen.nl/nl/trial/26676 ).

Socioecological Risk and Protective Factors for Sexual Victimization in Post-Secondary Students in Ireland: A Brief Report

Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV.

Psychological Symptoms Associated with Sexual Victimization Experiences: Differences as a Function of the Type and Number of Sexual Acts and Aggressive Tactics

Different types of sexual victimization are associated with different outcomes; for example, on average, physically forced sex is associated with worse psychological outcomes than verbally coerced sex. This study evaluated outcomes associated with sexual victimization as a function of sexual act and aggressive tactic, expanding upon the acts and tactics examined in prior studies. Participants who had experienced sexual victimization (N = 402) completed a survey about their most upsetting victimization experience, identifying the sexual act(s) and aggressive tactic(s) that occurred. They completed measures of PTSD, depression, anger, and trauma-related cognitions. Relationships between symptom severity and most upsetting act and tactic, as well as the number of acts and tactics, were analyzed. Related to the sexual act, non-penetrative sexual acts were associated with the lowest symptom severity on several measures. Related to the aggressive tactic, sex obtained through anger/criticism and physical force were associated with the greatest symptom severity on some measures. A larger number of tactics were associated with more severe symptoms on all measures, whereas number of acts only explained unique variance in PTSD symptom severity. The pattern of severity for outcomes differed from previous conceptualizations, suggesting that current hierarchies of victimization severity may require revision.

The Effects of Alcohol Intoxication on Perceptions of Consent and Refusal Indicators in a Fictional Alcohol-Involved Sexual Encounter

Alcohol intoxication may influence how bystanders interpret other people's consent and refusal cues. We examined the effects of alcohol intoxication on participants' perceptions of characters' consent and refusal indicators in a fictional vignette depicting an alcohol-involved sexual encounter. Young adults (n = 119, 52% women) participated in an alcohol administration experiment examining the influence of acute intoxication on bystander perceptions during a vignette depicting a character who is intoxicated and declines a sexual advance from another character, who ignores her refusal and continues to pursue sexual activity. Participants were randomly assigned to an alcohol or non-alcohol condition and then guided through a semi-structured interview in which we asked about the characters' consent and refusal cues. Interviews were analyzed using both inductive and deductive coding. Most participants eventually indicated the encounter was nonconsensual, but approximately 9% of participants described the encounter as entirely consensual and another 42% of participants described the interaction as initially consensual and then nonconsensual. Participants discussed nuanced accounts of consent and refusal cues, including indicators related to alcohol consumption. Disregarding intoxication and gender, participants eventually recognized the situation as nonconsensual and thus potentially risky. However, some participants recognized this risk earlier in the encounter than others. Consequently, bystanders who recognize risk later in a situation may have fewer opportunities to intervene before a situation escalates. We recommend sexual assault prevention educators take a more nuanced approach when discussing consent and refusal indicators, emphasizing contextual factors that may indicate risk.

Identifying the Impact of Sexual Scripts on Consent Negotiations

In light of research that shows the importance of effective sexual communication for healthier sexual relationships, less unwanted sexual activity, and less sexual violence, this article explores how both dominant and alternative sexual scripts influence sexual communication. Drawing on 51 in-depth interviews with adults in heterosexual, queer, non-monogamous, and kink sex communities about their actual communication and consent practices in sexual interactions, we asked 1) In what ways do dominant sexual scripts affect communication and consent in sexual interactions? 2) What factors encourage people to diverge from these dominant scripts? and 3) How do alternative scripts produce new forms of communication and consent? We found that traditional scripts remain common, especially among those with less sexual experience, and that adherence to these scripts is more likely to correspond to coercive or unwanted sex. Conversely, exposure to alternative sexual scripts via sexual experience, education, or communities often encourages sexual agency and communication. We conclude by discussing the implications of these insights about communicative consent negotiations for sexual violence prevention.

PACT: Developing and Evaluating a Digital Sexual Consent Program for Youth

Understanding affirmative sexual consent is crucial for violence prevention and health promotion, yet few adolescents receive adequate consent education. The current study aimed to evaluate the acceptability and preliminary efficacy of a brief online program designed to teach adolescents information and skills about communicating and interpreting affirmative sexual consent (PACT: Promoting Affirmative Consent among Teens) in a randomized controlled trial with a national sample of 833 U.S. adolescents (ages 14-16; 42% White, 17% Asian, 17% Black, 13% Latinx; 53% girls, 31% boys, 12% non-binary; 45% heterosexual; 29% sexually active). PACT, grounded in health behavior change and persuasion theories, was developed using feedback from youth advisors and usability testers. Participants considered the program generally acceptable. Compared to youth who completed a control program, PACT was efficacious at shifting three measures of affirmative consent cognitions (i.e., knowledge, attitudes, self-efficacy) from baseline to immediate posttest. Youth who completed PACT also demonstrated more accurate affirmative consent knowledge at 3 months post-baseline. PACT's effects on consent cognitions were generally similar among youth with various gender, racial/ethnic, and sexual identities. We discuss next steps for this program, including the possibilities of expanding to include additional concepts and tailoring to address the unique needs of specific youth.

Adults' Understandings and Experiences of the Capacity to Consent to Substance-Involved Sexual Activity

Most research on capacity to consent to substance-involved sex has focused exclusively on the implications of alcohol with little attention given to other or additional psychoactive drugs. This study aimed to explore people's understanding and experiences of the capacity to consent to alcohol- and/or drug-involved sexual activity. UK adults (N = 354) completed an online mixed-methods survey on sexual consent during sober, alcohol- and/or drug-involved sex. Qualitative data were analyzed using thematic analysis. Themes for capacity to consent were: (1) "There is no normative understanding of substance-involved sexual consent," (2) "Moving beyond the binary of consciousness versus incapacitation" and (3) "Substance-involved sexual decisions are viewed as irresponsible." The findings illustrated that capacity to consent is nuanced and multidimensional, and that people's understandings and experiences of capacity to consent to substance-involved sex are not solely individual, but rather, they are also shaped by their environment. We call for a multidimensional view of capacity to consent, where a standard of "unimpaired," rather than sober, is used and modeled by academics, legislators, and educators.

Clickable Consent: How Men Who Have Sex with Men Understand and Practice Sexual Consent on Dating Apps and in Person

Smartphone-based dating applications like Grindr are popular among men who have sex with men (MSM), and it is common for MSM to engage in sexual activity with other users. Despite this, there is limited research on MSM's negotiations of consent for online sexual interactions and in-person sexual encounters. This study examined MSM's understandings and practices of consent on dating apps and in person. Interpretative phenomenological analysis of 25 interviews with MSM dating app users revealed that many participants could identify key aspects of consent but did not always apply those understandings to their own practices. For online sexual interactions, some participants viewed consent as connecting to a dating app - a practice I term "clickable consent" - while other participants viewed consent as continuous and communicated consent in explicit and implicit ways. Although all participants negotiated consent online in preparation for an in-person sexual encounter, some renegotiated consent in person with explicit or non-explicit communication, while others did not renegotiate consent in person. Results shed light on how MSM's online conversations impact their in-app and in-person sexual activities, and reveal challenges that MSM face in digital and physical spaces. Conclusions, implications, and suggestions for future research are discussed further.

"It's Almost Boring When It Should Be Enjoyable and Fun": College Students' Definitions of Bad Sex

Some of the primary reasons for sexual activities among college students include self-focused motives such as pleasure, along with other-focused motives that facilitate relatedness such as intimacy and emotional connection. However, college students' motivations for sex (or lack thereof) may also be impacted by the meaning they make of their own or peers' experience of "bad sex" - sex that is consensual yet "bad" or "negative" in some way. Therefore, the current study qualitatively explored college students' definitions of "bad sex." A total of 300 college-attending emerging adults (ages 18-25) provided open-ended responses regarding their definition of "bad sex" that is not sexual assault or rape. Using a thematic analytic approach, we identified six main themes on how participants defined what constituted "bad sex": (1) Lack of Pleasure, (2) Negative Outcomes (3) Unmet Expectations, (4) Sexual Violence, (5) Lack of Connection, and (6) Bad Partner. Additionally, the themes were examined based on gender identity, sexual activity status, sexual orientation, and relationship status. Implications for college sex education along with areas of future research with diverse populations and qualitative methodology are discussed.

How Do College Students Perceive Their Partner Responds to Them When They Refuse Sexual Activity?

Refusal communication is a dyadic process, with one person communicating a refusal and another person responding. To enhance our understanding of this process, we surveyed college students to assess their interpretation of their partners' responses when they declined vaginal-penile sexual activity. In an online survey, participants were prompted to describe their partners' reactions when participants refused their partner's vaginal-penile sex initiation. Through content analysis, three themes were present: (1) partner accepted the refusal, (2) partner experienced negative emotions, (3) partner ignored their refusals. Participants frequently reported their refusals were accepted. Sexual assault prevention initiatives should work to normalize refusal communication.

Sexual Consent Norms in a Sexually Diverse Sample

Sexual consent has received increased attention in mainstream media, educational, and political settings since the rise of the #MeToo movement in 2017. However, long before #MeToo, sexual consent has been a core practice among people who engage in Bondage and Discipline, Dominance and Submission, Sadism, and Masochism (BDSM). This study examined sexual consent norms among a sexually diverse sample, including people who practice BDSM (n = 116), people who identify with another sexual minority group, such as swingers and sex workers (n = 114), and people who did not identify with a sexual minority group, termed sexual majority group members (n = 158). Explicit consent for both BDSM- and non-BDSM-related activities was rated as more common (descriptively normative) among people who were a member of the BDSM community compared to majority participants. Further, BDSM participants rated consent discussions as less sexually disruptive compared to majority participants. We found no significant group differences in the extent to which people thought sexual consent should be discussed. We also discuss findings from an open-ended question asking participants to recall a recent sexual experience with a new partner. This study demonstrates variability in consent norms between groups and points to the potential to shift sexual consent behaviors among majority participants.

Nonconsensual Sexual Experience Histories of Incarcerated Men: A Mixed Methods Approach

Nonconsensual sexual experiences (NSEs) may contribute to mental health concerns among incarcerated individuals, yet NSEs are understudied in this population. This study takes a novel approach in examining the prevalence of NSEs among incarcerated males by utilizing both quantitative and qualitative measures. The sample consisted of 189 men from three provincial maximum-security prisons in Ontario, Canada. Based on quantitative findings, 44.2% of the sample experienced NSEs before the age of 18, and 41.7% of the sample endorsed an experience that fit the legal definition of a NSEs as adults. Participants also responded to a qualitative open-ended question about their history of NSEs. Based on qualitative findings, a total of 23% of the men reported at least one incident of a NSE (e.g., child and adult). Based Findings highlight the high prevalence of NSEs among incarcerated men with quantitative responses demonstrating how the use of a behavioral questionnaire may, to some extent, correct for underreporting of NSEs. Qualitative responses illustrate the lived experience of incarcerated men and provide a deeper understanding of their NSEs. Responses also speak to the lack of resources and support available to these men. Findings underscore the need for proactive approaches in meeting mental health needs of incarcerated men in general and with regard to NSEs in particular. Results may inform the development of future correctional procedures (i.e., intake protocols that account for men with NSEs) and resources to support incarcerated men in navigating the psychological impact of non-consensual sexual experiences.

Exploring the Influence of Romantic Relationship Communication on Adolescents' Self-Efficacy to Ask for Sexual Consent

Adolescence represents a crucial period for sexual and romantic relationship development, and acquisition of skills and confidence essential for effective sexual consent communication. However, various barriers may interfere with adolescents' belief in their ability (i.e., their self-efficacy) to negotiate consent in practice. This study aimed to investigate the state of adolescents' self-efficacy to ask for consent and explore the influence of romantic relationship communication (a construct comprised of three characteristics: relationship assertiveness skills, positive conflict resolution, and communication awkwardness). Participants were 411 adolescents who had current or past relationships (61% girls, 77% Latine, 79% heterosexual). Participants generally reported above-average levels of self-efficacy to ask for consent (M = 4.14 out of 7, SD = 1.24), with LGBQ+ adolescents exhibiting statistically significantly higher levels of self-efficacy compared to heterosexual adolescents (M = 4.51 vs. 4.09, t = -2.66, p = .008). Self-efficacy to ask for consent was positively individually related to positive conflict resolution and relationship assertiveness skills, and negatively related to communication awkwardness (all ps < .001). In a path model, romantic relationship communication displayed a statistically significant association with adolescents' self-efficacy to ask for consent, with high positive conflict resolution, low communication awkwardness, and high relationship assertiveness skills being associated with higher self-efficacy to ask for consent. Findings suggest improving adolescents' romantic communication skills may enhance their self-efficacy to ask for consent, and contribute to increased rates of sexual consent communication. Intervention strategies should target multiple levels of influence to promote positive consent cognitions, behaviors, and cultural norms.

"It's Their Consent You Have to Wait For": Intimate Partner Violence and BDSM Among Gender and Sexual Minority Youth

Gender and sexual minoritized (GSM) youth are more likely than their cisgender heterosexual peers to experience intimate partner violence (IPV) and practice bondage and discipline, domination and submission, sadism, and masochism (BDSM). Although IPV and BDSM are vastly different phenomena, superficial similarities (e.g., violent behaviors) can lead to misidentification in both practice and research. This study explores how GSM youth (a) experience and understand the differences between IPV and BDSM and (b) report consensual violent and controlling behaviors when answering items on IPV measures. Nine demographically diverse GSM youth (mean age 21.2) were drawn from a GSM youth-serving organization in the Northeast United States. Participants were interviewed about their experiences with IPV, BDSM, and consent. Participants also were asked to describe the process of completing two standardized measures of IPV. Interviews were coded using conventional and directed content analysis. Eight of nine participants reported IPV victimization, and seven reported BDSM interest or experiences. Four themes emerged: (a) GSM youth experience a spectrum of IPV victimization, often related to their gender and sexual identity; (b) interest in BDSM does not imply an acceptance of IPV; (c) GSM youth have a nuanced understanding of consent and strategies to communicate consent with their partners; and (d) Consent is the organizing framework by which GSM youth distinguish IPV from BDSM. Participants reported various degrees of certainty that they would include BDSM behaviors when answering questions about violent behaviors. Findings underscore the importance of conceptually and operationally differentiating IPV and BDSM. Programs that serve GSM youth should address IPV victimization, offer sex-positive education regarding healthy relationships and BDSM, and assist GSM youth in differentiating abusive behaviors from consensual BDSM. Standardized measures that do not conflate BDSM with IPV are crucial for studying IPV among GSM youth.

Defining and Measuring Sexual Consent within the Context of University Students' Unwanted and Nonconsensual Sexual Experiences: A Systematic Literature Review

Lack of sexual consent forms the foundation of unwanted (and nonconsensual) sexual experiences (USEs), yet research suggests it is not well understood amongst university students. While the prevalence of USEs has been well documented within the university context, less is known about how sexual consent is defined or measured. This review aims to identify a consistent sexual consent definition and how current research examining USEs defines and measures sexual consent amongst university students. A systematic review of nine electronic databases (2000-2022) was conducted, and the results were assessed against inclusion criteria (e.g., studies had to focus exclusively on university students). Thirty-three articles were identified and reviewed against the study aims. Sexual consent was more often implicitly defined across measures and articles. Four themes were identified (incapacitation, use of force, use of threats, and lack of wantedness) across the implicit definitions but varied by study with some implicitly defining sexual consent within the context of a relationship. Only three studies explicitly defined sexual consent, referring to it as a willingness to engage in sexual behavior. Measures assessed sexual consent communication or, attitudes and behaviors that might predict sexual aggression. Two studies examined students' individual sexual consent conceptualizations. Sexual consent appears to be contextual so future research should examine the variability of sexual consent in student samples. Students may indeed rely on implicit sexual consent definitions (rather than explicit) but more research is needed. Lastly, researchers should take care to be clear on their sexual consent definitions, both in text and within measures.

"You kind of blame it on the alcohol, but. . .": A discourse analysis of alcohol use and sexual consent among young men in Vancouver, Canada

There is growing awareness about issues of sexual consent, especially in autonomy-compromising or "non-ideal" contexts, including sex involving alcohol. Understanding the conditions needed for consensual sex to occur in this emergent milieu is critically important, especially for young men (ages 18-30 years) who normatively combine drinking alcohol with sex and are most often perpetrators of sexual violence. This study offers a discourse analysis of young men's alcohol use and sexual consent. Data are drawn from qualitative interviews with 76 young men (including gay, bisexual, queer, and straight men) in Vancouver, Canada, from 2018 to 2021. Informed by Kukla's non-ideal theory of sexual consent and critical and inclusive masculinities, this analysis identified three discursive frames: careful connections, watering it down, and blurred lines. In careful connections young men discussed their efforts to actively promote sexual and decisional autonomy for themselves and their sexual partners when drinking. Yet, in watering it down young men invoked discourses of disinhibition, deflection, and denial to normalize alcohol use as being somewhat excusatory for sexual violence, downplaying the role and responsibility of men. Lastly, men operationalized blurred lines through a continuum of consent and of "meeting (masculine) expectations" when discussing sexual violence and victimization while intoxicated. Together, these discursive frames provide insights into the gendered nature of sexual violence and the extent to which idealized notions of sexual consent play out in the everyday lives of young men who use alcohol with sex. Findings hold philosophical and pragmatic implications for contemporary efforts to scaffold sexual consent.

Is Sexual Consent Sexy?: Investigating the Effects of a Televised Depiction of Verbal Sexual Consent on College Students' Sexual Consent Attitudes and Behavioral Intentions

Although depictions of sexual consent are rare in the media, such portrayals have the potential to instruct young people on the procedural details of sexual consent. Taking an entertainment-education (E-E) perspective, we examined the effects of a televised depiction of sexual consent that contained verbal sexual consent, versus a televised depiction that only included nonverbal sexual consent, versus a no-exposure control group to test for changes in college students' attitudes and behavioral intentions toward sexual consent. In the pretest-posttest experimental design, those who were assigned to the nonverbal video condition reported less favorable attitudes about sexual consent between pretest and posttest. Additionally, interpersonal liking was an important facilitator of the E-E impact of the verbal sexual consent condition; the more the participants liked the characters in the verbal condition, the more positively about sexual consent they felt and the more likely they were to plan to engage in sexual consent. Narrative engagement did not mediate the effects of experimental condition on sexual consent attitudes and behavioral intentions. The implications for E-E are discussed.

Negative Sexual Experiences Among Gay, Bisexual, and Other Men Who Have Sex with Men Using GPS-Enabled Hook-Up Apps and Websites

Gay, bisexual, and other men who have sex with men (GBMSM) often use GPS-enabled dating apps and websites to facilitate in-person sexual encounters. Many of these encounters are positive and enjoyable. However, there is limited research on GBMSM's negative experiences with partners from hookup and dating apps/websites, especially those characterized by threats to GBMSM's sexual, physical, and/or psychological safety. In this report, we investigated this matter. We analyzed data from interviews with GBMSM (N = 60) and identified four categories of negative sexual experiences, each of which were comprised by sub-categories: 1) sexual violence (physical sexual assault, verbal sexual coercion, intoxicated assault/coercion), 2) sexual health risk behaviors (condom use resistance and coercion, deception related to HIV/STI status), 3) non-negotiated behaviors (undiscussed/unexpected sex acts, rough sex, sexualized racism, undesired substance use by the partner), and 4) threats to physical safety beyond sexual violence (being blocked from leaving, stalked, robbed, drugged). These results can inform future research and interventions that aim to promote safety on dating apps/websites within the GBMSM community.

Ambiguous Encounters: Young women's expectations and experiences with intoxicated sexual relations in Danish nightlife

This article is based on 28 in-depth interviews with young women (18–25) about their experiences with intoxicated sexual encounters in Danish nightlife. Little research has examined the role intoxication plays in the processes of consensual and non-consensual sex. Using theories of intoxication and sexual scripts, this article focuses on how alcohol is used and perceived by these young women as a potential way of modifying behaviours and norms in their sexual encounters; how they characterize sexual consent and how they navigate intoxicated behaviour that can result in inappropriate, transgressive or victimizing situations. While the women talk about pleasurable and regrettable experiences, many described situations took on a much more ambiguous, fluid and nuanced role. The study points to the lack of knowledge on how ambiguity may play an active role in managing processes of sexual consent in intoxicated settings, especially for the youngest age groups.

"I Wouldn't Believe Her at First"-A Qualitative Study of Young People's Sexual Consent Perceptions and Negotiation in Nairobi Informal Settlements

Forced or coerced sexual experiences have serious consequences for young people's health and well-being. Healthy sexual consent communication can foster positive intimate relationships and help prevent unwanted sexual experiences. We aimed to explore how young people in Nairobi's informal settlements construct, communicate, and negotiate sexual consent within heterosexual partnerships, given the limited insight into such experiences from resource-poor, global-south contexts. A qualitative study with young men and women aged 15 to 21 years was conducted among former participants of a school-based sexual violence prevention intervention in four informal settlements (slums) of Nairobi. Twenty-one individual in-depth interviews (n = 10 females, n = 11 males) and 10 focus group discussions (five with n = 6-11 males vs. females, respectively), that is, n = 89 in total were conducted. Data were analysed using thematic network analysis and interpreted using the Sexual script theory. Participants' endorsement of incongruent sexual scripts shaped their perceptions and negotiations of sexual consent. Young men were committed to respecting sexual consent, but promoted male (sexual) dominance, and perceived women's refusals as token resistance. Per traditional scripts of sexual chastity, young women were largely bound by their use of a "soft no" to give consent, so as to not display direct sexual interest. Actual non-assertive refusals thus risked being interpreted as consent. Young women's "actual" refusals had to be more assertive (saying a "hard no") and were described as having been influenced by skills learned during the school-based intervention. Findings highlight the need for sexual consent education to address internalized gendered norms about female token resistance, destigmatize female sexuality, reduce male dominance norms, and encourage young people's respect for both assertive and non-assertive sexual consent communication.

Internal Consent, Affirmative External Consent, and Sexual Satisfaction Among Young Adults

Sexual satisfaction is an important part of sexual health. Recently, efforts have been underway to better understand what factors contribute to positive sexual experiences among young adults. One factor may be sexual consent. This study aimed to explore individual and interactive effects of two distinct, but related dimensions of sexual consent - internal consent and affirmative external consent - on young adults' feelings of sexual satisfaction following their most recent sexual intercourse experience. Participants were 294 young adults (ages 18-25, Mage = 23.7; 59% women) recruited from Amazon's MTurk. Results showed that each dimension of consent had a significant, unique relationship with satisfaction, and that the two dimensions of consent alone accounted for half of the variance in satisfaction. Additional analyses showed that there are specific components of both internal and affirmative external consent (e.g., safety/comfort; arousal; consent/want; communicator/initiator cues) that may be most influential in driving this relationship. As both consent dimensions greatly contribute to positive sexual experiences, researchers attempting to promote sexual wellbeing may be wise to attend to both internal and external consent.

Understanding Refusals, Using Coercion: Young Men's Understanding and Use of Normalized Sexualized Violence within Heterosex

Sexual coercion is normalized within dominant cultural narratives of seduction and heteronormativity. Many men assert that they abhor rape, but may not comprehend or accept that rape can occur in ways that would challenge their notion of what is acceptable within heteronormative understandings of gender, seduction, and heterosex. Analyses of in-depth, semi-structured interviews with seven male participants in Australia substantiates previous research demonstrating that men are indeed capable of nuanced communication and can understand refusals. Despite understanding refusals, this research found that men perform naivete regarding their use of coercion, or employ language that justifies and minimizes their use of coercion and its potential impact. By exploring sexual negotiation and adherence to heteronormative gender roles and sexual scripts, the findings indicate that coercion is understood by men and employed despite clear signs of refusal, yet ensuing sexualized acts continue to be positioned as "consensual." Suggestions that women should "just say no" overlook that men use coercion past the point of refusals, indicating problematic beliefs about gender, sex, and entitlement, rather than communication issues.

Romanticizing the Stolen Kiss: Men's and Women's Reports of Nonconsensual Kisses and Perceptions of Impact on the Targets of Those Kisses

Stolen kisses are often portrayed as resulting from uncontrollable passion and a need to connect intimately with another. This study examined stolen kisses, defined as kissing someone for the first time when the kisser perceived the kiss recipient was not expecting it, and had not provided consent for the kiss. These kisses were examined from the perspective of the individual initiating the kiss. Participants (N = 130; Mage = 32.27; 67% identified as male) completed an anonymous online survey assessing kissing experiences of having stolen a kiss and their open-ended responses were analyzed here. Men were more likely than women to report having stolen a kiss in line with traditional heterosexual scripts. Three scenarios emerged through content analysis: mutual attraction leading to a new relationship; no known mutual attraction but a positive outcome; and no known mutual attraction and a negative outcome. Stealing a kiss from someone for whom there was mutual attraction often led to the onset of an intimate relationship; thus, the kiss constituted a relationship catalyst. When there was no known shared attraction, some interactions ended positively, but others resulted in an end to cordial relations and often strong negative reactions. Findings are discussed in terms of the limited literature on kissing generally and the nonconsensual nature of these events.

Hey ChatGPT, Let's Talk About Sexual Consent

Access to sexual health education, such as education on sexual consent, is limited in the US. Artificial intelligence (AI), such as ChatGPT, provides a potential opportunity to increase access to sexual consent information and education. However, what ChatGPT knows about sexual consent and if this aligns with the current evidence-based literature on sexual consent is unclear. The goal of this research commentary was to explore what ChatGPT knows about sexual consent with a focus on: 1) the definition of consent, 2) how consent could be communicated, and 3) the impact that substances have on consent. We also examined the reliability of ChatGPT's responses by having three different researchers ask ChatGPT the same set of questions. Across our questions, ChatGPT provided similar and comprehensive responses that discussed key features of consent - that consent is freely given or reversible. ChatGPT provided examples of different verbal and nonverbal cues people can use to communicate and interpret consent and discussed the ways that substances can impact consent communication. Overall, ChatGPT could be a potential resource for educators and young people who seek information about sexual consent; however, we should proceed with caution. ChatGPT is not a replacement for an educator but rather a way to increase access to education.

"I Can Tell You Wanna F***": A Content Analysis of Sexual Communication in Popular Song Lyrics

Given that exposure to sexual messages in song lyrics can influence sociocultural norms and expectations surrounding consent communication between partners, we sought to understand the types of messages regarding sexual initiation and consent language that are available to media consumers. Through the lens of sexual script theory, we conducted a quantitative content analysis of sexual consent in pop (n = 197), hip-hop (n = 193), and country songs (n = 194) from 2016 to 2019. Differences in these messages were examined across singer gender, music genre, and time (pre- vs. post-#MeToo). Results indicated that references to sexual demands (e.g., "Strip that down") and sexual preferences (e.g., "I want it slow") were the most common types of sexual communication, appearing in approximately one-third of the singing parts included in the sample. Sexual suggestions (e.g., "Let's get nasty") and sexual requests (e.g., "Can I hit it?"), on the other hand, were the least common. References to inferred consent (e.g., "I can tell you wanna f***") appeared in approximately one-fifth of the singing parts. Both sexual demands and sexual preferences were more likely to appear in pop compared to hip-hop and country songs; however, these sexual communication messages did not significantly differ by male and female singers. Sexual requests were significantly more likely to appear in pre-#MeToo song lyrics. The messages embedded in popular songs may help to reinforce problematic scripts around sexual consent.

Sexual Consent on Television: Differing Portrayal Effects on Adolescent Viewers

We conducted two studies to examine the portrayal of sexual consent and refusal in adolescent-directed programing and the effects of viewing this content on adolescents. In a quantitative content analysis, nonverbal consent cues were more prevalent than verbal consent cues. The presence of consent cues did not significantly differ by character gender, relationship status, or sexual behavior. Using a three-way between-subjects experiment, we examined the influence of exposure to media depictions of verbal sexual consent on adolescents' intentions to seek verbal sexual consent (n = 402, 61.4% girls, ages 12-18, M = 15.8, SD = 2.1). Exposure to verbal consent positively influenced intentions to seek verbal consent via increased positive attitudes toward women. We discuss the theoretical and practical implications of these findings.

Prevalence of Intoxicating Substance Use Before or During Sex Among Young Adults: A Systematic Review and Meta-Analysis

Drug use before or during sex is a high-risk sexual behavior associated with adverse health risks and outcomes, such as increasing the likelihood of overdoses and of acquiring sexually-transmitted diseases. This systematic review and meta-analysis of three scientific databases examined the prevalence of the use of intoxicating substances, those tending to excite or stupefy the user on a psychoactive level, before or during sex, among young adults (18-29 years old). A total of 55 unique empirical studies met the inclusion criteria (48,145 individuals; 39% males), were assessed for risk of bias using the tools of Hoy et al. (2012), and were analyzed via a generalized linear mixed-effects model. The results produced a global mean prevalence of this sexual risk behavior of 36.98% (95% CI: 28.28%, 46.63%). Nonetheless, significant differences were identified between different intoxicating substances, with the use of alcohol (35.10%; 95% CI: 27.68%, 43.31%), marijuana (27.80%; 95% CI: 18.24%, 39.92%), and ecstasy (20.90%; 95% CI: 14.34%, 29.45%) significantly more prevalent than that of cocaine (4.32%; 95% CI: 3.64%, 5.11%), heroin (.67%; 95% CI: .09%, 4.65%), methamphetamine (7.10%; 95% CI: 4.57%, 10.88%), and GHB (6.55%; 95% CI: 4.21%, 10.05%). Moderator analyses showed that the prevalence of alcohol use before or during sex differed according to geographical sample origin, and increased as the proportion of ethnic whites in samples increased. The remaining demographic (e.g., gender, age, reference population), sexual (e.g., sexual orientation, sexual activity), health (e.g., drug consumption, STI/STD status), methodological (e.g., sampling technique), and measurement (e.g., timeframe) variables that were examined did not moderate prevalence estimates. Implications for sexual development interventions were discussed.

Paraphilic Interests Versus Behaviors: Factors that Distinguish Individuals Who Act on Paraphilic Interests From Individuals Who Refrain

Little is known about distinct factors linked with acting on paraphilic interests or refraining from engaging in paraphilic behaviors. Participants from Canada and the United States (N = 744), aged 19-42 years (M = 29.2; SD = 3.18), were recruited through Amazon's Mechanical Turk. Participants completed questionnaires about their paraphilic interests and behaviors, as well as potential key factors linked to behavioral engagement (i.e., perceptions of consent, sexual excitation/inhibition, impulsivity, moral disengagement, empathy). Results indicated that higher moral disengagement and impulsivity, lower sexual control (i.e., high sexual excitation, low sexual inhibition), and maladaptive understandings of consent were best able to differentiate individuals who reported highly stigmatized (e.g., hebephilia, pedophilia, coprophilia) or Bondage and Dicipline, Dominance and Submission, Sadism and Masochism(BDSM)/Fetish paraphilic interests and engagement in the paraphilic behaviours associated with these interests relative to individuals who did not report such paraphilic interests or behaviors. Moreover, higher moral disengagement, impulsivity, and maladaptive perceptions of consent were best able to differentiate non-consensual paraphilic interests and behaviours (e.g., voyeurism, exhibitionism) compared to individuals who did not report these paraphilic interests or behaviours. These results provide future directions for the exploration of mechanisms that may contribute to engagement in paraphilic behaviors and may be targets for intervention aimed at preventing engagement in potentially harmful paraphilias.

Influence of social media on how college students perceive healthy relationships and consent

Objective: Because of the high rates of sexual assault on college campuses, it is important to examine factors that influence perceptions of healthy relationships and consent, including social media. Because college students are heavy users of social media, it is imperative to consider how social media can influence their participation in risky behavior, including the attitudes and norms around sex and relationships. Participants: Undergraduate college students were recruited to participate in a study that sought to understand how college students navigate romantic and sexual relationships. Methods: Participants (N = 392) completed a survey that assessed social media use, and how they perceived healthy relationship behavior and consent. Results: Results showed social media had more of an influence on perceptions of healthy relationships. However, the influence of social media on consent and healthy relationships is inconsistent across platforms; emphasizing the need for further research.

Orgasm and Faking Orgasm: Heterosexual Interactions in China

This article examines the prevalence and correlates of orgasm and faking orgasm in the last year among a representative sample of Chinese men and women. Existing research on orgasm in China has largely been confined to medical research. To our knowledge, no published studies have examined faking orgasm in a Chinese context. These data come from the Chinese Health and Family Life Survey (CHFLS) conducted in 1999 and 2000. We used multivariable logistic regression to identify independent correlates of orgasm and faking orgasm among 1496 women and 1497 men, ages 20-64. In accounting for orgasm and faking orgasm in China, we found evidence that men and women are trying to manage social expectations and to act in accordance with gender expectations, consistent with research in other countries. Results provide insight into how specific sexual practices (e.g., oral sex) and interactional pressures (e.g., insecurity) are correlated with orgasm and faking orgasm. Findings pave the way for future research on the presence of gender inequality as evidenced through lower orgasm rates among women and higher rates of faking orgasm. These findings have implications for how we conceptualize and study gendered and interactional components of sex, which are often overlooked in research and programmatic efforts in China.

Sexual diversity on college campuses: using a BDSM framework to discuss consent

Sexual assault in higher education is a continuing concern. At the same time, college students are engaging in a range of consensual sexual behaviors that could appear to be sexual violence. Sexuality education on college campuses should address the spectrum of sexual behaviors and college health professionals and administrators need to be able to distinguish consensual rough sex from sexual violence. Common consent negotiations in BDSM (bondage and discipline, dominance and submission, sadism and masochism) contexts may serve as an appropriate model for acquiring consent. This viewpoint article aims to (1) review the increased participation of college students in diverse sexual behaviors, and (2) introduce the consent process of BDSM as a framework for college health professionals to discuss consent for other sexual behaviors.

Sexual consent norms in a cross-sectional national sample of the UK

BACKGROUND

Sexual assault is a pervasive problem in the UK, and young women are disproportionately affected. We sought to provide an initial account of sexual consent norms in the UK and whether they differ by gender and age.

METHOD

The present study was a secondary analysis of data collected by the Family Planning Association, which conducted an online survey (N = 2003) to assess experiences with, knowledge of, and attitudes toward consent. The sample represented all regions of the UK and spanned ages 14-55.

RESULTS

Definitions of sexual consent endorsed by women and older age groups more closely aligned with the tenets of affirmative consent compared with men and younger age groups. Women and older age groups were also more likely to perceive that various nonverbal cues may be used to interpret sexual consent or refusal and were more supportive of people being able to withdraw their sexual consent.

CONCLUSION

Maladaptive sexual consent norms seemed to be prevalent among men and young people in the UK, which may contribute to young women's elevated risk of experiencing sexual assault. Our findings support the UK's recent relationships and sex education curriculum that actively promotes healthy sexual consent norms.

Interpersonal scripts and sexual communication: experiences and perspectives of young people in St. Petersburg, Russia

In Russia, young adults face many barriers that prevent them from accessing reliable and up-to-date knowledge about what sexual communication between partners can look like. This may lead to episodes of sexual miscommunication, which in turn sometimes result in sexual aggression. The study aimed to identify how following prevalent sexual scripts facilitates clear sexual communication or alternatives leads to miscommunication between Russian young adults. Individual in-depth interviews were conducted with 14 women and 11 men aged 19-25 years living in St. Petersburg (Russia) who had had at least one sexual partner of the opposite sex. Data were analysed thematically. Four themes were developed from the interviews: (1) endorsing (or not endorsing) traditional sexual scripts, (2) the presence or absence of sexual compliance, (3) softening refusal of sexual contact or intercourse, (4) the belief that asking for consent is unusual. Findings indicate that patterns and clarity of sexual communication differ depending on the type of relationship (serious, casual, and other), its stage, and partners' beliefs. Study findings underscore the need for sex and sexuality education for young people in Russia.