Alcohol consumption and women's vulnerability to sexual victimization: can reducing women's drinking prevent rape?

The role of recurrent trauma on post-traumatic stress disorder symptoms and substance use among trauma exposed youth

Comorbidity between post-traumatic stress disorder (PTSD) and substance use disorder may be explained by a prospective trauma risk conferred by both conditions. The current study modeled concurrent and prospective associations of trauma, PTSD symptoms, and substance use (SU) behavior among trauma exposed youth (ages 8-20). Clinical interviews assessed trauma exposure, PTSD symptom severity, and SU behavior at baseline and at six- and 12-month follow up study visits (N = 2,069). Structural equation models assessed the associations of trauma, PTSD symptoms, and SU behavior. Lifetime trauma was associated with more severe PTSD symptoms and SU behaviors, whereas trauma exposure during the study was only associated with PTSD symptoms. PTSD symptom severity was prospectively associated with trauma exposure. PTSD symptom severity and SU behavior at follow-up study visits were prospectively associated. These results highlight the dynamic interplay between trauma, PTSD symptoms, and SU behavior during youth, a developmental period during which complex psychiatric presentations can have longstanding consequences for health.

Precollege Risk Markers for College Rape and Verbal Sexual Coercion: Same or Different?

Verbal sexual coercion (VSC) and rape are common experiences among college women. Although they have been theorized to involve different risk markers, few prospective studies have examined predictors of VSC and rape separately. The present prospective study was designed to identify precollege risk markers for VSC and rape in first-year college women, with the goal of considering the degree to which they overlap or differ. Women (N = 449) recruited from the community just prior to high school graduation completed measures of sexual victimization (SV) since age 14 but prior to college, sexual refusal assertiveness, high school heavy episodic drinking (HED), college drinking intentions, and sociosexuality. Follow-up surveys at the end of the first and second college semesters assessed VSC and rape. Using the Sexual Experiences Survey's severity scoring method, women were classified into one of three groups according to the most severe type of SV reported in the first year of college: neither VSC nor rape (71%), VSC (16%), and rape (13%). Most women who experienced rape (73%) also experienced VSC. Precollege SV and college drinking intentions predicted both rape and VSC. Sexual refusal assertiveness and high school HED did not independently predict either form of victimization. Sociosexuality predicted rape but not VSC. Findings suggest a substantial overlap in the predictors of VSC and rape and support the severity continuum underlying many conceptualizations of SV.

Examining the Risks of Multiple Types of Interpersonal Victimization for Transgender and Gender Non-Conforming College Students

Recent research has shown that transgender and gender non-conforming (TGNC) individuals are at risk of experiencing interpersonal violence, yet there may be differences within this group and across victimization types. The current study examined rates of seven types of interpersonal victimization based on six gender identities (cisgender women, cisgender men, trans women, trans men, nonbinary, and another identity) among a national study of college students. Data from the Spring 2021 American College Health Association's National College Health Assessment III (ACHA-NCHA III), a national-level study of U.S. college students, were used. We examined the association between gender identity and seven types of interpersonal violence victimization (violent victimization, sexual victimization, intimate partner violence victimization, stalking, bullying, microaggression, and discrimination) that occurred within the past 12 months. Logistic regression analyses were performed to examine if, when controlling for competing factors, gender identity was associated with an increase in the expected odds of victimization for each victimization type. Analyses revealed that TGNC college students reported experiencing a greater amount of all seven types of victimization compared to cisgender college students. These findings corroborate previous research indicating that rates of interpersonal violence are higher among TGNC college students compared to those who identify as cisgender, even after controlling for sexual orientation, related demographic factors, and substance use. Findings from the current study suggest that there are differences within individuals who identify as TGNC in terms of their risk for interpersonal victimization and that rates differ across victimization types. More work is needed to provide tailored prevention programming for TGNC college students.

Longitudinal associations among experiences of sexual assault, posttraumatic stress disorder symptoms, and heavy drinking in young adults

Prior research with young adults has demonstrated clear associations between experiences of sexual assault, symptoms of posttraumatic stress disorder (PTSD), and alcohol use, but most studies have been cross-sectional or have not considered multiple theoretical pathways to understand these associations. Using six waves of data from a longitudinal cohort sample of 1,719 young adults, we examined associations among experiences of past-year sexual assault (i.e., rape, unwanted sexual touching, and physical intimidation in a sexual way), PTSD symptoms, and the frequency of binge drinking over time, allowing for the exploration of symptom-induced, interpersonal risk, and substance-induced pathways for male and female participants. For both male, βs = 2.84 to 6.55, and female participants, βs = 2.96 to 10.1, higher prior levels of PTSD symptoms were associated with larger increases in binge drinking over time. For female participants, higher prior levels of sexual assault were associated with larger increases in PTSD symptoms over time, βs = 3.48 to 4.25, whereas for male participants, higher prior levels of past-year binge drinking were associated with decreases in PTSD symptoms over time, βs = -2.75 to -0.53. Continued efforts are needed to prevent sexual assault among young adults and address PTSD symptoms among those who experience sexual assault. Interventions that target binge drinking are also needed for individuals who experience PTSD symptoms, especially young adults, to address potentially hazardous drinking before problems escalate and become chronic.

Emotion Regulation Difficulties Moderate the Association Between Typical Drinking and Sexual Assault Victimization Among Sexual and Gender Minority University Students

Sexual and gender minority (SGM) students report higher alcohol consumption, emotion regulation difficulties, and sexual assault victimization severity than cisgender, heterosexual individuals. A sample of 754 undergraduate students completed an online survey assessing alcohol use, emotion regulation, and sexual victimization. Regression analyses indicated that, among SGM students with higher emotion regulation difficulties, typical weekly drinking was positively associated with sexual assault victimization severity, but among cisgender, heterosexual students and SGM students with lower emotion regulation difficulties, there was no association between drinking and victimization severity. Thus, SGM students benefit from interventions targeting alcohol use and emotion regulation difficulties.

Incapacitated and/or Forcible Rape Experience Predicting College Women's Rape Victim Empathy

Rape experience is common and victim empathy may help address it (e.g., prevention, victim support). We examined rape victim empathy based on type of rape experience (none, incapacitated, forcible, combined). Undergraduate women (n = 658) completed the Rape Victim Empathy-During Subscale and Sexual Experiences Survey-Short Form Victimization. Rape experience was associated with greater empathy, especially for those with any forcible experience. Perhaps due to weaker memory of their own rape event, incapacitated victims may be relatively less able than forcible victims to understand another victim's perspective during a rape. Researchers should consider examining incapacitated and forcible rape as distinct experiences.

Race-based Traumatic Stress Predicts Risky Drinking, Over and Above Negative Affect, and Non-race-related Trauma Symptoms in Racial/Ethnic Minority Female College Students

OBJECTIVES

Alcohol misuse remains a major concern in college student populations and rates of risky and problematic drinking are specifically on the rise for women. One important factor that has been shown to be positively associated with substance use/misuse for women from historically marginalized or minoritized racial/ethnic backgrounds is exposure to racial discrimination and possible resulting traumatic stress reactions. Questions remain about the relationship between race-based traumatic stress and risky drinking particularly among diverse female college students who are at greater risk due to their marginalized status in their racial/ethnic and gender groups.

DESIGN

The current study examined race-based traumatic stress as a unique predictor of risky drinking when controlling for negative affectivity and general trauma symptoms, additional risk factors for risky drinking in women.

RESULTS

Hierarchical linear regressions revealed that race-based traumatic stress made a significant and unique contribution to the amount of variance in risky drinking, above negative affectivity, and general trauma symptoms.

CONCLUSION

These findings highlight the importance of considering experiences of racism as risk factors in substance use prevention and intervention, specifically for female college students from marginalized or minoritized racial/ethnic backgrounds.

Sexual violence against sexual minority women in STEM: Compound backlash

BACKGROUND

Recent research has found that gender parity (i.e., the ratio of women to men) in Science, Technology, Engineering, and Math (STEM) disciplines is associated with sexual violence (SV) victimization for women. This finding may reflect a type of backlash wherein SV is a means of punishing women who are perceived to be violating their gender roles and threatening the male hegemony. Sexual minorities, who are likewise disproportionately victims of SV, report experiencing heterosexist hostility and harassment in STEM disciplines. There is reason to suspect that the combination of these marginalized identity positions (e.g., a sexual minority woman in gender-balanced STEM) may amplify perceived gender role violations and exacerbate the risk of SV victimization.

METHODS

Data were collected from undergraduate women at five institutions of higher education in the United States. Sampling was stratified by STEM vs. non-STEM majors and male-dominated vs. gender-balanced majors. Sexual violence was measured via the revised Sexual Experiences Survey. We tested the interaction of sexual minority status and gender parity in STEM on SV via fixed effects OLS regression.

RESULTS

Sexual minority women in gender-balanced STEM were most frequently victims of SV. Women in male-dominated STEM majors were at no greater risk of SV victimization, regardless of sexual minority status, than their peers in non-STEM majors.

IMPLICATIONS

These findings suggest the possibility of a compound form of backlash, wherein women are exponentially victimized because their sexual identity and their membership in these STEM fields are seen as dual challenges to the male hegemony. If true, this could exacerbate health disparities rather than promote health equity for these sexual minority women. Findings point to the ongoing need to challenge hegemonic gender norms, focus prevention programs on populations most at risk, and ensure they are provided the appropriate resources for support.

Do Risk Factors for Incapacitated and Other Sexual Assault Differ for Black and White College Women? A Preliminary Investigation

Heavy episodic drinking (HED) and hookups are risk factors for college women's sexual assault (SA). Black women engage in these behaviors less frequently than White women. We prospectively examined HED and hookups as mechanisms of incapacitated SA (ISA) and other SA (OSA) risks for Black and White first-year college women and sociocontextual factors that may contribute differentially to risk. In mediation analyses, Black women's less frequent HED predicted lower ISA. SA characteristics (e.g., setting) also differed by race. Mechanisms and types of assault risk may not be the same for all college women, an important consideration for intervention efforts.

Alcohol-related sexual harassment in the workplace: A between and within industry analysis

INTRODUCTION

Sexual harassment as a political/legal issue was revitalised by the #MeToo movement in 2017. We estimate the prevalence and development of alcohol-related sexual harassment (ASH) across industries over the years 2015 to 2021, including potential changes from 2017, and assess differences in the risk of ASH according to industry- and individual-level characteristics.

METHODS

Based on annual surveys (2015-2021) among employees in 21 Norwegian industries (observations N = 11,512, individuals N = 6353). Age range 20-69 years, 48% women. Associations between ASH and industry- and individual-level demographics, work autonomy, work-related drinking and intoxication were estimated in linear probability models RESULTS: ASH prevalence was 6% between 2015 and 2021 and varied between 4% and 13% across industries. Men showed a gradual increase in ASH from 2015 to 2021. The was no significant trend among women or a change after #MeToo. Industries with older employees, more women and frequent intoxication at work-related occasions had more ASH, while those with more highly educated employees had less. At the individual level, frequent work-related drinking occasions, tendency to get intoxicated at these occasions, being a woman and younger age were associated with more ASH. We found no individual- or industry-level association between work autonomy and ASH.

DISCUSSION AND CONCLUSIONS

Annually, 6% of Norwegian employees experience alcohol-related sexual harassment in work-related settings. The risk of ASH is higher among employees who are young, female, frequently drink and drink to intoxication at work-related events, and that work in industries with older employees, more women, less formal education and frequent intoxication.

Sexual Victimization in Adolescence: Pathways of Risk from Sexual Harassment via Risky Alcohol Use and Delinquency Among U.S. Adolescents

Sexual harassment is a common, yet understudied form of peer victimization experienced by adolescents during a critical period in the development of sexual identity. Adverse sexual experiences early in life (e.g., child sexual abuse) can increase risk of future sexual assault victimization; however, it is unclear as to whether sexual harassment victimization is also a risk factor for sexual assault. We examined the prospective association between peer sexual harassment and experiencing sexual victimization in the following year among a community sample of 13-15-year-old adolescents (N = 800, 57% female) from the northeastern USA. We also examined whether risky alcohol use and delinquency mediated the association between sexual harassment and sexual assault victimization, as well as whether the paths differed by gender. Results indicated that sexual harassment victimization prospectively predicted later sexual victimization for both girls and boys. Using a parallel mediation path model, we determined that for girls, sexual harassment victimization predicted both risky alcohol use and delinquency, but only risky alcohol use was predictive of sexual victimization. For boys, sexual harassment victimization predicted delinquency but not risky alcohol use. Risky alcohol use was not associated with sexual victimization for boys. Findings indicate that sexual harassment victimization increases risk of later sexual victimization in adolescence, but the pathways differ by gender.

"Letting Go and Staying Connected": Substance Use Outcomes from a Developmentally Targeted Intervention for Parents of College Students

We present results of a randomized, controlled, efficacy trial of a handbook intervention for parents of first-year college students. The aim of the interactive intervention was to decrease risk behaviors by increasing family protective factors. The handbook, based in self-determination theory and the social development model, provided evidence-based and developmentally targeted suggestions for parents to engage with their students in activities designed to support successful adjustment to college. We recruited 919 parent-student dyads from incoming students enrolled at a university in the U.S. Pacific Northwest and randomly assigned them to control and intervention conditions. We sent handbooks to intervention parents in June before students' August matriculation. Research assistants trained in motivational interviewing contacted parents to encourage use of the handbook. Control parents and students received treatment as usual. Participants completed baseline surveys during their final semester in high school (time 1) and their first semester at college (time 2). Self-reported frequency of alcohol, cannabis, and simultaneous use increased across both handbook and control students. In intent-to-treat analyses, odds of increased use were consistently lower and of similar magnitude for students in the intervention condition than in the control condition, and odds of first-time use were also lower in the intervention condition. Contact from research assistants predicted parents' engagement, and parent and student report of active engagement with handbook predicted lower substance use among intervention than control students across the transition to college. We developed a low-cost, theory-based handbook to help parents support their young adult children as they transition to independent college life. Students whose parents used the handbook were less likely to initiate or increase substance use than students in the control condition during their first semester in college.ClinicalTrials.gov Identifier: NCT03227809.

Examining gender and the longitudinal effect of weight conscious drinking dimensions on body mass index among a college freshman cohort

Objective: This study aims to: (1) examine gender differences for weight conscious drinking among college students accounting for the broader phenomenon (e.g. including the Alcohol Effects dimension); and (2) longitudinally examine the effect of weight conscious drinking behaviors on body mass index (BMI). Participants: United States freshmen students from eight participating universities (N= 1,149). Methods: Structural equation modeling was used to model the effect of gender on weight conscious drinking dimensions at 7-month follow-up. Results: Findings suggest a significant effect of gender on Alcohol Effects (β = -.15, SE = .05, p = .005) at 7-month follow-up among college freshmen. Weight conscious drinking dimensions predicted no significant change in BMI at 7-month follow-up among college freshmen. Conclusion: Findings contribute to weight conscious drinking theory and provide campus weight conscious drinking prevention initiatives with evidence to tailor their programming to address female tendencies to engage in compensatory strategies to enhance the psychoactive effects of alcohol.

The Role of Coping Behaviors and Intoxication in Trauma Symptomology Subsequent to Sexual Victimization

College women are at an elevated risk for sexual victimization (SV) and secondary physical and psychological consequences. While some women experience negative outcomes such as posttraumatic stress disorder (PTSD), others experience reduced or complete absence of distress following SV. The variation in outcomes may be associated with the victim's level of intoxication, which may in turn affect their processing of and coping with the event. We examined the effects of SV severity on PTSD via coping and intoxication using a moderated mediation analysis among female college students (N = 375). Results demonstrate that coping mediates the association between SV severity and PTSD symptomology; however, intoxication did not moderate these associations. Results suggest that regardless of intoxication, SV severity influences various coping styles and plays an important role in a victim's adjustment post-victimization.

A Web-Based Sexual Violence, Alcohol Misuse, and Bystander Intervention Program for College Women (RealConsent): Randomized Controlled Trial

BACKGROUND

Sexual violence (SV) incidence among college women has been invariant for the past 20 years. Innovative prevention strategies that are low resource and technology driven but demonstrate efficacy are greatly needed.

OBJECTIVE

The aim of this study was to determine the efficacy of a novel theoretically driven internet-based intervention for first-year college students who identify as women (RealConsent) in reducing their risk of exposure to SV and alcohol misuse as well as increasing alcohol protective and bystander behaviors.

METHODS

This randomized controlled trial involved first-year college students who identified as women (n=881) attending 1 of 3 universities in the southeastern United States. Participants aged 18 to 20 years were randomized to RealConsent (444/881, 50.4%) or to an attention-matched placebo control (437/881, 49.6%). RealConsent is fully automated and consists of four 45-minute modules that incorporate entertainment-education media and proven behavior change techniques. The primary outcome was exposure to SV; the secondary outcomes were alcohol protective behaviors, dating risk behaviors, alcohol misuse, and bystander behavior. Study outcomes were assessed at baseline and 6-month follow-up.

RESULTS

Among participants with some exposure to SV, those in the RealConsent group experienced less exposure to SV than the placebo group (adjusted incidence rate ratio 0.48, 95% CI 0.33-0.69; P=.002). Furthermore, participants in the RealConsent group engaged in more alcohol protective behaviors (adjusted odds ratio 1.17, 95% CI 0.12-2.22; P=.03) and were less likely to binge drink (adjusted incidence rate ratio 0.81, 95% CI 0.67-0.97; P=.003). Finally, participants in the RealConsent group who had 100% dosage were more likely to engage in bystander behavior than those with <100% dosage plus placebo group (adjusted odds ratio 1.72, 95% CI 1.17-2.55; P=.006).

CONCLUSIONS

A comprehensive exposure to SV, alcohol use, and bystander educational program was successful in decreasing the occurrence of exposure to SV among those most at risk and in increasing alcohol protective behaviors. Because of its web-based and mobile technologies, RealConsent can be easily disseminated and holds potential for reducing campus SV.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03726437; https://clinicaltrials.gov/ct2/show/NCT03726437.

Violence Victimization and Alcohol Use Among Venue-Based Female Sex Workers in Pattaya, Thailand: Unpacking the Temporal Relationship

Female sex workers (FSWs) face prevalent violence victimization and alcohol consumption at work, yet the bidirectional pathways between these factors are not well defined. Using cohort data from 232 venue-based FSWs in Pattaya, associations of violence and alcohol use were examined within a time period and prospectively via structural equation models. Within the time period, violence victimization and alcohol use were consistently associated; by contrast, violence was not prospectively associated with FSW alcohol use. Findings define alcohol as an important risk factor for violence in sex work environments. Alcohol safety interventions should be explored as a vital component of FSW violence prevention.

"Are they into each other?" What drinking alcohol and leaving a party together signal to college students about sexual intent

OBJECTIVE

Misperception of sexual intent is linked to incidence of sexual assault. The present study tested the effects of gender, alcohol consumption, and leaving a party together, in isolation and in interaction, on perceptions of sexual intent.

PARTICIPANTS

Undergraduates (N = 438) completed an online survey between Winter 2017 and Winter 2018.

METHODS

Participants read one of eight versions of a vignette about a social interaction between male and female college-aged acquaintances and rated the targets' sexual interest in each other. Who was consuming alcohol (both targets, female only, male only, or neither) and whether the targets left together were manipulated.

RESULTS

Alcohol consumption and leaving together interacted. Leaving together signified to participants that both targets had greater sexual intent. When targets left separately, participants viewed both targets as less sexually interested in each other when only the female was drinking.

CONCLUSIONS

Implications for sexual assault on college campuses are discussed.

The role of positive affect in the association between stress and college student alcohol use

OBJECTIVE

To examine the associations among stress, positive affect, binge drinking, and coping drinking motives.

PARTICIPANTS

Students (n = 351, M_age=19.7, 74.6% female) at a northeastern public university.

METHODS

Participants completed an online survey assessing perceived stress, frequency of experiencing positive emotions, frequency of binge drinking, and coping drinking motives.

RESULTS

Stress and positive emotions were not significantly related to frequency of binge drinking but were significantly correlated with coping motives for drinking. Regression analyses with all predictors, age, and gender in the model revealed the same: stress and positive emotion were not significantly related to binge drinking but were significantly related to coping motives. The interaction between stress and positive emotions predicting frequency of binge drinking or coping motives was nonsignificant.

CONCLUSIONS

Findings suggest the utility of exploring positive emotions in risk and resilience research focused on college student drinking and of targeting positive emotions to decrease students' coping-related alcohol use.

Student-Athlete Preferences for Sexual Violence Reporting: A Discrete Choice Experiment

BACKGROUND

Sexual violence (SV) is prevalent among US college athletes, but formal reports are rare. Little is known about adaptations to institution-level reporting policies and procedures that could facilitate reporting.

METHODS

We conducted a discrete choice experiment (DCE) survey with 1004 student-athletes at ten Division I NCAA member institutions to examine how attributes of the reporting system influence the decision to formally report SV to their institution. Changes in utility values were estimated using multinomial logistic regression and mixed multinomial logistic regression. Importance scores were compared to understand student-athlete preferences.

RESULTS

In order of relative importance, the two attributes most preferred by student-athletes were higher probabilities of students perpetrating SV being found in violation of code of conduct policies (relative importance score = 33), and the availability of substance use amnesty policies (relative importance score = 24). Student-athletes with prior SV experiences were more likely to opt out of formally reporting in the DCE paired choice, had lower estimated utility values for all attributes, and had less between-person heterogeneity. While anonymous reporting and survivor-initiated investigations were preferred by student-athletes on average, there was considerable valuation heterogeneity between student-athletes (sizeable deviations from mean estimated utilities). These two attributes also varied in relative importance; anonymous reporting had higher relative importance after interacting levels with prior SV experiences and competitive status, but lower relative importance after interacting levels with whether a student-athlete played on men's or women's sports teams.

CONCLUSIONS

Changes to reporting policies and procedures (e.g., transparency about SV reporting outcomes, implementing substance use amnesty policies) may be promising institution-level interventions to increase formal reporting of SV among student-athletes. More research is needed to understand preference heterogeneity between students and generalize these findings to broader student populations.

Institution of Higher Education Substance Use Amnesty Policies and Sexual Violence Reporting

Sexual violence (SV) is common among college students, but the vast majority of these experiences are not formally reported to institutions of higher education (IHEs). While it is well known that alcohol and drug use is highly associated with SV, little is known about whether policies and procedures regarding substance use (SU) at IHEs may contribute to low rates of reporting. This study describes the association between SU violations and SV reporting at IHE campuses in the US and examines whether SU amnesty policies are associated with more SV reporting. Linear regression was used to estimate the association between SU violations and SV reporting and assess differences between IHE campuses by amnesty policy status. Around 50% of campuses between 2001 and 2018 document neither SV reports nor SU violations. IHE campuses with amnesty policies have more SV reports. On average, IHEs with amnesty policies have 2.7 SV reports per 1000 students and an additional 0.02 SV reports for each SU violation per 1000 students. Amnesty policies that reduce the potential costs of reporting like facing disciplinary action for alcohol or drug use are positively associated with both the level and rate of SV reporting. Institutions of higher education administrators interested in making reporting an option for more SV survivors should examine how their policies, especially those related to alcohol, may play in creating barriers to SV reporting.

Teen Well Check: an e-health prevention program for substance use, sexual assault, and sexual risk behaviors for adolescents in primary care

Objective: Adolescents are at risk for substance use, sexual assault, and sexual risk behaviours; however, to date no integrated prevention programmes address all three risk behaviours. The goal of this study was to evaluate the usability and acceptability of Teen Well Check, an e-health prevention programme targeting substance use, sexual assault, and sexual risk among adolescents in primary care settings.Methods: The current study included content analysis of interviews with adolescents in primary care (aged 14-18; n = 25) in the intervention development process, followed by usability and acceptability testing with qualitative interviews among adolescents in primary care (aged 14-18; n = 10) and pediatric primary care providers (n = 11) in the intervention refinement process. All data were collected in the Southeastern U.S.Results: Feedback on Teen Well Check addressed content, engagement and interaction, language and tone, aesthetics, logistics, inclusivity, parent/guardian-related topics, and the application of personal stories. Overall, providers reported they would be likely to use this intervention (5.1 out of 7.0) and recommend it to adolescents (5.4 out of 7.0).Conclusions: These findings suggest preliminary usability and acceptability of Teen Well Check. A randomized clinical trial is needed to assess efficacy.

Sexual Harassments Related to Alcohol and Drugs Intake: The Experience of the Rape Centre of Turin

A cross-sectional study was conducted that describes the characteristics of sexual violence episodes related to the intake of alcohol and drugs observed among women that turned to the "Centro Soccorso Violenza Sessuale" (SVS) of the Sant'Anna Hospital in Turin between 1 January 2008, and 31 December 2017. Two hundred twenty-two patients were enrolled, 25 of which were minors, 141 were Italians, and most of them knew their aggressor and were raped in a private home. One hundred and fifty-five of them declared to the healthcare personnel to have taken alcoholic substances and/or drugs in conjunction with the event (86 reported having drunk alcohol, 36 having taken drugs and 33 disclosed both alcohol and drug abuse). If the woman knew her abuser, alcohol consumption was described as voluntary in more than 80% of cases, while in relation to drugs the consumption was equally voluntary or fraudulent. About 73% of women who reported having drunk alcohol just had amnesia or amnesia related to other symptoms, while amnesia was present in about 63% of women who reported only drug use. Physicians observed physical injuries on 156 women. Patients who reported to have assumed alcohol presented a significantly higher risk to suffer any physical injury and have a significantly increased risk to suffer injuries to their head and/or neck. The results obtained underline how even in Northern Italy alcohol intake represents the most widespread psychoactive substance in case of drug-facilitated sexual assault. There is therefore a need to promote education and prevention campaigns among citizens, especially among the youngest.

Correlates of Bystander Intervention Among Heavy Drinking College Men

The present study utilized survey assessments to examine correlates of bystander intervention intentions among heavy drinking college men (N = 210). Intentions to engage in bystander intervention were associated with fewer heavy drinking days, lower alcohol-related consequences, greater use of strategies to limit drinking, and lower endorsement of alcohol expectancies. A range of constructs commonly associated with perpetration of sexual aggression demonstrated a negative association with intentions to engage in bystander intervention. Multivariate analyses revealed that greater use of strategies to limit drinking and lower pornography use emerged as predictors of intentions to engage in bystander intervention.

Perceived Realism and Wishful Identification: College Students' Perceptions of Alcohol Ads and Their Intentions to Sexually Coerce with or Without Using Alcohol

Sexual coercion is a serious health problem in the United States, and it is the most prevalent form of sexual victimization that occurs on college campuses. The present study aimed to identify factors, such as exposure to objectified women in alcohol advertisements, that may contribute to college students' intentions to sexually coerce with alcohol use and without alcohol use. We also investigated the potential effects of gender stereotypes, wishful identification of alcohol ads, perceived realism of alcohol ads, and alcohol expectancies related to sexual enhancement on students' intentions to coerce. An online experiment was conducted with 1208 students from a large Northwestern university. Participants were randomly assigned to two conditions in which they were exposed to alcohol advertisements that included either highly objectified images of women or low-objectified images of women. The regression analyses indicate beliefs in gender stereotypes were the most consistent predictor across women and men's sexually coercive intentions, regardless if alcohol was used. Wishful identification with models in alcohol advertisements was positively associated with intentions to coerce, and perceived realism of alcohol ads was negatively associated with intentions to coerce. For college men's intentions to sexually coerce using alcohol, there were significant interaction effects between exposure to highly objectified advertisements and gender stereotypes. For women's intentions to sexually coerce using alcohol, the interaction between wishful identification and perceived realism was significant. Education efforts are needed to deal with the endorsement of gender stereotypes on college campuses. Media literacy may help college students critically evaluate portrayals of women in the media, and thus, in turn, may help lower intentions to sexually coerce.

Sexual Assault: Approach to Reality in the Area of Santiago de Compostela (Galicia, Spain) through a 12-Year Retrospective Study

Sexual assault constitutes a severely traumatic experience that impacts the lives of far too many victims each year. The underlying behaviors of the offenders are often associated with psychological, physical and social distress, and the use of psychotropic substances was found in a good number of cases. A descriptive and retrospective review of sexual assault cases has been undertaken to identify trends in the toxicology findings in Drug-Facilitated Sexual Assault in Santiago de Compostela over the past 12 years. During this period, a total of 69 cases were referred to the Forensic Toxicology Service as sexual assault cases. The sex and age distribution of the cases showed that females between the ages of 14 and 65 years constituted the group most frequently submitted to sexual assault, with a peak of 55.1% in the 18- to 30-year age group. Alcohol consumption was positive in 77.1% of positive cases determined, followed by drugs (34.4%) and illicit drugs (26.2%). Our results showed a high percentage of alcohol consumption in sexual assault cases.

Direct and Indirect Exposure to Trauma, Posttraumatic Stress Disorder Symptoms, and Poor Subjective Sleep Quality in Patients with Substance Use Disorder

Background

Despite the frequent co-occurrence of posttraumatic stress disorder and substance use disorder, screening for trauma exposure and posttraumatic stress disorder symptoms is not a routine practice in substance use disorder clinics. The aims of this study were to examine the prevalence of exposure to traumatic events, posttraumatic stress disorder symptoms, and subjective sleep quality in substance use disorder inpatients after detoxification. In addition, we analyzed associations of sociodemographics, direct and indirect exposure to traumatic events, and sleep quality with posttraumatic stress disorder symptom severity.

Methods

Adults diagnosed with substance use disorder (n = 188; 25% women, mean age 46.6 ± 12.3 years) from 2 inpatient addiction clinics were assessed at approximately 4 days post-admission for age, gender, educational level, self-reported substance use, trauma exposure, general and posttraumatic stress disorder-specific subjective sleep quality, and posttraumatic stress disorder symptom severity. Correlates of posttraumatic stress disorder symptom severity were identified with linear regression analyses.

Results

The prevalence of direct trauma exposure was high (89%), 51% of participants screened positive for posttraumatic stress disorder and 87% reported clinically significant poor sleep quality. Younger age, female gender, direct and indirect exposure to more traumatic events, and poor subjective sleep quality were associated with more severe posttraumatic stress disorder symptoms.

Conclusion

Nearly all substance use disorder patients admitted for detoxification in our study had been directly or indirectly exposed to 1 or more traumatic events, and many reported posttraumatic stress disorder symptoms and poor sleep quality. Younger and female substance use disorder patients were at higher risk of posttraumatic stress disorder symptoms. Our results emphasize the need for systematic screening for direct and indirect trauma exposure, posttraumatic stress disorder symptoms, and poor sleep quality in patients admitted for clinical substance use disorder treatment.

An Ecological Momentary Assessment of College Women's Decisions to Use Protective Behavioral Strategies

Protective behavioral strategies (PBS) have been associated with reduced risk for sexual assault victimization in college women. Sexual assault risk reduction programs have had limited success increasing PBS use, particularly among heavy drinkers, suggesting a need for additional research on the malleable predictors of PBS use. Whereas longitudinal studies show women's decisions to use PBS can be both planned and reactive, little is known about the decision-making processes that affect PBS use on drinking days, when sexual assault risk may be elevated. The current study used ecological momentary assessment to examine variability in the associations between decision-making and PBS use within and across drinking days in first-semester college women. Participants (56 female drinkers) completed a 14-day protocol with three daily measures of intentions and willingness to use PBS, and once-daily diaries of PBS use. Multilevel models examined between-day and within-day effects of intentions and willingness to use PBS with regards to sexual assault PBS (e.g., communicating sexual boundaries) and drinking PBS (e.g., limiting alcohol consumption), respectively. On days when sexual assault PBS willingness increased throughout the day, women tended to use more sexual assault PBS. This association was strongest among women who were typically less willing to use these PBS. Among women who were the least willing to use drinking PBS, their drinking PBS use decreased on days when they reported increased willingness to use them. Decisions to use sexual assault and drinking PBS on drinking days were qualified by women's typical levels of willingness to use the different PBS. This suggests the need for a multi-faceted intervention strategy that targets both typical and event-level risk. Individual-level alcohol and sexual assault risk reduction approaches could be enhanced with event-level PBS messaging and evaluation.

Increased Risk for Sexual Violence Victimization on Drinking Days Involving Pregaming

Alcohol consumption has been associated with increased risk for sexual violence victimization and perpetration. Pregaming, a popular activity among college students that involves heavy and quick drinking prior to going out for the night and often results in high blood alcohol levels (BALs), may convey increased risk for sexual violence-potentially due to greater likelihood of contact with intoxicated perpetrators and significantly impaired victim ability to consent or resist. Yet no published work has evaluated whether there is increased risk for victimization on drinking days that involve pregaming. Using a sample of 390 college student drinkers who completed a past 30-day Timeline Followback, we examined heavy drinking behavior, estimated BALs, and experience of sexual violence victimization during 1,899 drinking days, of which 30% involved pregaming. After controlling for demographics, we found that participants drank approximately two more drinks and reached significantly higher BALs on drinking days where they pregamed as compared to drinking days where they did not pregame. Nearly 6% of drinking days that included pregaming involved sexual violence victimization, compared to about 2% of drinking days where pregaming did not occur. Participants were at 2.71 times the odds of experiencing sexual violence, primarily unwelcomed comments and nonconsensual sexual touching, during drinking days with pregaming. This study represents a first step toward greater understanding of the sexual violence and pregaming link, but future research assessing perpetrator behavior and context-specific factors (e.g., amount consumed by victims and perpetrators, location of sexual violent events and peers present) are needed.

A Qualitative Analysis of Sexual Consent among Heavy-drinking College Men

The current study sought to examine how heavy-drinking college men describe communication of sexual interest and sexual consent. Thematic analysis of semi-structured interviews with 12 heavy-drinking college men identified three themes. Themes included: (a) expectations about parties and sexual activity, (b) observing and communicating sexual interest, and (c) communication of sexual consent. Men reported visiting drinking environments to locate women who they assumed would be open to sexual advances. In these environments, sexual interest was inferred indirectly through shared alcohol use. Anticipating token resistance men reported "trying and trying again" to pursue escalating types of sexual activity. Consent was inferred when participants did not hear "no" from a sexual partner, highlighting the importance of continued education on verbal consent in the context of sexual assault prevention programs.

The differential effects of verbal sexual coercion and forcible sexual assault on alcohol use and consequence trajectories in the first year of college

OBJECTIVE

Verbal sexual coercion (VSC) is the most prevalent and pervasive form of sexual victimization that women experience, yet the long-term harmful effects of this type of experience are unknown. The current study examined the effects of verbal sexual coercion versus forcible sexual assault (FSA) on alcohol use and alcohol consequences, two deleterious outcomes that have been linked to sexual victimization.

METHOD

In a sample of college women (N = 649), lifetime history of VSC and FSA were examined as predictors of trajectories of alcohol outcomes with latent growth models. Participants were assessed at six timepoints over their first year of college, a critical transition period of increased risk for both alcohol use and trauma exposure. We also examined the influence of victimization characteristics, such as relationship to the perpetrator and revictimization experiences in these associations.

RESULTS

VSC experiences were predictive of higher levels of alcohol use and alcohol-related consequences (i.e., intercept). This risk was sustained throughout the first year of college. VSC experiences did not predict changes (i.e., slope) in alcohol outcomes over this time. In contrast, FSA was not predictive of either initial level or change in alcohol use and consequences over time.

CONCLUSION

Findings highlight the importance of distinguishing among types of coercive experiences, as they show unique associations with later harmful outcomes. Verbal sexual coercion, common in the lives of young women but often overlooked in the extant literature, is associated with substantial negative impact during the first year of college. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Prevalence and correlates of sexual violence among adolescent girls and young women: findings from a cross-sectional study in a South African university

BACKGROUND

Epidemiological data on the prevalence and factors associated with sexual violence is critical to understanding the magnitude of the problem and designing effective interventions. Drawing from cross-sectional data from a South African university, we examined the prevalence and correlates of sexual violence among adolescent girls and young women (AGYW).

METHODS

We analysed data of 451 AGYW selected using stratified sampling. Sexual violence was defined as any sexual acts, and attempt to obtain sexual acts without consent. We used adjusted and unadjusted logistic regression models to examine the factors associated with exposure to sexual violence while controlling for relevant covariates.

RESULTS

The lifetime and past-year prevalence of sexual violence was 37.9% and 25.3%, respectively. A higher prevalence of sexual violence was reported by heavy episodic drinkers of alcohol (lifetime 48.4% and past year 34.0%), those who received insufficient financial support (lifetime 58.0% and past year 35.8%) compared to non-users of alcohol (lifetime 27.2% and past year 17.2%),) and those who received adequate financial support (lifetime 20.8% and past year 13.1%). AGYW who reported heavy episodic use of alcohol had higher odds of reporting lifetime (AOR: 1.86; 95% CI: 1.07-3.25) and past year (AOR: 2.03; 95% CI: 1.10-3.75) experience of sexual violence compared to non-users. However, individuals who received adequate family financial support were 76% and 65% less likely to report lifetime and past year experience of sexual violence than those who received inadequate family financial support. Also, AGYW who rated themselves as very religious were 80% and 75% less likely to report lifetime and past year experience of sexual violence compared to those who were not religious.

CONCLUSION

Our study shows that sexual violence affects a large proportion of girls, requiring intervention that not only focuses on increasing social support for survivors, facilitating reporting, and ensuring perpetrators are convicted, but also target alcohol use reduction and poverty alleviation.

Association of Addictive Substance Use with Polyvictimization and Acceptance of Violence in Adolescent Couples

Theoretical framework: The objectives of this study were to analyse the possible influence that some variables such as substance use (alcohol and marijuana) might have on relevant aspects related to violence in adolescent dating (victimization, frequency of violence and acceptance of violence). Methods: The sample included 2577 adolescents between the ages of 14 and 18. The instruments used were two questionnaires. The first identified and analysed the types and frequency of violence experienced by the victims, and their acceptance of violence. The second analysed the use of alcohol and marijuana in adolescents. Results: The results indicate that victims frequently take on the role of polyvictims, suffering aggression in up to more than five different forms at the same time. Furthermore, it was found that this phenomenon is precipitated by substance use, the frequency of abuse and the acceptance of violence in a cycle of mutual interaction.

An International Comparison of a Web-Based Personalized Feedback Intervention for Alcohol use During the Transition out of High School in the United States and Sweden

Young adult drinkers engage in a range of drinking patterns from abstaining to heavy drinking in both the United States and Sweden. Heavy drinking during young adulthood in both countries is associated with a variety of negative consequences. Personalized feedback interventions have been identified as effective prevention strategies to prevent or reduce heavy drinking in the United States. This study examined transitions in drinking profiles and compared the efficacy of a personalized feedback intervention for 3965 young adults in the United States (1,735) and Sweden (2230) during their transition out of high school. Using goodness-of-fit criteria, results indicated that three drinking profiles exist among young adults transitioning out of high school: very low drinkers/abstainers, moderate to heavy drinkers, and very heavy drinkers. Latent Markov models revealed a moderating effect of country on personalized feedback intervention such that intervention condition participants in the United States were more likely to belong to the light drinker/abstainer or moderate to heavy profile relative to the very heavy drinking profile at 6-month follow-up. There was no significant effect of personalized feedback intervention in Sweden. Future research could investigate the impact of when personalized feedback interventions are administered and could examine if personalized feedback interventions should be more intentionally culturally adapted in order to be more effective.

Are All Substance-Involved Sexual Assaults Alike? A Comparison of Victim Alcohol Use, Drug Use, and Combined Substance Use in Sexual Assaults

Sexual assaults involving victim substance use at the time of the assault are common, but little is known about how different types of substances used at the time of the assault impact post-assault outcomes. The current study sought to compare victim alcohol use, drug use, and combined substance use in sexual assaults among a community sample of 693 victims. It was hypothesized that victims in the combined substance use assault type would report overall worse post-assault outcomes, more contextual and interpersonal traumas, and higher assault severity. Our results partially confirmed these hypotheses, but victims in the drug-involved assault type group overall reported higher assault severity and worse post-assault outcomes. These findings are probably partially attributed to the demographic characteristics of victims in the drug-only group (e.g. Black victims) who are more likely to experience a higher severity of violence. Implications for future research and policy regarding drug decriminalization are discussed.

Bidirectional associations between alcohol use and intimate partner violence and sexual assault victimization among college women

Whereas some prior studies have explored whether alcohol increases the risk for victimization and/or whether distress resulting from victimization increases the risk for alcohol use, few studies have simultaneously tested these bidirectional hypotheses among a high-risk sample (i.e., undergraduate women), while including both sexual assault (SA) and intimate partner violence (IPV) victimization, and exploring potential moderating effects of PTSD symptoms on these paths. Among 631 college women, the present study tested these bidirectional associations using cross-lagged panel models across two measurement periods (i.e., Time 1 [T1] and Time 2 [T2], six months later). Results suggested that T1 alcohol use increased risk for T2 SA (but not T2 IPV victimization), and PTSD symptoms moderated this association; at lower levels of PTSD symptoms, there were no significant associations between alcohol use and subsequent SA victimization, whereas at higher levels of PTSD symptoms, alcohol use predicted subsequent SA victimization. By contrast, the opposite directional hypothesis was not supported; neither T1 lifetime SA nor IPV were associated with T2 drinking, regardless of the level of their PTSD symptoms. Prevention and intervention efforts should simultaneously address risk factors for alcohol use and victimization using trauma-informed practices.

Preventing and Responding to Sexual Misconduct: Preliminary Efficacy of a Peer-Led Bystander Training Program for Preventing Sexual Misconduct and Reducing Heavy Drinking Among Collegiate Athletes

Sexual misconduct occurs with disproportionate frequency on college campuses, and alcohol is involved in most sexual assaults. Importantly, collegiate athletes are at risk for both heavy drinking and sexual misconduct. Thus, the current study evaluated the efficacy of a novel, 2.5-hr, peer-facilitated, interactive, group-based bystander intervention program for student athletes that integrated information on sexual misconduct and risky drinking (Preventing and Responding to Sexual Misconduct [PRSM]). In all, 205 athletes completed 25-min surveys immediately before and after the training, and 76 (of 94 invited) completed a 3-month follow-up. Participating in the workshop was associated with significant increases in acknowledgment that sexual misconduct is a problem on campus, knowledge of where to get help if sexual misconduct occurs, knowledge about the college's procedures for addressing sexual misconduct, confidence that the college's procedures for addressing sexual misconduct are fair, bystander confidence, and engagement in a range of bystander activities. A significant decrease in rape myths also was observed. Participating in the workshop also produced changes in alcohol-related beliefs and behaviors. After participating in PRSM, athletes reported increased expectations that drinking alcohol can produce negative effects including aggression and acute intoxication. Participating in the workshop also was associated with significant reductions in drinking frequency, the total number of drinks consumed per month, the maximum drinks consumed in 24 hours, the frequency of binge-drinking episodes, and the experience of alcohol-related problems. In sum, the PRSM program evidenced preliminary efficacy as a program designed to increase prosocial bystander behavior and decrease high-risk drinking among collegiate athletes; changes in beliefs and behaviors consistent with reducing risk for sexual misconduct and problem drinking were observed after workshop participation. Future research should evaluate whether the PRSM program is effective for use with other high-risk populations like fraternity members or more diverse institutions of higher education including large universities.

Alcohol Consumption, History of Sexual Assault in Adolescence, and Revictimization in a Sample of University Students in the Western United States

This study evaluated alcohol consumption as a moderator of the association between adolescent sexual assault and risk of sexual assault in college. It was hypothesized that sexual assault in adolescence would be associated with higher risk of college victimization and that this association would be moderated by alcohol consumption. Predominantly female and European-American university students (N = 201) completed self-report measures of alcohol consumption and sexual assault victimization in adolescence and since enrolling in college at a medium-sized university in the Western United States. Controlling for effects of age and gender, there was a significant interaction between alcohol consumption variables (i.e., typical weekly alcohol consumption and binge drinking) and adolescent sexual assault, such that the greatest risk for sexual assault in college was incurred by the heaviest drinkers with the greatest frequencies of adolescent sexual assault. This study highlights the importance of considering past victimization history in concert with alcohol consumption in efforts to prevent sexual victimization in college.

Unwanted Sexual Acts Among University Students: Correlates of Victimization and Perpetration

Unwanted sexual experiences are common among university students in the United States and pose a substantial public health concern. Campus policies and programs to prevent unwanted sexual incidents in university settings require research on prevalence and risk correlates of both victimization and perpetration. This study determined the prevalence of unwanted sexual victimization and perpetration experiences among students, both before and after joining the university, and examined risk correlates for both unwanted sexual victimization and perpetration experiences. Data were collected from 3,977 full-time graduate and undergraduate students using an online survey in a large private university. The findings revealed nearly one in eight students surveyed were victimized by unwanted sexual incidents at the university. Risk correlates of victimization by unwanted sexual incidents included female gender, undergraduate student status, and victimization experiences prior to joining the university. Most (95.5%) sexual violence incidents occurred when the victim was incapacitated due to alcohol, substance, or asleep. An acquaintance, peer, or colleague was the most frequently reported perpetrator. Risk correlates of perpetration included male gender, undergraduate student status, and perpetration of unwanted sexual activities before joining the university. Perpetrators most frequently reported perpetration of unwanted sexual behaviors against a current or former intimate partner or a stranger. The findings highlight the importance of enhanced efforts to reduce prevalence of unwanted sexual incidents, particularly among students most at risk for victimization and perpetration.

Unwanted Sex Due to Intoxication among Australians Aged 16-69 Years

Intoxication can be a factor in unwanted sex, but research on the extent of the issue in both women and men is limited. We assessed the prevalence, correlates, and 10-year time-trends of unwanted sex due to intoxication among a representative sample of 4,279 women and 3,875 men aged 16-69 years in Australia and considered how these vary by gender. In 2012-13, 16% of women and 10% of men reported ever having had a sexual experience when they "did not want to because they were too drunk or high at the time." For both women and men, this was associated with younger age, bisexual activity, and reports of lifetime injection drug use, sexually transmitted infections, and forced sex. Among women only, it was associated with drinking above guideline levels and ever having terminated a pregnancy. Among men only, it was associated with current tobacco smoking, elevated psychosocial distress, and poor general health. Compared with 2001-02 data, fewer men reported unwanted intoxicated sex, while there were no changes for women as a whole. Interpreting these findings through an intersectional assemblage framework supports stronger understanding of the multiple factors influencing sexuality and substance use with implications for promoting equity, safety, and sexual health.

"Miscommunication" and Undergraduate Women's Conceptualizations of Sexual Assault: A Qualitative Analysis

Approximately 60% of legally defined rape victims do not label their experiences as "rape," most of whom label the experience as "a serious miscommunication." However, little research has examined why women choose this label. Labeling rape as a miscommunication could be problematic if chosen due to stereotypical conceptions that one's experience is not "real" rape. The present study used a mixed-methodological approach to understand why women might refer to rape as a "miscommunication," and how their reasons for labeling might differ from those who label their experiences and those who are nonlabeled (i.e., unequivocally state that they were "not victimized"). Participants included 123 undergraduate women who experienced rape. Participants responded to how they labeled rape and answered questions regarding assault characteristics, disclosure, reporting, and self- and perpetrator blame. Chi-square analyses assessed labeling group differences. Responses to an open-ended question about factors contributing to their labeling decision were content analyzed. Whereas miscommunication-labeled and nonlabeled victims reported similar assault characteristics in the quantitative analyses, qualitative content analyses revealed varying reasons for labeling rape as miscommunication, not victimization, and rape. Over three quarters of miscommunication-labeled victims reported that one or more of the following factors influenced their labeling: victim and perpetrator substance use, sexual activity prior to the rape, and perceptions that one did not express nonconsent strongly enough and that the perpetrator "did not realize" their lack of desire. Whereas miscommunication-labeled and nonlabeled victims reported similar assault characteristics, the extent to which those assault characteristics affected their labeling differed. Those who labeled their experiences as miscommunication gave reasons for their label that centered on factors which reflect inconsistencies between their experiences and "stereotypical rape." Misperceptions of rape can be addressed via prevention programming and clinical work.

History of sexual assault, past-year alcohol use, and alcohol-related problems in American Indian adolescents

American Indian (AI) adolescents have been found to experience higher rates of sexual violence, alcohol misuse, and alcohol-related consequences compared to other racial and ethnic groups. Adolescent alcohol use and sexual assault experiences have been linked to increased negative consequences across physical and mental health, school, work, and legal domains. The purpose of the present study was to examine the associations among endorsing a history of experiencing sexual assault, past-year alcohol use, and experiences of alcohol-related problems, and to examine how these associations differed across sex, using a large, nationally-representative sample of reservation-dwelling AI adolescents. The present study utilized secondary data analysis of a sample of 3498 AI 7th to 12th grade students from a larger national epidemiological study. Participants completed The American Drug and Alcohol Survey™ to assess their alcohol use, sexual assault history, and alcohol-related consequences. Multilevel regression analyses revealed a significant effect of an alcohol use by sex by sexual assault history interaction on experiencing alcohol-related problems (b = -0.88, 95%CI [-1.55, -0.22], p = .009). Furthermore, results revealed that males who endorsed a history of experiencing sexual assault demonstrated the strongest relationship between past-year alcohol use and alcohol-related consequences (b = 2.60, p < .001). Results indicate the importance of early intervention for alcohol use, alcohol-related problems, and sexual assault, perhaps particularly among adolescent males. Future research should examine the directionality between alcohol-use and sexual assault among AI adolescents.

Increasing awareness of the severity of female victimization by opportunistic drug-facilitated sexual assault: A new viewpoint

The victimization of women by opportunistic drug-facilitated sexual assault in leisure contexts was studied in this work by applying a novel approximation. A multifocal analytical strategy based on an intersectional gender-sensitive approach was used to analyse the evidence coming from both forensic case studies and contextual studies about sexual interrelation and drug use. The process of victimization comprises social changes affecting consumption patterns and sexual interaction, intersecting in the hegemonic recreational nightlife model. However, victims experience a range of situations that make it difficult for them to self-acknowledge themselves as such. Widespread myths about the victimization process add to the social questioning faced by victims, stemming from gender-based double standards which condition the expected female behaviors regarding the use of drugs and sexual interaction. The victims usually experience amnesia, lack of injuries and emotional harm, which make difficult the self-acknowledgement as a victim of sexual assault and the reporting of the episode suffered. Consequently, it is an urgent public health need to implement a new viewpoint about the victimization of women by opportunistic drug-facilitated sexual assault in leisure contexts, able to increase awareness of the severity of this form of sexual violence. Society must recognize the existence of this problem within itself to help victims to acknowledge themselves as such, lodge a complaint and seek adequate help. The lack of this social support feeds the perpetuation of the victimization process, which exacerbates the risk of locking victims into spirals of cyclical re-victimization and favors both the underreporting as well as inadequate coping strategies. In addition to focusing on the need to increase awareness of the severity of female victimization by opportunistic drug-facilitated sexual assault in leisure contexts, other recommendations include the use of the term "take advantage", the development of specific criminal approaches, and the in-depth knowledge of the phenomenon via victimization surveys. These steps are necessary for developing well-targeted and evidence-based preventive measures consistent-with-reality.

Meeting Kids Where They Are At-A Substance Use and Sexual Risk Prevention Program via Telemedicine for African American Girls: Usability and Acceptability Study

BACKGROUND

Rural African American youth lack access to drug and sexual risk-taking prevention programs available in more urban areas. Recent data indicate that rural youth now use substances at higher rates and at younger ages than their urban peers.

OBJECTIVE

This study aims to evaluate the initial usability and acceptability of a low-cost, technology-based approach to delivering effective, culturally tailored, integrated substance use disorder (SUD) and HIV risk behavior prevention programs to African American female youth to inform the use of this intervention via telemedicine for rural youth.

METHODS

Effective SUD prevention strategies and emotion regulation skills were integrated into an existing evidence-based HIV risk reduction program culturally tailored for African American female adolescents-Sisters Informing, Healing, Living, and Empowering (SIHLE)-and delivered to 39 African American female youth via group telehealth. The evaluation of the resulting program, 12-session SIHLEplus, was completed by 27 girls who also completed self-report measures that assessed sexual risk behaviors (eg, number of partners and age of sex initiation), substance use, exposure to traumatic events, and emotion regulation.

RESULTS

The descriptive and qualitative results of the pilot study demonstrate the initial usability and acceptability of delivering evidence-based prevention successfully via telehealth to help address health disparities in this vulnerable population.

CONCLUSIONS

Although more research is needed, the findings from this study suggest that SIHLEplus has demonstrated initial usability and acceptability.

The relationship between binge drinking and prosocial bystander behavior among college men

Objectives: This study prospectively examined binge drinking's effect on prosocial bystander behavior and indicators of bystander behavior: intentions to intervene, self-efficacy to intervene, and positive outcome expectancies for intervening. Participants: College men were recruited from February to April 2010. Methods: Pre- and posttest surveys were administered as part of a randomized controlled trial (n = 743). Potential confounders were identified using Pearson product-moment correlations. Controlling for covariates, multiple linear regression was used to examine whether binge drinking was predictive of prosocial bystander behavior and indicators of bystander behavior. Results: Binge drinking was related to lower bystander behavior (p<.05), lower intentions to intervene (p<.001), and less positive outcome expectancies for intervening (p<.05). Conclusions: Binge drinking may reduce the ability to notice a risk situation and intervene as a prosocial bystander. Results highlight the need for bystander programs to address alcohol use within the context of bystander behavior.

Does Alcohol Use in Large Group Contexts Mediate the Association Between Sex-Related Alcohol Expectancies and Rape?

Women who hold positive beliefs about alcohol's role in sexual experiences may be more likely to drink alcohol in large group contexts such as bars and parties than other women. These contexts may confer risk for rape. In the current article, we examined the association between sex-related alcohol expectancies and rape during college, and whether drinking in large group contexts mediates this association. College women completed surveys for seven consecutive semesters. Contrary to previous cross-sectional research, women with more positive sex-related alcohol expectancies at the start of college and women who drank alcohol more frequently in large groups at the start of college were no more likely to experience rape during college. Longitudinal research is critical to identify risk factors that may be targeted for prevention.

An Event-Level Investigation of Factors Associated With Young Women's Experiences of Coerced Consensual Sex

Little is known about instances of coerced consensual sex in which women report both that they consented to have sex and that their partner used coercive tactics (e.g., made threats) to get them to have sex when they did not want to. Yet, these experiences are frequently reported by young sexually active women. We examined the relationship between sexual victimization history and the woman's level of alcohol intoxication in the likelihood of experiencing coerced consensual sex using event-level data collected over a 1-year period from 548 young adult nonproblem drinking women who engaged in sexual activity with men. Twenty percent (n = 112) reported at least one incident of coerced consensual sex. A generalized estimating equation model revealed main effects of daily estimated blood alcohol content (eBAC) and sexual victimization severity. The more women increased their alcohol consumption above their own average and the more severe their sexual victimization history, the more likely they were to experience coerced consensual sex. Our findings highlight the fact that coercion and consent are not mutually exclusive in some situations and shed light on this important yet understudied coercive sexual experience.