Barriers to Condom Negotiation and Use Among Female Sex Workers in the United States and United States-Mexico Border Cities: A Systematic Review.

Despite the effectiveness of male condoms, many Female Sex Workers (FSWs) report using condoms infrequently with multiple clients during sexual activity. As such, inconsistent condom use by FSWs is a public health concern as it can increase STI and HIV transmission. This systematic review synthesized extant evidence regarding barriers to condom use experienced by FSWs in the U.S and U.S. - Mexico border towns. The search was conducted through PubMed, CINAL, Cochrane, Medline, and PsychInfo. Studies were included if: they were conducted in the U.S. or U.S. - Mexico borders, their target population was FSWs, they examined condom use barriers experienced by FSWs, and they were published in English between 2011 and February 2021. Condom use barriers among FSWs were reported in all the articles including alcohol consumption and drug use before sex, venue stability, socio-economic status vulnerability, violence and gendered power dynamics, trust of regular clients, and age. The review findings indicate the need to develop interventions promoting condom use for both FSWs and their clients, as well as alternative interventions for HIV prevention such as pre-exposure prophylaxis (PrEP).

Sexual Compulsivity Mediates the Association Between Childhood Sexual Abuse and Condom Use Resistance Among Men Who Have Sex with Men and Women.

Despite the continued prevalence of HIV and condoms' proven effectiveness in HIV prevention, many young men continue to engage in condom use resistance (CUR). Research shows that sexual compulsivity and childhood sexual abuse (CSA) victimization are risk factors for CUR. Given that sexual activity between men is the most common method through which HIV is transmitted, and that men who have sex with men and women (MSMW) are up to five times as likely to contract or transmit HIV as men who have sex with women only (MSWO), understanding the CUR behaviors of MSMW is uniquely important. Young, single men who had had sex with a woman in the past year (N = 623) completed questionnaires assessing their previous sexual experiences with men and women, history of CSA, sexual compulsivity, and CUR to determine how MSMW classification may moderate the associations between these variables. Results revealed full, moderated mediation, such that CSA was significantly associated with sexual compulsivity among MSMW, but not MSWO. Furthermore, sexual compulsivity was subsequently associated with CUR, in a model accounting for 5.35% of CUR variance. Such findings suggest that exposure to CSA may render MSMW especially susceptible to maladaptive, sexually compulsive desires and behaviors. As a result, MSMW may be more likely to disregard the inherent risks associated with condomless sexual activity and engage in CUR. Thus, intervention programs seeking to reduce the transmission of HIV and other STIs should prioritize targeting MSMW who experienced CSA to reduce sexual compulsivity and increase condom use.

The Effect of State, Trait, and Situational Factors on Young Men's Coercive Condom Use Resistance.

Coercive Condom Use Resistance (CUR) is a significant problem, associated with increases in STIs, unplanned pregnancy, feelings of betrayal, and a loss of sexual autonomy. Furthermore, young men are much more likely to perpetrate coercive CUR than young women. Thus, the present study sought to examine the past experiences, trait characteristics, and state emotions which may precede coercive CUR perpetration intentions, including alcohol intoxication, childhood emotional abuse, trait impulsivity, sexual sensation seeking, state impulsivity, and state anxiety, using an alcohol administration procedure. Young, single, non-problem drinking, and sexually active men who have sex with women from the United States (N = 297; 66% White, 9.4% Black, 10.7% Multi-racial, 5.1% Asian, 1.0% Native American, 1.0% Pacific Islander, and 10.4% Hispanic or Latino) were recruited for participation. They were randomly assigned to either receive alcohol or remain sober before projecting themselves into a hypothetical sexual scenario with a woman who asked to use a condom. Results showed that greater levels of childhood emotional abuse were associated with increased trait impulsivity and sexual sensation seeking, and that sexual sensation seeking was associated with increased state impulsivity and subsequent anxiety during the scenario. Finally, alcohol intoxication moderated the relationship between state anxiety and coercive CUR such that state anxiety was positively associated with coercive CUR among intoxicated men only. Findings suggest that interventions targeting coercive CUR behavior may be improved by focusing on men who have experienced childhood trauma, as well as their alcohol consumption and in-the-moment experiences of impulsivity and anxiety.

Coerced Condomless Sex: A Scoping Review of Qualitative Studies.

Coerced condomless sex is a prevalent form of sexual coercion that is associated with severe negative health consequences. This scoping review addresses the current lack of synthesized qualitative evidence on coerced condomless sex. Our systematic literature search yielded 21 articles that met review eligibility criteria. Themes of coerced condomless sex were organized into three categories (tactics, motives, and sequelae) and presented separately for studies based on whether researchers stipulated pregnancy promotion intent as underlying the behavior. Coerced condomless sex perpetration tactics ranged from verbal pressure to physical assault. Besides pregnancy promotion, perpetration motives included control, dominance, entrapment, enhancing sexual experiences, and avoiding conflict. Following coerced condomless sex, victims reported developing protective strategies. They also reported experiencing various negative emotional, relational, and physical health effects. Interventions that specifically address coerced condomless sex perpetration and provide supportive programs for those who have experienced coercive condomless sex may be beneficial.

A Scoping Review of Nonconsensual Condom Removal ("Stealthing") Research.

Nonconsensual condom removal (NCCR; also known as "stealthing") involves the removal of a condom before or during sexual intercourse without a partner's sexual consent. Within the past several years, nations across the globe have codified NCCR as a form of sexual violence penalized by civil and/or criminal penalties. Given the recent legal attention to this behavior, we performed a scoping review of the peer-reviewed, empirical, English-language studies conducted on NCCR in order to summarize the current state of this field of research. Our scoping review yielded 27 articles meeting study inclusion criteria. Data on NCCR victimization and perpetration prevalence rates and correlates, as well as perceptions of NCCR, were extracted. The majority of the reviewed studies were conducted within the past 5 years and pertained to NCCR victimization. Rates of NCCR victimization ranged from 7.9% to 43.0% for women and 5.0% to 19.0% for men who have sex with men; rates of NCCR perpetration ranged from 5.1% to 9.8% for men and 0% for women. NCCR correlates included sociodemographic variables, relationship type, psychological factors, and sexual health concerns. Perceptions of NCCR were largely negative. The nascent field of NCCR research provides empirical evidence from several countries regarding concerning rates of NCCR. Building upon this foundation, continued research regarding NCCR is imperative. Studies that further delineate NCCR prevalence, risk factors, and outcomes would provide critical information beneficial to the development of evidence-based prevention and intervention programs targeting reductions in NCCR.

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.

Receipt of Coercive Condom Use Resistance: A Scoping Review.

Condom use resistance (CUR) refers to practices used to obtain unprotected sex with a partner who wishes to use a condom. Coercive CUR is a manipulative and aggressive form of CUR, which is associated with detrimental mental, physical, and sexual health consequences. This review synthesizes quantitative evidence on the prevalence and correlates of experiencing coercive CUR. A systematic approach, including title, abstract, and full-text review, was used to identify relevant empirical studies. Thirty-seven articles met the inclusion criteria. Prevalence of experiencing coercive CUR ranged from 0.1% to 59.5%. Significant correlates of receiving coercive CUR included interpersonal violence, sexually transmitted infection (STI) diagnosis, emotional stress, and drug use. Importantly, vulnerable populations (e.g., racial/ethnic minorities, men who have sex with men, sex workers) and people with low perceived control and resistive efficacy (i.e., the ability to say "no") had an increased likelihood of experiencing coercive CUR. Methodological weaknesses in the current literature include a lack of longitudinal studies and studies that examine the effectiveness of interventions, as well as failure to use consistent measures and include samples of men and sexual minorities. Future research should address these limitations. Intervention and prevention strategies should prioritize populations that are at greater risk for experiencing coercive CUR to achieve better health equity outcomes.

Men's Coercive Condom Use Resistance: The Roles of Alcohol and Emotional Factors.

OBJECTIVE: Men's coercive condom use resistance (CUR) with female partners is common and is associated with greater alcohol consumption than men's noncoercive CUR engagement. Prior research indicates that emotion-related factors are relevant to alcohol-involved coercive CUR. Thus, in this alcohol administration study, we examined emotional factors as distal and proximal predictors of alcohol-involved coercive CUR among young men who have sex with women. METHOD: Non-problem drinking young adult men who have sex with women (N = 282) were recruited from the local community, and as part of a larger study, completed a background survey and an in-lab alcohol administration session that included a mood induction and sexual scenario task using a 2 (sober vs. intoxicated) x 2 (positive mood vs. negative mood) experimental design. RESULTS: Path analysis testing a moderated mediation model revealed that for participants in the sober, positive mood, and intoxicated, negative mood conditions, there was a positive association between distal ER difficulties and motives to have sex to cope with negative emotions. Additionally, distal ER difficulties were positively associated with proximal difficulties modulating one's emotions among intoxicated participants. Among those with greater proximal difficulties modulating their emotions, state anger was positively associated with coercive CUR intentions. CONCLUSIONS: Results demonstrate the importance of alcohol intoxication, emotions and emotion regulation, and sexual coping motives in men's coercive CUR likelihood, demonstrating potential malleable targets for prevention efforts.

Attitudes, Emotions, and Emotion Regulation as Underlying and In-The-Moment Predictors of Men's Intentions to Perpetrate Sexual Assault: An Application of the I3 Model.

Sexual assault is a significant problem among young men, and several underlying and in-the-moment factors are associated with this behavior. However, research has not examined how underlying factors may influence men's in-the-moment use of emotion regulation (ER) strategies, emotional experience during sexual situations, or intentions to perpetrate sexual assault. 187 young, single men from the United States who had sex with a woman in the past year completed questionnaires, projected themselves into hypothetical sexual scenarios, and indicated how they would behave when their partner withdrew consent during these scenarios. Participants were grouped into profiles of ER strategy use, which was used as part of a model predicting sexual assault perpetration. Specifically, men with greater hostility toward women were especially likely to use a "low acting with awareness, low resignation" profile, which was associated with greater anger, impulsivity, and intentions to perpetrate. This could be attributed to the increased cognitive load, increased rumination on their partner's refusal, or increased drive to obtain sex associated with this profile. Future research should replicate these results in a more diverse sample, and examine the efficacy of interventions redirecting participants away from a "low acting with awareness, low resignation" profile on sexual assault prevention.

Profiles of Emotion Regulation Strategies and Intentions to Perpetrate Sexual Assault.

Objective: Sexual assault perpetration remains prevalent among young men, and emotion regulation (ER) is a prominent contributor to sexual assault perpetration among young men experiencing anger or sexual arousal. However, little is known about the specific ER strategies which men use when perpetrating. Thus, the present study used latent profile analysis to group men into profiles based on their in-the-moment use of several ER strategies during two, hypothetical sexual situations: one which induced anger and another which induced sexual arousal. Method: In total, 187 single, young, heterosexually active men from the United States provided responses to an online study, in which they projected themselves into two hypothetical sexual scenarios and answered questions regarding their use of ER strategies and intentions to perpetrate sexual assault after their hypothetical partner indicated she did not consent. Results: Participants were grouped into four profiles based on their use of different ER strategies. Men in the "high acting with awareness, low resignation" profile reported lower perpetration intentions than men in the "low acting with awareness" or "moderate all strategies" profiles following both scenarios. Conclusions: Men in the "high acting with awareness, low resignation" profile may have reported lower perpetration intentions because of the reduced cognitive load associated with acting with awareness relative to other ER strategies, and the increased self-efficacy to avoid sexual aggression associated with low resignation. Thus, future research should replicate the results with this profile in other contexts to determine its feasibility and effectiveness for reducing sexual assault in future interventions.

Typical Drinking, Sensation Seeking, and Alcohol Expectancies Regarding Sexual Coercion as Predictors of Coercive Condom Use Resistance Perpetration.

Although condoms are effective at preventing sexually transmitted infections (STIs) and unwanted pregnancies, condom use resistance (CUR) remains prominent. In particular, coercive CUR, or the use of coercive tactics to resist condom use with a partner who wants to use one, comprises a unique combination of sexual aggression and risky sexual behaviors, making it especially problematic. The present study sought to examine the relationship between coercive CUR and a variety of factors associated with both sexual aggression and risky sexual behaviors (e.g., typical alcohol consumption, alcohol expectancies regarding sexual aggression, and sensation seeking) to determine whether such factors may also contribute to the etiology of coercive CUR. To do so, a nationwide study of 102 young, heterosexual men who had previously perpetrated coercive CUR were recruited to complete an online, cross-sectional survey. Data were analyzed using a hierarchical linear regression model, which showed that alcohol expectancies regarding sexual coercion and sensation seeking moderated the relationship between typical drinking quantity and previous coercive CUR perpetration, such that typical drinking was positively associated with coercive CUR among men who reported greater sensation seeking and alcohol expectancies regarding sexual coercion. However, among men who were low in one or both of these factors, typical drinking was not associated with coercive CUR. These results suggest that typical drinking, alcohol expectancies, and sensation seeking may all be important to the etiology of coercive CUR, and that a reduction in one or more may be sufficient to reduce the likelihood of coercive CUR perpetration. Future research should confirm these findings using experimental and/or longitudinal methodologies and seek to develop intervention programs targeting typical alcohol use, alcohol expectancies related to sexual coercion, and sensation seeking in young men.

Sensation seeking and alcohol expectancies regarding sexual aggression as moderators of the relationship between alcohol use and coercive condom use resistance intentions.

OBJECTIVE: Despite condoms' effectiveness at preventing sexually transmitted infections (STIs) and unplanned pregnancy, coercive condom use resistance (CUR; i.e., using coercive tactics to resist condom use with a partner who wants to use one) is relatively common. However, research has not examined how risk factors, including alcohol use, alcohol expectancies related to sexual coercion, and sensation seeking, may interact to predict coercive CUR. The present study used an alcohol administration experiment to assess sensation seeking and alcohol expectancies as moderators of the relationship between acute alcohol intoxication and intentions to perpetrate coercive CUR during a hypothetical scenario. METHOD: Single, young, heterosexual men (N = 313) were randomly assigned to a control, placebo, low (BrAC = .04%), or high dose alcohol condition (BrAC = .08%). Participants then read and projected themselves into a sexually explicit stimulus story and indicated the likelihood that they would perpetrate coercive CUR. RESULTS: Findings indicated that intoxication interacted with expectancies and sensation seeking to predict coercive CUR intentions, such that alcohol intoxication was associated with greater coercive CUR intentions only among participants who reported greater sensation seeking and stronger alcohol expectancies. CONCLUSIONS: Both alcohol expectancies and myopia play a key role in coercive CUR intentions, especially among sensation seeking individuals. Thus, intervention programs should evaluate men's alcohol use, alcohol expectancies, and sensation seeking behaviors as possible targets to reduce the perpetration of coercive CUR. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Coercive Condom Use Resistance: A Scoping Review.

Objective: Sexual aggression research has recently expanded to include empirical investigations of coercion during condom negotiation and use. This scoping review presents and discusses peer-reviewed, quantitative, English-language studies conducted on coercive condom use resistance (CUR) behavior and intentions. Method: Our systematic literature search yielded 20 articles that assessed coercive CUR perpetration behaviors or intentions and met other inclusion criteria. Data on rates and correlates of coercive CUR behavior and intentions were extracted. Results: Identified studies used varied methods including cross-sectional surveys, 3-month longitudinal studies, and alcohol administration experiments, primarily with young adult samples. Overall, results indicated that a substantial minority (up to 42.6%) of sampled individuals endorsed lifetime perpetration of coercive CUR, with men reporting higher prevalence of coercive CUR perpetration than women. The majority of studies (70%) assessed coercive CUR through the Condom Use Resistance Tactics Scale (Davis et al., 2014). Although correlates largely differed by gender, alcohol-related variables emerged as risk factors for both men and women. Conclusions: Burgeoning evidence indicates that coercive CUR is relatively common, and, particularly for men, risk factors are similar to those associated with sexual aggression more generally. Review findings demonstrate that continued research in this area is warranted and should expand to include more diverse populations, to consider other risk factors and sequelae, and to utilize novel methodological approaches.

An event-level evaluation of women's self-medicated drinking: The role of sexual assault severity, affect, and drinking motives.

OBJECTIVE: Women with sexual assault (SA) histories report heavier and more frequent drinking. Consistent with the motivational model of alcohol use, women with SA histories may consume alcohol to both downregulate negative emotions and upregulate positive ones. The present event-level study used a Bayesian multilevel moderated mediation approach to examine the extent to which women's alcohol use and intoxication was influenced by coping and enhancement drinking motives to downregulate or upregulate affect, respectively. METHOD: Women ages 21-30 were recruited from the community to participate in a larger study that included a 32-day daily diary assessment of affect, drinking motives, and alcohol use. RESULTS: We found consistent support for women's tendencies to be motivated to drink to cope or enhance negative or positive affect, respectively, and those drinking motives were associated with indicators of increased drinking. Becoming intoxicated to downregulate negative emotion was common and this pathway was particularly strong for women who reported more severe SA histories. Although women with more severe SA histories were generally more likely to drink more, they were not likely to do so as a way to enhance positive experiences. CONCLUSIONS: Alcohol interventions that provide adaptive regulatory strategies are needed for women who experience increased negative or positive affect, with a particular focus on self-medication for young women with more severe SA histories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Roles of Emotion Regulation, Alcohol Consumption, and Women's Condom Request Style in Men's Coercive Condom Use Resistance Intentions.

Condom use resistance (CUR) remains a significant problem, and many men employ coercive CUR strategies to avoid using condoms with partners who do not consent to unprotected sex. To assess the decision-making process underlying men's coercive CUR, the present study administered alcohol to assess the effects of alcohol intoxication, condom request style, and emotion regulation (ER) strategies (i.e., cognitive reappraisal, expressive suppression) on intentions to use coercive CUR to have unprotected sex during a hypothetical sexual scenario. Sexually active, male social drinkers (N = 297) were randomly assigned to either consume alcohol or remain sober, and to project themselves into a hypothetical sexual scenario during which they received either indirect, direct, or insistent condom requests. Results showed that, although cognitive reappraisal had no relationship with coercive CUR or unprotected sex intentions, expressive suppression's relationship with intentions to have unprotected sex was mediated by coercive CUR and moderated by alcohol intoxication and condom request. Specifically, suppression was positively associated with coercive CUR among sober individuals who received an indirect condom request only. Such results suggest that sober men with suppressive tendencies may use coercive CUR to regulate negative emotions, such as frustration at not being able to have unprotected sex.

Building a Model to Predict Sexual Assault Victimization Frequency Among Undergraduate Women.

Previous research has identified several factors, including sexual risk behaviors, alcohol consumption, sexual refusal assertiveness, impulse control difficulties, drinking to cope, and sex to cope, as being associated with sexual assault victimization. Data were collected from 465 adult, undergraduate women, and analyzed using structural equation modeling to determine how these variables related to one another. Results showed that together, these factors predicted 17.1% of the variance in victimization frequency. These findings may help future researchers better understand the etiology of sexual assault victimization on college campuses and prove crucial to the development of future intervention programs which reduce victimization.

The Interplay of Sexual Arousal and Power-Related Emotions in Men's Alcohol-Involved Sexual Aggression Intentions.

Research has identified power/dominance and sexual arousal as key motivators of men's sexual aggression; however, little research has examined the interplay of these two factors in alcohol-involved sexual aggression. Two alcohol administration experiments investigated the roles of power-related sex motives and power- and sexual arousal-related emotions on men's sexual aggression intentions. In Study 1, participants (N = 96) read a sexual aggression scenario after random assignment to consume either an alcoholic (target peak BrAC = .10%) or nonalcoholic beverage. Results indicated that power-related sex motives indirectly predicted stronger sexual aggression intentions through greater in-the-moment power-related emotions but not through sexual arousal-related emotions. Intoxicated men with more severe perpetration histories reported stronger sexual aggression intentions. In Study 2, participants (N = 203) completed similar measures after random assignment to receive either a brief emotion regulation-focused intervention (cognitive restructuring or mindfulness) or a control, followed by either alcohol (target peak BrAC = .08%) or nonalcoholic beverage consumption. Results demonstrated that greater power-related sex motives indirectly predicted stronger sexual aggression intentions through greater feelings of power and sexual arousal. Additionally, findings suggest that cognitive restructuring approaches may mitigate these relationships in sober men, while mindfulness approaches may exacerbate these relationships in intoxicated men.

Impulse Control Difficulties and Hostility Toward Women as Predictors of Relationship Violence Perpetration in an Undergraduate Male Sample.

Relationship violence in college students continues to be an important social problem. Prior research has identified several risk factors for relationship violence including trauma exposure, impulse control difficulties, and hostility toward women; however, previous research assessing these variables has mainly focused on bivariate relationships, with little work attempting to connect multiple correlates to relationship violence while utilizing a theoretical, interactive approach. The purpose of this study was to simultaneously examine several correlates of relationship violence (i.e., hostility toward women, trauma exposure, and impulse control difficulties), and to examine male perpetration of relationship violence among a sample of male college students using a cross-sectional design. It was hypothesized that among men in this sample, hostility toward women and trauma exposure would moderate the relationship between impulse control difficulties and relationship violence. The findings suggested that college-aged men, who have high impulse control difficulties, high hostility toward women, and who have multiple trauma exposures, may be more likely to perpetrate relationship violence against a female intimate partner than those who are low in impulse control difficulties, report low levels of hostility toward women, or report fewer or no trauma exposures. Thus, the current study suggests that exposure to trauma predisposes men with specific attributes to relationship violence, which may provide a treatment target for future intervention programs.

Alcohol-involved sexual aggression: Emotion regulation as a mechanism of behavior change.

OBJECTIVE: Sexual aggression remains a significant public health problem, with the majority of sexual assaults involving alcohol. Founded upon an experimental medicine approach to behavior change, the current study used a proximal change experiment to target and test emotion regulation (ER) as a mechanism underlying alcohol-involved sexual aggression. METHOD: Heavy episodic drinking men aged 21-30 with a sexual assault perpetration history (N = 209) were randomly assigned to a brief, online, ER-focused cognitive restructuring or mindfulness intervention or to control. Intervention effects were evaluated during sober and intoxicated states through laboratory-based alcohol administration (target BrAC = .08%). Intoxicated and sober participants completed a proximal change protocol that included implementing ER skills during a sexual aggression analogue that assessed relevant emotions and intentions. RESULTS: Path analysis demonstrated that relative to control, the cognitive restructuring intervention improved emotional modulation and emotional clarity, resulting in lower sexual arousal and anger, respectively, followed by decreased sexual coercion intentions. The mindfulness intervention yielded mixed results, predicting decreased sexual aggression intentions compared to control but also predicting stronger coercive tactic intentions in intoxicated men with more severe sexual aggression histories. Both interventions improved emotional acceptance relative to control, but only for sober men. CONCLUSIONS: Overall, the current study demonstrated that ER-focused interventions improved proximal ER skills associated with reduced sexual aggression intentions, signifying ER as an important mechanism for changing sexually aggressive behavior. Because intervention efficacy varied by intoxication state, further research is needed to assess the effectiveness of ER interventions targeting real-world alcohol-involved sexual aggression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effects of Alcohol, Condom Request Style, and State Anger on Men's Condom Use Resistance.

OBJECTIVE: The purpose of this study was to examine the distal predictors (alcohol expectancies, adversarial heterosexual beliefs) and proximal predictors (alcohol intoxication, partner's condom use request style, state anger) of young men's condom use resistance (CUR). METHOD: Young, male, non-problem drinking, inconsistent condom users (N = 297) completed an alcohol administration experiment. After completing background measures, participants were randomly assigned to receive a control or alcoholic beverage (target peak breath alcohol concentration = .08%). They then read a randomly assigned hypothetical sexual scenario in which their female partner requested to use a condom either indirectly, directly, or insistently. Participants' desire to have condomless sex, state anger, and both coercive and noncoercive CUR intentions were assessed. RESULTS: Path analyses demonstrated that alcohol intoxication directly predicted noncoercive CUR intentions. In addition, a moderated mediation pathway was found such that, relative to sober participants, intoxicated men's sexual aggression-related alcohol expectancies were positively associated with their state anger in response to the partner's condom use request. This increased anger was related to stronger noncoercive CUR intentions. Adversarial heterosexual beliefs both directly and indirectly predicted coercive and noncoercive CUR intentions. CONCLUSIONS: Path analysis demonstrated that alcohol intoxication increased intentions to resist condom use through noncoercive tactics. In addition, men's misogynistic attitudes and alcohol intoxication were associated with greater feelings of anger, which predicted stronger coercive and noncoercive CUR intentions.