What do States Recommend We Teach Adolescents about Sexual Consent? A Content Analysis of K-12 Health Education Standards in the US.

Although universities in the US commonly implement sexual consent education programs for students that focus on understanding how to communicate sexual consent, it remains unclear to what extent sexual consent education is taking place in grades K-12. The goal of this study was to assess K-12 health education standards recommendations for sexual consent education. We conducted a content analysis of health education standards from 43 states in the US to evaluate the guidelines provided to health educators across different grade levels. Using inductive and deductive coding, we identified six themes related to sexual consent. These themes were: 1) defining sexual consent, 2) explaining the legal standard of sexual consent, 3) defining personal space, 4) promoting healthy decision-making, 5) emphasizing good communication skills, and 6) defining healthy relationships. Fewer states directly focused on sexual consent education; instead, they provided information that could indirectly relate to consent, such as discussions on relationships and personal space. Across grade levels, topics related to sexual consent became more prevalent as adolescents progressed through school. While many states' health standards do not explicitly discuss sexual consent, they may implicitly address consent through other topics. Educators and policymakers should advocate for more explicit and detailed education on sexual consent in the K-12 school system. This could help increase the number of students educated on sexual consent before entering higher education, potentially reducing rates of sexual violence, and promoting healthier sexual behaviors and attitudes.

Examining the role of alcohol and cannabis use patterns in bystander opportunity and behavior for sexual and relationship aggression.

OBJECTIVE: This study aimed to investigate the association between alcohol and cannabis use patterns and bystander intervention for sexual and relationship violence risk among college students who have used cannabis in the past year. The study tested two hypotheses: (1) reports of bystander opportunities will differ based on participants' alcohol and cannabis use patterns, and (2) among those who report bystander opportunities, reports of bystander behaviors will differ based on their alcohol and cannabis use patterns. METHOD: Participants were 870 students recruited from two large, minority-serving universities in the United States who reported past year cannabis use. Participants reported about their typical alcohol and cannabis use patterns and bystander opportunities and behaviors. Students were grouped for analysis based on their reported average substance use into four groups: alcohol and cannabis use on the same day, alcohol use only, cannabis use only, or no use. RESULTS: Students who reported alcohol and cannabis use on the same day, compared with those who reported alcohol use only, reported more bystander opportunities and behaviors in situations at risk for sexual and relationship violence. Compared with alcohol use only, students who reported only using cannabis or no use reported fewer bystander opportunities and behavior related to keeping others safe in party settings. CONCLUSIONS: Alcohol and cannabis use patterns are associated with bystander intervention, emphasizing the need to include knowledge about cannabis and co-use in bystander programming that aims to reduce sexual and relationship violence.

A Within-Person Examination of Alcohol Involved and Non-Alcohol Involved Internal and External Sexual Consent Communication.

OBJECTIVE: External consent communication and internal consent feelings may be influenced by alcohol consumption. However, whether the way someone communicates sexual consent differs when alcohol is or is not involved is not well understood. The goal of this study was to assess the within and between person effects of alcohol use, gender, and sexual identity on internal and external consent. METHOD: Young adults (n = 375) completed a 10-minute web administered survey about their internal and external consent in a recent alcohol and non-alcohol involved sexual encounter. External consent included five different behaviors to communicate consent. We conducted a repeated measures ANOVA to assess the within and between person effects of alcohol use, gender, and sexual identity on internal and external consent. RESULTS: Internal consent did not differ across sexual experiences or identities. In alcohol involved encounters, there was a decreased use of implicit communication. Heterosexual women used more verbal communication during alcohol encounters than sober encounters. Compared with men, women used more nonverbal and implicit communication across encounters. DISCUSSION: Alcohol use did not influence internal consent and was associated with a reduced use of implicit communication. The disinhibiting effects of alcohol may lead people to feeling more confident and open about expressing their sexual desires. Affirmative consent initiatives can use findings to encourage more clear communication and continue to educate on gender differences in sexual consent.

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

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

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

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

Alcohol intoxication, condom use rationale, and men's coercive condom use resistance: The role of past unintended partner pregnancy.

OBJECTIVE: Cisgender men's condom use resistance (CUR), deliberate attempts to avoid using a condom with a partner who wishes to use one, may include coercive strategies, such as deception and force, and places their partners at risk for unintended pregnancy and sexually transitted infections (STIs). This investigation used an alcohol administration design to examine one distal (history of unintended partner pregnancy) and two proximal (acute alcohol intoxication, condom use rationale) contributors to men's intentions to engage in coercive CUR. METHOD: Nonproblem drinking, cisgender men (N = 313) completed questionnaires, then were randomized to a beverage condition (control, placebo, low dose [.04%gm], and high dose [.08%gm]). Participants completed a sexual risk analog and reported their coercive CUR intentions after a hypothetical, female partner provided a condom use rationale (STI avoidance or pregnancy avoidance). RESULTS: Men who received the pregnancy condom use rationale reported higher intentions to engage in coercive CUR when they received a high alcohol dose relative to sober men. For men who had a history of unintended partner pregnancy, receiving a pregnancy condom use rationale was associated with greater intentions to have forced, condomless sex if they received a high alcohol dose relative to sober men. CONCLUSIONS: Intoxicated men may be more likely to engage in coercive CUR; this may indicate that when intoxicated, pregnancy risks are less salient relative to STI-related outcomes. As reproductive rights are being decimated, effective interventions targeting CUR, particularly when intoxicated, are needed in tandem with policies that affirm one's ability to prevent and terminate pregnancy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Association of Acute Intoxication and Threats to Masculinity on Laboratory-Based Sexual Aggression.

OBJECTIVE: Men's alcohol intoxication and perceptions of their masculinity as precarious (i.e., viewing masculinity as easily threatened) are independently related to men's perpetration of sexual aggression. Yet, the interactive effects of these constructs on sexual aggression are unclear. The goal of this study was to assess if precarious masculinity-measured as a static trait-and acute alcohol intoxication-measured in a laboratory setting-were positively associated with men's perpetration of laboratory-based sexual aggression after their masculinity is threatened. METHOD: Cisgender heterosexual men (n = 120, ages 21-30 years) completed a self-report measure of precarious masculinity, were randomly assigned to consume an alcoholic or nonalcoholic beverage, and engaged in the Sexual Imposition Paradigm, which assessed laboratory-based sexual aggression perpetration toward a female confederate. Immediately before the Sexual Imposition Paradigm, all participants' masculinity was threatened via feedback from an ostensible personality test that indicated they are less masculine than other men. RESULTS: Self-reported precarious masculinity and the Precarious Masculinity × Beverage Condition interaction were not associated with laboratory-based sexual aggression. However, intoxicated men showed higher levels of laboratory-based sexual aggression than sober men. CONCLUSIONS: Acute alcohol intoxication facilitated men's sexually aggressive responding toward women when their masculinity was threatened. Consistent with pertinent theory and research, this effect suggests that acute intoxication facilitates men's focus on salient cues (i.e., threatened masculinity), which then may proximally motivate sexual aggression. Sexual aggression prevention programs should continue to address alcohol in their programming.

Alcohol's Effects on the Bystander Decision-Making Model: A Systematic Literature Review.

To decrease rates of sexual assault victimization, young people are encouraged to become involved when they see questionable sexual situations (i.e., be a prosocial bystander). Several factors can facilitate or inhibit intervention, including alcohol use. To inform bystander prevention programs that aim to address alcohol's impact on bystanders, the current study reviewed research focused on alcohol use and bystander decision making. In December 2022, the authors searched published studies from six major electronic databases. Empirical articles were deemed eligible if they examined alcohol and the bystander decision-making model within the context of sexual assault, were based in the United States or Canada, and not an intervention study; 32 studies were included in the final review. Across 32 studies published between 2015-2022, 12 assessed the proximal effects of alcohol on bystander constructs and the additional studies examined the distal effects of alcohol on bystander constructs. Alcohol use appeared to impede earlier steps of the bystander decision-making model; however, alcohol use was associated with impeding and facilitating bystander decision making at the latter half of the model. Overall, alcohol use appears to be negatively rather than positively associated with bystander constructs. Bystander intervention programs may want to move beyond the narrative of alcohol as a risk factor for sexual assault and discuss how alcohol impairs a bystanders' ability to recognize risk. More work is needed to ensure researchers assess alcohol consistently and with similar methods (number of drinks, subjective intoxication) to increase generalizability of findings to prevention programs.

Hey ChatGPT, Let's Talk About Sexual Consent.

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

Sexual and Gender Minority Men's Bystander Behaviors and Barriers in Response to Witnessing Minor Sexual Aggression.

Objective: Sexual and gender minority (SGM) men experience sexual assault victimization. Encouraging people to become involved when they witness high-risk sexual situations as a prosocial bystander is one preventative mechanism to address sexual assault victimization. However, research assessing the extent that SGM men will intervene when they witness a concerning male-to-male sexual situation and barriers that prevent intervention is lacking. We sought to address these gaps. Method: SGM men (n = 323, Mage = 39.4, range 18-77) completed a web-administered survey. Participants were asked if they had witnessed a high-risk sexual situation and, if so, to describe how they intervened; if they did not intervene, they were asked to explain why not. Data were analyzed using thematic analysis. Results: Nearly 50% (n = 157) of participants reported witnessing a situation that may require intervention, of those men 40% reported involvement. When SGM men intervened, their behaviors included direct and indirect verbal and nonverbal strategies. Reasons for not intervening included not appraising the situation as risky, not viewing it as their responsibility to intervene, or lacking the self-efficacy to act. Conclusion: SGM men reported similar barriers to intervention that heterosexual young adults encounter. Participants also provided a variety of intervention tactics that could be included in bystander intervention initiatives to increase their effectiveness and inclusivity. Additional efforts are needed to modify intervention initiatives at both the individual and community level.

Examining the Moderating Role of Heavy Drinking Behaviors and Precarious Masculinity on Sexual Aggression Among Young Adult Men.

OBJECTIVE: Men's heavy drinking behaviors are related to their engagement in sexual aggression and may be amplified by other factors, such as precarious masculinity (i.e., perceiving masculinity as tenuous in nature). Yet, researchers' understanding of how alcohol consumption, in combination with precarious masculinity, may increase risk of sexual aggression is lacking. The goal of this study was to assess if precarious masculinity moderated the relationship between men's heavy drinking and their sexual aggression. METHOD: Young adult men (958 men, M age = 21.1 years, SD = 3.1) completed a web-administered questionnaire assessing sexual aggression, heavy drinking, and precarious masculinity. RESULTS: We ran a logistic regression examining the association between heavy drinking, precarious masculinity, and their interactive effect on men's engagement in sexual aggression. Heavy drinking (odds ratio [OR] = 1.17) and precarious masculinity (OR = 1.73) were independently and positively associated with men's sexual aggression; however, the interaction was not significant. CONCLUSIONS: In line with prior research, men's heavy drinking behaviors continue to be positively associated with sexual aggression. Building on masculinity literature, men viewing their masculinity as precarious and vulnerable appears to be associated with sexual aggression, potentially because engaging in sexual aggression can offset men's masculinity insecurities. Collectively, results suggest that both alcohol consumption and masculinity should be targeted in sexual assault prevention programs.

Assessing Sorority Women's Perceptions of Barriers to Reporting Sexual Assaults That Occur Within College Campus Greek Organizations.

Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers' understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur.

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

BACKGROUND: Sexual assault is a pervasive problem in the UK, and young women are disproportionately affected. We sought to provide an initial account of sexual consent norms in the UK and whether they differ by gender and age. METHOD: The present study was a secondary analysis of data collected by the Family Planning Association, which conducted an online survey (N = 2003) to assess experiences with, knowledge of, and attitudes toward consent. The sample represented all regions of the UK and spanned ages 14-55. RESULTS: Definitions of sexual consent endorsed by women and older age groups more closely aligned with the tenets of affirmative consent compared with men and younger age groups. Women and older age groups were also more likely to perceive that various nonverbal cues may be used to interpret sexual consent or refusal and were more supportive of people being able to withdraw their sexual consent. CONCLUSION: Maladaptive sexual consent norms seemed to be prevalent among men and young people in the UK, which may contribute to young women's elevated risk of experiencing sexual assault. Our findings support the UK's recent relationships and sex education curriculum that actively promotes healthy sexual consent norms.

Do college students feel confident to consent to sex after consuming alcohol?

OBJECTIVE: College students engage in consensual sexual activity after consuming alcohol, perhaps because they feel confident to do so. However, why students feel confident consenting to sex after consuming alcohol is unclear. We conducted a mixed-method evaluation of students' confidence consenting to sex after consuming alcohol; we examined individual (gender, relationship status, Greek life, alcohol and sex expectancies) and contextual (drinking behaviors) factors' association with confidence to consent to sex. We then qualitatively examined why students felt confident. METHOD: 232 college students completed a survey assessing alcohol and sexual activity. RESULTS: Gender, Greek life involvement, and drinking behaviors were related to confidence to consent; open-ended responses suggested students had their own norms for combining consent and alcohol. CONCLUSIONS: Students were confident consenting to sex after consuming alcohol. Sexual assault prevention educators may consider focusing on misunderstandings surrounding alcohol's effects on people's ability to consent.

Rates of Forced Sexual Experiences Among High School Students From 2001 to 2019.

Public awareness of sexual assault and initiatives aimed at preventing sexual assault continue to increase over the years. However, whether rates of sexual assault have diminished because of such cultural shifts remains unclear. The purpose of this study was to assess if rates of sexual assault (i.e., forced sex) have changed over the past 18 years for adolescent girls and boys as well as potential differences across racial/ethnic identities. Using nationally representative data from the Youth Risk Behavioral Surveillance Survey from 2001 to 2019, we conducted logistic regressions to assess rates of experiences of forced sex by sex and by sex and racial/ethnic identity, while accounting for grade level. Participants included 135,837 high school students. From 2001 to 2019, rates of forced sex maintained for girls; however, there was a decrease over time for boys. For girls, there were inconsistent differences in rates of forced sex by racial/ethnic identities. However, boys who identified as Black, Hispanic, Multi-Racial, and Other Race/Ethnicity were at higher risk to report forced sex than their White peers, until 2015; only Other Race/Ethnicity was at higher risk in 2019. As girls and boys aged, the risk of forced sex increased. Despite prevention efforts, rates of forced sex did not decrease from 2001 to 2019 for adolescent girls disregarding race/ethnicity, and for racial/ethnic minority boys. That rates of forced sex continue to be high is problematic as experiencing sexual assault at an earlier age is associated with myriad consequences. Further, results suggest current prevention initiatives may be inadequate at addressing risk factors for forced sex, and more broadly, sexual assault. Moving forward, researchers and educators may want to re-evaluate the strategies used to address and measure sexual assault experiences.

Assessing models of concurrent substance use and sexual consent cues in mainstream films.

ObjectiveCollege students may not view sexual consent communication while under the influence of substances (i.e., alcohol and drugs) as problematic if media models the co-occurrence of these behaviors. The purpose of this study was to assess the types of consent cues used by characters who are and are not under the influence of substances in mainstream films. Method: Four researchers inductively analyzed popular mainstream films (N = 50). Films were assessed for substance use and consent communication cues. Results: Characters using substances were depicted using implicit verbal and explicit nonverbal consent cues more than characters who had not used substances. Conclusion: Films may perpetuate cultural narratives that substance use can be part of the consent process and that consent is communicated differently when people have used substances. Prevention programs could include media literacy to address misleading messages college students may internalize about substance use and sexual consent communication.

An Assessment of the Cues College Students Interpret From a Sexual Partner to Determine They Are Refusing.

The purpose of this study was to assess the cues college students use to determine a sexual partner is refusing vaginal-penile sex (i.e., refusal interpretations). As a secondary aim, we explored the influence of item wording (not willing/non-consent vs refusal) on college students' self-reported refusal interpretations. A sample of 175 college students from Canada and the United States completed an open-ended online survey where they were randomly assigned to one of two wording conditions (not willing/non-consent vs refusal); students were then prompted to write about the cues they used to interpret their partner was refusing. An inductive coding procedure was used to analyze open-ended data. Themes included explicit and implicit verbal and nonverbal cues. The refusal condition elicited more explicit and implicit nonverbal cues than the not willing/non-consent condition. Frequency results suggested men reported interpreting more explicit and implicit verbal cues. Women reported interpreting more implicit nonverbal cues from their partner. Our findings reflect prior research and appear in line with traditional gender and sexual scripts. We recommend researchers consider using the word refusal when assessing the cues students interpret from their sexual partners as this wording choice may reflect college students' sexual experiences more accurately.

Effects of Typical and Binge Drinking on Sexual Consent Perceptions and Communication.

Young adults frequently engage in sexual activity after consuming alcohol and, consequently, may try to communicate sexual consent while intoxicated. We aimed to assess how people's drinking behaviors relate to their consent perceptions and communication with their current sexual partners. Using aggregated data from a 30-day daily diary study, young adults (n = 86, 77.9% women, 86% in a monogamous relationship) reported instances of partnered sexual activity and their perceptions of whether that activity was consensual. For each partnered sexual event, participants reported what they said or did to perceive the sexual activity as consensual. Responses were coded as active consent communication (i.e., using verbal or nonverbal cues) or tacit knowledge (i.e., using context to understand consent). During an exit survey, participants retrospectively reported how many days they drank (i.e., typical drinking) during the 30-day study and whether they binge drank. Typical and binge drinking were associated with identifying sexual experiences as consensual. Participants who binge drank relied less on active consent communication and more on context compared with those who did not binge drink. Young adults who binge drink may rely more on tacit knowledge because alcohol impedes their ability to process complex stimuli-such as active consent cues.

Examining Women's Sexual Assault Victimization Experiences since Entering College via Two Behavioral Assessments.

Measuring sexual assault experiences is considered a methodological challenge in survey research. Researchers can test the validity of sexual assault measures by comparing responses to different, albeit related, measures of sexual assault to determine if they identify similar groups of women. The goal of this study was to compare two measures of sexual assault victimization to determine if women report experiencing sexual assault in both assessments. Cisgender college women (n = 902) completed two separate measures of sexual victimization: the Sexual Coercion Inventory (SCI) and Sexual Experience Survey-Short Form Victimization (SES-SFV). Responses to both measures were coded to identify different sexual assault experiences (i.e., unwanted touching, attempted, and completed oral, vaginal, or anal rape) resulting from verbal coercion, threats of force, and use of force since enrolling in the university. Results suggested the SES-SFV produced higher overall rates of sexual assault experiences than the SCI. Specifically, the SES-SFV elicited more non-consensual sexual experiences resulting from threats and use of force, whereas the SCI elicited more non-consensual sexual experiences resulting from verbal coercion. Findings suggested discrepant responding across the two measures. Development of comprehensive sexual assault measures that fully capture women's victimization experiences is warranted.

Assessing Young Adults' Internal Feelings Related to Refusing Sexual Behavior.

Young people describe refusing sexual activity as difficult or embarrassing; however, what specific internal feelings young adults associate with refusing sexual activity is unclear. We assessed the positive and negative internal feelings related to refusing different sexual behaviors using sentiment analysis. We also examined if positive and negative internal refusal feelings varied by gender and the intersection of gender and racial/ethnic identity. Young adults (n = 574, 481 women, 93 men, M = 19.2, SD = 1.43) from Canada and the U.S. completed an open-ended survey about how they felt about their experiences refusing sexual activity. Using sentiment analysis, responses were coded as either positive or negative and overwhelmingly, feelings associated with refusing sexual activity were identified as negative. Women and women of color reported more negative feelings than men and White women. However, there were some distinct positive feelings noted from young adults (e.g., feeling respected, comfortable). Young adults appear to internalize negative feelings about their refusals which may relate to social and cultural norms. Moving forward, sexual health programs could focus on normalizing and destigmatizing refusals so that young adults do not feel negatively about refusing sexual activity, with a particular emphasis on helping women and women of color to feel confident and empowered in their refusals.