Alcohol Expectancies for Sexual Enhancement, Event-Level Alcohol Use, and Likelihood of Sexual Aggression Perpetration: A Timeline Followback Approach.

Sexual aggression (SA) is a significant public health problem, with the majority of SA involving alcohol. The present study examined associations between alcohol expectancies for sexual enhancement, event-level alcohol use, and the likelihood of SA perpetration. Young, adult non-problem drinking men participated in a laboratory session and completed a background survey that included measures of alcohol expectancies. Subsequently, men completed 6-week and 3-month follow-up surveys in which they reported their sexual experiences each day during the intervening 6-week period using Timeline Followback procedures. The analytic sample consisted of the 421 men (Mage = 24.66, SD = 2.69) who reported having sex at least once during the follow-up period. Multilevel models showed a significant alcohol expectancies X alcohol use interaction at the between-person level: Controlling for time and alcohol expectancies for aggression, stronger alcohol expectancies for sexual enhancement were associated with greater SA perpetration likelihood among men who consumed high amounts of alcohol before sexual encounters but not among men who consumed low amounts. Alcohol prevention programs should consider addressing men's alcohol expectancies for sexual enhancement to reduce risk for SA perpetration.

Safer Bars: A cluster-randomized effectiveness evaluation of alcohol-related sexual violence prevention through bar staff bystander training.

BACKGROUND: Sexual assault is consistently associated with social contexts that support high levels of alcohol consumption such as alcohol-serving establishments (i.e., bars). The significant rates of alcohol-involved sexual assault among college students demonstrate the critical need for evidence-based efforts to reduce alcohol-involved sexual assault in this population. Although bystander approaches have demonstrated some promise for reducing alcohol-involved sexual assault, to date no published studies have examined the effectiveness of implementing bystander prevention approaches with bar staff. Given the robust evidence indicating that bars serve as hot spots for sexual aggression, interventions that improve bar staff's ability to identify and intervene in sexually aggressive situations may offer a useful approach for reducing rates of alcohol-involved sexual assault. METHODS: The Safer Bars study utilizes a cluster-randomized trial design that randomizes participants at the bar level into intervention and waitlist control arms. The sample includes bars (Nbars = 56) within a three-mile proximity to the three major public Arizona universities, with an average of 10 staff members per bar (Nstaff = 564). Assessments of individual-level and bar-level outcomes occur at baseline, training completion, and 3-months post-training, with an additional individual-level assessment at 6 months. Community-level effects are assessed using GIS data regarding police dispatches. CONCLUSION: Safer Bars represents a novel, theory-driven approach to promote effective bystander behavior among bar staff working in close proximity to university campuses to reduce rates of alcohol-involved sexual assault.

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.

Potential consequences of the Dobbs v. Jackson Women's Health Organization decision.

OBJECTIVE: In June 2022, the U.S. Supreme Court released a landmark decision in which they held that the right to abortion is not protected by the U.S. Constitution, ending almost 50 years of federally legal abortion in the United States. Because prior research demonstrates linkages between reproductive health and substance use at multiple socioecological levels, in this special section, we present studies that take a broad scope to understanding how addictive behaviors and reproduction-related behaviors, options, and access to care interrelate across a variety of contexts. METHOD: In this introduction, the guest editors detail the impetus for this special section, provide a brief overview of the present studies, discuss policy and intervention implications, and suggest future research directions. RESULTS: The five studies presented in this special section span a wide range of populations, methods, and substance use and reproduction-related issues, including reasons for past abortions among women with opioid use disorder, alcohol effects on men's condom use resistance, considerations regarding alcohol-involved rape on implementation of "rape exceptions" to abortion bans, the role of early exposure to substance use and sexual abuse on reproductive health outcomes, and the effects of exposure to abortion-related media coverage on alcohol use intentions following the Supreme Court decision. CONCLUSIONS: The studies in this special section highlight the ways in which substance use and reproductive health are inextricably intertwined. Recent and future changes in reproductive health legislation and policy underscore the critical need for continued empirical inquiry into these intersecting public health concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of Acute Alcohol Consumption on Sexuality: A Look at Psychological Mechanisms.

Alcohol's link with sexuality is long-standing and prominent. While research continues to document robust associations between drinking and sexual behavior, attention now centers primarily on evaluating mechanisms and attendant theoretical frameworks to advance our understanding of how alcohol exerts a causal impact. We describe four domains with reliable evidence of alcohol effects: sexualized social perceptions, sexual arousal, sexual risk taking, and sexual assault. We consider three contextual frames: distal factors associated with encountering opportunities for alcohol-involved sex, proximal factors associated with alcohol's acute effects, and distal-proximal interactions. We then examine the empirical support for mechanisms embedded within four theoretical frameworks: alcohol disinhibition, alcohol expectancy, alcohol myopia, and emotion regulation. Support for disinhibition mechanisms is evident with sexual arousal only. Expectancy and myopia mechanisms enjoy support across domains and make up bases for integrative expectancy-myopia causal explanations. Emotion regulation mechanisms evidence preliminary support in risk taking and sexual assault. Implications and future directions are considered. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Preliminary Efficacy of Mindfulness and Cognitive Restructuring Interventions to Reduce Nonconsensual Sex Intentions.

OBJECTIVE: Victims of sexual violence experience detrimental physical and mental health consequences. Therefore, developing programs to prevent sexual violence is of utmost importance. Our previous work provided preliminary support for the efficacy of brief mindfulness and cognitive restructuring (CR) interventions in reducing sexual violence intentions. Because alcohol use and alcohol expectancies (AE) have been identified as risk factors for sexual violence, this secondary data analysis aimed to examine whether alcohol use and men's expectations that alcohol may affect women's vulnerability of being sexually coerced moderate the usefulness of these two interventions on nonconsensual sex intentions. METHOD: Single, young, heterosexual, heavy episodic drinking men with sexual violence histories were randomly assigned to receive mindfulness or CR skills training, or attention control. Half of the participants in each intervention condition were then randomized to alcohol or sober conditions. All participants read a hypothetical sexual scenario and rated their intention to engage in nonconsensual sex with their hypothetical sexual partner. RESULTS: Mindfulness was effective in lowering nonconsensual sex intentions among sober men with high AE for women's vulnerability and intoxicated men with low AE for women's vulnerability to sexual coercion. CR was effective in lowering nonconsensual sex intentions among intoxicated men with low and moderate AE for women's vulnerability to sexual coercion. CONCLUSIONS: Our results provide preliminary evidence for the efficacy of mindfulness and CR in lowering nonconsensual sex intentions under certain circumstances and highlight men's AE about women's vulnerability to sexual coercion as a critical factor that interacts with alcohol use to influence the efficacy of mindfulness and CR.

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.

Alcohol-involved rape: Limitations of the "rape exception" for abortion access.

OBJECTIVE: In June 2022, the U.S. Supreme Court removed federal abortion protections, giving individual states the authority to enact abortion regulations. Since that ruling, many states have enacted abortion bans; however, several of these states allow "rape exceptions," theoretically providing rape victims who become pregnant access to abortion services. Notably, alcohol use by the rape victim and perpetrator is common. In this brief report, we describe findings from research on alcohol-involved rape that have the potential to impact the utility of rape exceptions. METHOD: In this synthesis of the research literature pertaining to alcohol-involved rape victimization and perpetration, we focus on key concepts detailed in extant research likely relevant to accessing abortion services through rape exceptions. RESULTS: Victim alcohol intoxication may limit the use of rape exceptions to abortion bans by delaying rape acknowledgment, increasing victim blame, undermining victim credibility, and deterring rape reporting. Commensurately, perpetrator alcohol intoxication may increase the need for victims to access abortion services by reducing perpetrator condom use during rape and increasing other sexually aggressive acts such as nonconsensual condom removal. CONCLUSIONS: Research evidence suggests that alcohol-involved rape incidents present critical obstacles to utilizing statutory rape exceptions to banned abortion services beyond challenges that non-alcohol-involved rape survivors are also likely to experience. Rape survivors from oppressed communities (e.g., people of color, gender minorities, and/or sexual minorities) may be disproportionately impacted. Empirical investigations specifically examining how substance use during rape impacts reproductive health care accessibility are paramount for informing health care providers, law enforcement, legal practitioners, and policymakers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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).

Preliminary Efficacy of a Brief Cognitive Restructuring Intervention to Reduce Sexual Coercion Intentions: Roles of Alcohol and Emotion Regulation.

Sexual coercion (SC), the use of nonphysical tactics to obtain sexual contact with a nonconsenting partner, is a prevalent form of sexual misconduct that is associated with several physical and psychological health concerns. Therefore, effective preventative interventions to reduce SC prevalence are needed. Alcohol consumption and difficulties in emotion regulation (ER) are two risk factors that contribute to SC. Cognitive restructuring (CR) has the potential to reduce SC intentions by improving ER through actively challenging one's thoughts to modify emotions. This study represents a secondary data analysis to examine the effectiveness of a brief, web-based CR intervention in reducing SC intentions. To test whether the intervention would remain beneficial in the presence of alcohol, we tested effects among intoxicated versus sober participants. Young, male, heavy episodic drinkers with a history of sexual aggression (N = 137) were randomized into a CR intervention versus control condition as well as alcohol consumption versus no alcohol condition. Then, participants completed a sexual aggression analog scenario. General linear regression analyses showed that intoxicated men reported stronger SC intentions than sober men. Additionally, relative to controls, men in the CR condition who had better preexisting ER cognitive reappraisal skills had significantly lower SC intentions. Our findings provide preliminary support for CR as an effective strategy to reduce SC intentions among sexually aggressive, heavy episodic drinking men with better cognitive reappraisal skills. If findings are replicated, this brief, web-based CR intervention could overcome potential challenges in dissemination and be easily applied in clinical settings.

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.

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.

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.

Sexual Decision Making When Intoxicated: Women's Reasons for and Against Having Sex in a Laboratory-Based Scenario.

Young adult women report high condom use intentions, but inconsistent condom use. Cognitive appraisals during sexual encounters are important determinants of condom use decisions, but a nuanced understanding of what cognitions emerge during women's "hot states" (e.g., sexual arousal, alcohol intoxication) remains lacking. To address this gap, we examined women's heat of the moment cognitions in their own words using mixed methods. Young adult women (N = 503; Mage = 25.01, SDage = 2.66) were randomized to a beverage condition (alcohol or control), then read and responded to questions about an eroticized sexual scenario. The nature and strength of reasons for and against having sex were reported before and after learning no condom was available. Multilevel models revealed intoxicated participants were more likely to let the partner decide how far to go sexually than sober participants at both timepoints, but the strength of cognitive appraisals (reasons for, reasons against, and feeling conflicted) only differed between beverage conditions after knowledge of no condom. These results suggest alcohol myopia was evident in the presence of inhibition conflict. Content analysis of these reasons revealed multifaceted cognitions that changed upon learning there was no condom. Findings highlight cognitions to target through interventions and underscore the importance of both alcohol and situational context in decision making.

Associations Among Alcohol-Related Factors and Men's Nonconsensual Condom Removal Perpetration.

Nonconsensual condom removal (NCCR) is a form of sexual violence that a significant minority of men use to obtain unprotected sex. Experiencing NCCR is associated with serious physical and mental health consequences, such as sexually transmitted infections, unplanned pregnancies, anxiety, and depression. Alcohol use is known to be associated with sexual violence in general; however, limited research has been done on the association between alcohol-related factors and NCCR specifically. Thus, the present study examined the associations between event-level drinking, daily drinking, drinking motives, alcohol expectancies, and NCCR. Young, single, heterosexually active men (N = 96) completed cross-sectional measures of their NCCR behavior, event-level drinking, drinking motives, and alcohol expectancies. A total of 19 (19.8%) participants reported successfully engaging in NCCR at least once since age 14. Results showed that consuming more alcohol during the event, having more highly intoxicated partners, drinking to enhance sex, and holding more negative alcohol expectancies were associated with increased likelihood of NCCR. To effectively decrease the rates of NCCR, prevention efforts could aim to decrease event-level alcohol consumption for both men and their partners and to challenge men's beliefs regarding alcohol's role in sexual behavior. Given the current study's limitations, future studies should consider employing an ecological momentary assessment design to avoid recall bias and include more diverse samples to increase the generalizability of findings.

Sexual Assault, Posttraumatic Stress, Alcohol Use, and Suicidality Among Diverse College Students.

Suicide is the second leading cause of death among college-aged populations. This study examined the association of demographics (sexual orientation, gender identity, age, and race), sexual assault, posttraumatic stress symptoms (PTSS), and alcohol use with suicidality, current urge to self-harm, and current suicidal intent among a diverse sample of college students (n = 2,160) from two universities. Over half of participants reported any suicidality (63.5%), 12% reported current urge to harm themselves, and 5% reported current suicidal intent. A linear regression indicated that participants who identified as a sexual minority, gender minority, consumed more drinks per week, and had more severe PTSS reported higher levels of suicidality. University also was associated with suicidality. A negative binomial regression demonstrated that participants who identified as a sexual minority and had more severe PTSS had more current urge to harm themselves. Further, a negative binomial regression demonstrated that first-generation college students, students with more severe sexual assault histories, and students with more severe PTSS had higher current suicidal intent. Findings suggest that risk factors may differ for college students' general suicidality, self-harm urges, and suicidal intent, suggesting that these may be separate constructs. More comprehensive models, incorporating multiple risk factors and multiple ways of assessing suicidality, are needed to better understand the range of college student suicidal behavior and risks.

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).

The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women.

This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.

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.