Unplanned sexual activity as a consequence of alcohol use: a prospective study of risk perceptions and alcohol use among college freshmen

OBJECTIVE: The authors' goal was to show how risk perceptions regarding unplanned sexual activity following alcohol use are prospectively related to subsequent alcohol consumption. PARTICIPANTS: Undergraduate students (N = 380) completed questionnaires at 2 time points during their freshman year. METHODS: In the middle of the academic year (T1), students estimated their risk of engaging in unplanned sex and reported their alcohol use during the previous term. Four months later (T2), they again reported alcohol use and indicated whether they had engaged in unplanned sex since T1. RESULTS: Students who consumed more alcohol at T1 rated their risk of unplanned sex more highly, suggesting relative accuracy. Those with higher risk perceptions consumed more alcohol at T2 (controlling for T1 use), suggesting that they maintained the high-risk behavior. Last, those who were unrealistically optimistic (ie, estimated low risk at T1 yet had unplanned sex by T2) reported greater alcohol use at T2. CONCLUSIONS: These findings highlight the role that risk perceptions regarding sexual activity may play in college students' alcohol use.     

Understanding the Relationship Between Alcohol and Sex: Latino and White College Students and Problematic Sexual Experiences While Drinking

Objectives: The authors examined whether the relationship between alcohol expectancies and sexual experiences while drinking differed between Latino and white college students. Participants: The authors considered students if they were white or Latino, unmarried, aged 18-25 years, reported any drinking, and had at least 1 sexual partner in the present school year. Methods: The investigators collected surveys from a random sample of 13,868 undergraduate students from the 14 California public university campuses. They used tests of group differences and hierarchical multiple regressions. Results: Social-facilitation alcohol expectancies were associated with the total number of different alcohol-related sexual experiences among Latino students. Neither social facilitation nor sexual-enhancement alcohol expectancies were differentially predictive of white or Latino students' frequency of sexual experiences. Conclusions: Additional research is necessary to determine whether concepts targeted by alcohol prevention programs operate in a differential manner for Latino students.     

Assessing God Locus of Control as a Factor in College Students’ Alcohol Use and Sexual Behavior

Abstract. Objectives: This study explored God locus of control beliefs (ie, God's control over behavior) regarding their influence on alcohol use and sexual behavior as an alternative religiosity measure to religious behaviors, which does not capture perceived influence of religiosity. Additionally, demographic differences in religious beliefs were explored. Methods: College students aged 18–24 (N = 324) completed a survey between April 2012 and March 2013. Principal components and multivariate analyses were conducted. Results: Findings suggest that measures provide reliable, valid data from college students. God locus of control is linked to not consuming alcohol or engaging in sex. There were differences regarding relationship status and religious denomination. Conclusions: God locus of control beliefs are an appropriate construct for collecting data about college students’ religiosity. Furthermore, health educators at faith-based institutions could incorporate this construct into their programming, encouraging abstinence but also behaving responsibly for those who do drink and are sexually experienced.     

The Impact of Pubertal Timing on Adolescents’ Alcohol Use

The relation between pubertal timing and alcohol use was investigated in a nationally representative sample (N= 4,686) of junior high school students who were followed up 2 years later (N= 3,862). Information regarding pubertal timing and status, sex‐role identification, number of alcohol intoxications, substance use, sexual behavior, friends’ alcohol use, and involvement in other types of problem behaviors was obtained. The results showed that early timing of pubertal development correlated with number of alcohol intoxications and number of units consumed on each occasion, and, to a lesser degree, with the frequency of alcohol use. Moreover, correlations were stronger among males than among females. Substantial parts of the association between pubertal timing and alcohol intoxications were mediated through friends’ problem behavior. Pubertal timing predicted alcohol use at follow‐up, but the effect was mostly due to increased alcohol intoxications at initial testing.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.     

Sexual Coercion,Verbal Aggression,and Condom Use Consistency Among College Students

Abstract

Objective: The relationship between condom use and 2 less visible categories of intimate partner violence (IPV), sexual coercion and verbal aggression, was examined among college students. Methods: In March 2007 a random cross-sectional sample of undergraduates from the southeast region of the United States was taken to collect information about sexual coercion and verbal aggression, in addition to condom use consistency. Alcohol use was also assessed. Results: Of the 142 participants, 31.7% reported being victims of sexual coercion, and 78% reported having verbally aggressive partners. Participants who reported experiencing sexual coercion in their relationship were significantly less likely to consistently use condoms. Additionally, alcohol use before or during episodes of verbal aggression was negatively associated with condom use. Alcohol use was also significantly associated with heightened incidents of coercion and aggression. Conclusions: Results indicate that among college students, the presence of sexual coercion adversely affects condom use, as does alcohol use.     

Health behaviors of culturally diverse inner-city community college students

ABSTRACT

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies.     

Use of Drinking Protective Behavioral Strategies and Sexual Perceptions and Behaviors in U.S. College Students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.     

Alcohol use and strenuous physical activity in college students: A longitudinal test of 2 explanatory models of health behavior

Objective: To help clarify the effect of gender on the bidirectional relationship between alcohol use and strenuous physical activity in college students. Participants: Five hundred twenty-four (52% female) college students recruited in August 2008 and 2009 and followed up in April 2009 and April 2011, respectively. Methods: Participants reported their alcohol use and strenuous physical activity on 2 occasions (baseline and follow-up) spaced approximately 1 or 2 years apart. Results: For females, alcohol use quantity at baseline was associated with increased strenuous physical activity at 1- and 2-year follow-ups, and alcohol use frequency at baseline was associated with decreased strenuous physical activity at 2-year follow-up. For males, alcohol use frequency at baseline predicted decreased strenuous physical activity at 1-year follow-up. Conclusions: Gender differences may be explained from an eating disorders perspective such that women use physical activity as a compensatory strategy to combat potential weight gain from calories consumed during alcohol use.     

What College Students Do Not Know: Where Are the Gaps in Sexual Health Knowledge?

Abstract

Objective: This study aimed to understand the gaps in college students’ knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper about their experience. The papers were analyzed using conventional content analysis for information that was new to participants by looking for key words that suggested learning took place. Results: The findings indicated that the majority of participants learned new information. Most learning occurred regarding sexually transmitted infections (ie, types, symptoms, prevalence, treatment, testing) and correct condom use. There were also demographic differences regarding reported new information. Conclusions: Findings can be used to develop future sex education programs for college students by providing college educators with an understanding of where students lack knowledge of sexual health.     

A Prospective Examination of Men’s Condom Use Resistance: Event-Level Associations with Sexual Aggression,Alcohol Consumption,and Trait Anger

Burgeoning research suggests that men engage in a variety of coercive and non-coercive tactics to avoid condom use (condom use resistance; CUR), suggesting a risk nexus regarding sexual risk and sexual aggression (SA). Laboratory-based research has found that acute alcohol intoxication is associated with CUR; however, no study has examined event-level associations among alcohol consumption, SA history, and CUR or the moderating effects of trait anger. Non-problem drinking young adult men who have sex with women (N = 430) completed a background survey and follow-up assessments regarding their sex events and alcohol consumption over three months. CUR was reported in 113 sex events; 6.2% of these involved SA and 40.7% involved alcohol consumption. Generalized estimating equations demonstrated that men with more severe SA histories were more likely to perpetrate CUR. Men lower in trait anger were more likely to perpetrate CUR the more they increased above their typical level of alcohol consumption, whereas men higher in trait anger were similarly likely to perpetrate CUR regardless of their alcohol consumption. Results suggest that men with greater SA histories and high trait anger are at increased risk of perpetrating CUR, and that risk of CUR increases among other men the more they increase their alcohol consumption beyond their average.     

Referent Group Proximity,Social Norms,and Context: Alcohol Use in a Low-Use Environment

Abstract

Objective: The purpose of this study was to investigate the relationship between perceived normative use of alcohol and reported consumption in an environment where relatively little alcohol use occurs. Participants: A total of 585 undergraduate students completed an online survey on alcohol use in March 2006. Methods: Participants reported personal alcohol use and perceptions of use by “friends,” “the average student,” and “the average student who drinks.” Results: Due to the large number of students reporting zero alcohol use, zero-inflated negative binomial regression was used to analyze the data. Results showed that perceptions of use and beliefs about the acceptability of use by proximal groups were strongly and positively correlated with personal alcohol use. Perceptions of distal groups were either not correlated or were correlated negatively with personal use. Conclusion: These findings suggest that the use of distal referent groups for a social norms campaign in a low-use environment may have paradoxical effects.     

Preliminary Results of a Longitudinal Study of Collegiate Alcohol Abuse

Abstract

Objective: Hookah smoking is a popular form of tobacco use on university campuses. This study documented use, attitudes, and knowledge of hookah smoking among college students. Participants: The sample included 943 university students recruited between February 2009 and January 2010. Respondents (M age = 20.02) included 376 males, 533 females, and 34 who did not report sex. Methods: An anonymous online questionnaire was completed by respondents. Results: In this sample, 42.9% of college students had tried hookah, and 40% of those individuals had used it in the past 30 days. Students perceived fewer negative consequences of hookah smoking compared with cigarette smoking. Age, sex, racial background, marijuana/cigarette use, and perceptions of side effects were significantly associated with hookah use. Conclusions: University students are misinformed regarding the health consequences of hookah smoking. Programs aimed at education, prevention, and intervention for hookah use are needed to address this growing public health concern.     

Alcohol Use and Participation in Organized Recreational Sports Among University Undergraduates

Objective: The authors examined alcohol use among students involved in recreational sports. To the authors' knowledge, this is the first study of alcohol use in which researchers separate recreational sports participants from intercollegiate athletes and examine them as a separate group of interest. Participants: The authors generated a random sample of 494 students from the undergraduate population at a 4-year university. Methods: They used a Web-based survey to collect data and stratified and weighted the sample by residence status to more accurately reflect the population. Results: Students who participated in recreational sports used alcohol at a greater frequency and intensity than did those who were not involved in recreational sports across a variety of measures, even alongside other variables, including race, sex, and Greek membership. Conclusions: On the basis of these findings, alcohol consumption among those participating in recreational sports appears to be an area worthy of consideration in future research.     

Profiles of African American College Students’ Alcohol Use and Sexual Behaviors: Associations With Stress,Racial Discrimination,and Social Support

Though studies show that alcohol use and sexual activity increase during emerging adulthood, few studies examine within–ethnic group differences, particularly among African American college students. This investigation utilized a latent class analytic methodology to identify risk behavior profiles of alcohol use (frequency and amount of alcohol consumed), sexual activity (number of intimate partners), and co-occurring risk behaviors (drinking before sexual intercourse) among 228 African American college students. This investigation also examined whether identified risk behavior profiles were associated with stress (interpersonal, intrapersonal, academic, and environmental), experiences of racial discrimination, and social support (from family, friends, and the college community). Results identified five distinct profiles within this sample: (a) High Sexual Risk—above-average sexual activity; (b) Abstainers—below-average alcohol use and sexual activity; (c) Low Risk—average alcohol use and sexual activity; (d) Alcohol Risk—above-average alcohol use and below-average sexual activity; and (e) Co-Occurring Risk—above-average alcohol use and sexual activity. Identified profiles differed across interpersonal and environmental stress, and self-reported frequency of experiences with racial discrimination. Implications for prevention programs and interventions aimed at reducing alcohol and sexual activity for African American college students are discussed.     

Sexual Decision Making for the “Better Than Average” College Student

Abstract

Objectives: To examine the impact of downward social comparison and the “known partner is a safe partner” heuristic on college students’ sexual decisions. Participants: One hundred-eighty heterosexual or bisexual undergraduate college students. Methods: Participants read dating vignettes that varied on perspective and familiarity and then rated the likelihood the couple would engage in sexual intercourse and use a condom. Results: There were no differences in rated likelihood based on familiarity, suggesting that the students did not view the 2 partner types as significantly different. Students rated the likelihood of sexual intercourse lower and condom use higher when the vignette was presented from the second person perspective. Conclusions: The students’ use of downward social comparison is consistent with the “better than average effect,” suggesting that the students perceive their own behavior as safe. The implication is that safer sex messages might be most effective if they focus on what students will gain by practicing safer sex behaviors, not just avoidance of a risk behavior.     

College students' use of technology to communicate with romantic partners about sexual health issues

Objective: To examine college students' technology-assisted sexual communication perceptions and practices alongside their beliefs about the effectiveness of face-to-face (F-t-F) sexual communication. Participants: 144 college students at a private university in the Northeast, U.S., completed a survey in October 2016. Method: A cross-sectional online survey examined how college students use text messaging and private social media messaging to communicate with romantic partners about sexual health issues. Results: Students who have communicated with romantic partners via technology reported being likely to do so again in the future, to perceive the effectiveness of technology-assisted sexual communication to be comparable to F-t-F sexual communication, and to be confident in their ability to initiate sexual communication with romantic partners via F-t-F communication. Conclusions: College students may see text messaging and social media messaging as useful for sexual communication, which has important implications for college health professionals who wish to promote frequent, effective sexual communication.     

The Culture of High-Risk Alcohol Use Among Club and Intramural Athletes

Abstract

Objective: The purpose of this study was to examine the drinking patterns of club and intramural college athletes and compare their alcohol consumption, perceived norms around the excessive use of alcohol, experience of negative consequences, and employment of protective strategies with those of campus varsity athletes. Participants: A total of 442 undergraduate students attending a private, suburban institution in the Northeast participated in the American College Health Association National College Health Assessment-II Web survey in spring 2011. Thirty-five students identified themselves as varsity athletes, 76 identified as club sport athletes, and 196 students identified themselves as intramural athletes. Methods: Survey responses were analyzed using Statistical Package for the Social Sciences. The Pearson's correlation coefficient and test for independence were applied to identify significant relationships between athlete status and identified variables related to alcohol use. Results: Results indicated that there were significant correlations between athlete status and all variables, to varying degrees. Conclusions: These findings have implications for campus health promotion professionals and athletics program coordinators seeking to address high-risk alcohol use among college athletes.     

High-Risk Sexual Behavior Among Students of a Minority-Serving University in a Community With a High HIV/AIDS Prevalence

Objective: The authors used a stratified cluster sampling design to inform campus sexually transmitted diseases prevention programs. Participants and Methods: They conducted a cross-sectional study of students (N = 1,130) at a large, urban, minority-serving university in South Florida using the 2004 National College Health Assessment Survey instrument. Results: Of the 1,130 participants, 14.0% reported risky sexual behavior (having more than 1 sexual partner in 1 year and not using a condom the last time they had vaginal intercourse), and 11.9% reported consistent risky sexual behavior (having more than 1 partner in 1 year and not using condoms most or all of the time during the past 30 days). In multivariable analysis, past-month alcohol use had the strongest independent association with both risky and consistent risky sexual behavior. Illicit drug use was marginally significant in both models. Conclusions: Administrators should address the use of alcohol and other drugs on campus in planning interventions to promote safe sexual behavior.