Academic journal article Journal of Alcohol & Drug Education

Prospective Associations between Alcohol and Drug Consumption and Risky Sex among Female College Students

Academic journal article Journal of Alcohol & Drug Education

Prospective Associations between Alcohol and Drug Consumption and Risky Sex among Female College Students

Article excerpt

ABSTRACT

Females who had vaginal sex were interviewed annually in their first two years of college (n=386, ages 17 to 20 at study outset) and asked about risky sex behaviors and substance use. In year one, [60.2%.sub.wt] had intoxicated sex, [31.4%.sub.wt] had multiple sex partners, and [48.9%.sub.wt] had unprotected sex (i.e., without a condom). At follow-up, high rates of persistence (86.0%, 52.7%, 78.8% respectively) and initiation (36.0%, 23.9%, 41.8%) were observed. In multiple logistic regression analyses, drug use and drinking were independently associated with having multiple sex partners. Intoxicated sex independently predicted condom non-use and multiple sex partners, and appeared to mediate the relationship between substance use and multiple sex partners.

Implications for prevention and future research are discussed.

INTRODUCTION

Sexual health and substance use are two of the chief concerns facing college health professionals in the U.S., and there is considerable overlap between them. "Risky sex" is a broad term encompassing a number of behaviors that place a person at risk for unintended pregnancy, sexually transmitted infection (STI), sexual violence, or other adverse outcomes. Having sex without a condom, having numerous sex partners, having sex with a stranger, and having sex while under the influence of alcohol are a few examples of risky sex behaviors that have been studied in college students. Cross-sectional studies of college students have repeatedly demonstrated the high prevalence of risky sex. For example, the most recent national data indicate that nearly half of sexually active students did not use a condom during their most recent sexual encounter, and 13.9% of all students have had unprotected sex during the past year as a result of their drinking (American College Health Association, 2007). Empirical evidence points to a strong link between binge drinking and both unplanned sex and unprotected sex among college students (e.g., Wechsler, Lee, Kuo, & Lee, 2000). Moreover, serial patterns of casual sex, sometimes known as "hooking up," are a common part of the cultural landscape for many college students and are linked both situationally to alcohol and drug use (Grello, Welsh, & Harper, 2006) and to more severe overall patterns of alcohol intoxication (Paul, McManus, & Hayes, 2000).

A great deal of research has explored the psychological, social, and cognitive mechanisms by which alcohol use might influence risky sex. First, heavy alcohol use is related to riskier patterns of decision-making about sex partners, namely, in having more sex partners (Graves, 1995; Wechsler, Dowdall, Davenport, & Castillo, 1995), having sex that was not planned (O'Hare, 1998; Wechsler et al., 2000), and having sex with casual and new partners (Bon, Hittner, & Lawandales, 2001; Goldstein, Barnett, Pedlow, & Murphy, 2007; Graves, 1995; Testa & Collins, 1997). Risky partner choices are thought to be attributable, in part, to alcohol's acute disinhibiting effects and lowered risk perceptions with new sex partners (Fromme, D'amico, & Katz, 1999). Second, alcohol use can have a deleterious effect on safer-sex behaviors once a sexual encounter has begun. Several studies have demonstrated that alcohol intoxication appears to reduce the likelihood of using condoms and other contraceptives (Goldstein et al., 2007; Hingson, Heeren, Zakocs, Kopstein, & Wechsler, 2002; Meilman, 1993), thereby putting students who drink more heavily at greater risk for adverse outcomes such as unwanted pregnancy (Perkins, 2002) and STI (Chesson, Harrison, & Stall, 2003).

In contrast to the wealth of information available on alcohol-related risky sex, fewer studies have examined the association between illicit drug use and risky sex. One cross-sectional study of college students found an association between marijuana use and condom non-use while drunk or high, independent of alcohol use (Bon et al. …

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