%0 Journal Article %J Arch Sex Behav %D 2014 %T A qualitative examination of men's condom use attitudes and resistance: "it's just part of the game". %A Davis, Kelly Cue %A Schraufnagel, Trevor J %A Kajumulo, Kelly F %A Gilmore, Amanda K %A Norris, Jeanette %A George, William H %K Adult %K Condoms %K Female %K Focus Groups %K Health Knowledge, Attitudes, Practice %K Humans %K Male %K Qualitative Research %K Risk-Taking %K Sexual Behavior %K Sexual Partners %K Sexually Transmitted Diseases %K Unsafe Sex %X

The purpose of this study was to investigate the variability in young heterosexual men's perceptions of the advantages and disadvantages of condom use in their casual sexual relationships. Because men who perceive greater disadvantages of condom use may be more likely to resist using them, we also explored the tactics that men employ to avoid using condoms. Semi-structured focus groups were conducted with single men who have sex with women (n = 60), aged 21-35 years, all of whom reported using condoms inconsistently. Transcripts were analyzed using a framework analysis approach. As expected, participants reported advantages and disadvantages to condom use that pertained to the likelihood and quality of sex, physical sensations during intercourse, and the risk of sexually transmitted infections and unwanted pregnancies. Within each of these topics, however, participants' appraisals of the relative pros and cons of condom use varied considerably. Additionally, participants reported that men use a wide range of condom use resistance tactics, including seduction, deception, and condom sabotage, and that the use of these tactics was viewed as normative behavior for men their age. These findings suggest that the effectiveness of sexual health prevention efforts could be enhanced by increasing young men's motivations to use condoms and by targeting social norms regarding condom use resistance. Additionally, the issue of men's condom use resistance clearly merits increased empirical investigation and intervention attention.

%B Arch Sex Behav %V 43 %P 631-43 %8 2014 Apr %G eng %N 3 %R 10.1007/s10508-013-0150-9 %0 Journal Article %J Arch Sex Behav %D 2014 %T Sexual victimization, alcohol intoxication, sexual-emotional responding, and sexual risk in heavy episodic drinking women. %A George, William H %A Davis, Kelly Cue %A Masters, N Tatiana %A Jacques-Tiura, Angela J %A Heiman, Julia R %A Norris, Jeanette %A Gilmore, Amanda K %A Nguyen, Hong V %A Kajumulo, Kelly F %A Otto, Jacqueline M %A Andrasik, Michele P %K Adult %K Alcoholic Intoxication %K Child %K Child Abuse, Sexual %K Crime Victims %K Ethanol %K Female %K HIV Infections %K Humans %K Libido %K Rape %K Risk %K Risk-Taking %K Sexual Behavior %K Unsafe Sex %K Young Adult %X

This study used an experimental paradigm to investigate the roles of sexual victimization history and alcohol intoxication in young women's sexual-emotional responding and sexual risk taking. A nonclinical community sample of 436 young women, with both an instance of heavy episodic drinking and some HIV/STI risk exposure in the past year, completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. A majority of them reported CSA and/or ASA, including rape and attempted rape. After random assignment to a high alcohol dose (.10 %) or control condition, participants read and projected themselves into an eroticized scenario of a sexual encounter involving a new partner. As the story protagonist, each participant rated her positive mood and her sexual arousal, sensation, and desire, and then indicated her likelihood of engaging in unprotected sex. Structural equation modeling analyses revealed that ASA and alcohol were directly associated with heightened risk taking, and alcohol's effects were partially mediated by positive mood and sexual desire. ASA was associated with attenuated sexual-emotional responding and resulted in diminished risk taking via this suppression. These are the first findings indicating that, compared to non-victimized counterparts, sexually victimized women respond differently in alcohol-involved sexual encounters in terms of sexual-emotional responding and risk-taking intentions. Implications include assessing victimization history and drinking among women seeking treatment for either concern, particularly women at risk for HIV, and alerting them to ways their histories and behavior may combine to exacerbate their sexual risks.

%B Arch Sex Behav %V 43 %P 645-58 %8 2014 May %G eng %N 4 %R 10.1007/s10508-013-0143-8 %0 Journal Article %J J Sex Res %D 2014 %T Women's unprotected sex intentions: roles of sexual victimization, intoxication, and partner perception. %A Masters, N Tatiana %A George, William H %A Davis, Kelly Cue %A Norris, Jeanette %A Heiman, Julia R %A Jacques-Tiura, Angela J %A Gilmore, Amanda K %A Nguyen, Hong V %A Kajumulo, Kelly F %A Otto, Jacqueline M %A Stappenbeck, Cynthia A %K Adult %K Adult Survivors of Child Abuse %K Alcoholic Intoxication %K Child %K Female %K Humans %K Intention %K Sex Offenses %K Social Perception %K Unsafe Sex %K Young Adult %X

Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence.

%B J Sex Res %V 51 %P 586-98 %8 2014 %G eng %N 5 %R 10.1080/00224499.2012.763086 %0 Journal Article %J Arch Sex Behav %D 2013 %T Influences of situational factors and alcohol expectancies on sexual desire and arousal among heavy-episodic drinking women: acute alcohol intoxication and condom availability. %A Gilmore, Amanda K %A George, William H %A Nguyen, Hong V %A Heiman, Julia R %A Davis, Kelly Cue %A Norris, Jeanette %K Adult %K Alcoholic Intoxication %K Arousal %K Binge Drinking %K Condoms %K Decision Making %K Ethanol %K Female %K Humans %K Libido %K Sexual Behavior %K Social Environment %K Unsafe Sex %X

Although studies suggest that alcohol increases women's sexual desire, no studies to our knowledge have examined the effects of acute alcohol intoxication on women's sexual desire. The majority of research examining alcohol's effects on sexual arousal in women suggests that alcohol increases self-reported arousal. In an alcohol administration study in which women projected themselves into an eroticized scenario depicting a consensual sexual encounter with a new male partner, we examined the effects of alcohol and condom condition on women's sexual desire and arousal. The moderating effects of sex-related alcohol expectancies were also examined. Results revealed that alcohol intoxication was related to less desire to engage in sex with a new partner and condom presence was related to more desire. Alcohol interacted with sexual disinhibition alcohol expectancies, indicating that more expectancy endorsement was associated with greater sexual desire and self-reported arousal in the alcohol condition, but not the control condition. Condom condition had no effect on self-reported sexual arousal. The present research suggests that sexual desire merits research attention in non-clinical samples, and experimental methodology can provide valuable information about alcohol's influence on women's sexual desire, thus advancing our understanding of this relationship beyond cross-sectional correlations. The current findings also provide evidence that sex-related alcohol expectancies may play an important role in alcohol-involved sexual experiences including desire and arousal.

%B Arch Sex Behav %V 42 %P 949-59 %8 2013 Aug %G eng %N 6 %R 10.1007/s10508-013-0109-x %0 Journal Article %J Arch Sex Behav %D 2012 %T Risky sex: interactions among ethnicity, sexual sensation seeking, sexual inhibition, and sexual excitation. %A Nguyen, Hong V %A Koo, Kelly H %A Davis, Kelly Cue %A Otto, Jacqueline M %A Hendershot, Christian S %A Schacht, Rebecca L %A George, William H %A Heiman, Julia R %A Norris, Jeanette %K Adult %K African Americans %K Asian Americans %K Condoms %K Ethnic Groups %K European Continental Ancestry Group %K Female %K HIV Infections %K Humans %K Male %K Risk Factors %K Sexual Behavior %K Sexuality %K Sexually Transmitted Diseases %K United States %K Unsafe Sex %X

Rates of sexually transmitted infections, including HIV, vary across ethnic minority groups, yet few studies have evaluated sexual risk behaviors and their psychological correlates to determine if risk and protective factors vary by ethnicity. The purpose of the current study was to assess sexual sensation seeking (SSS), sexual inhibition (SIS1 and SIS2), and sexual excitation (SES) as correlates of risky sexual behaviors in 106 (55 male and 51 female) Asian Americans, African Americans, and Caucasian Americans. Results revealed that higher SSS was associated with more vaginal and anal sex partners. Further, the association between SSS and the number of anal sex partners was positive among Asian Americans and Caucasians, but non-significant among African Americans. SIS1 was positively associated with unprotected sex on the first date among Asian Americans and African Americans. However, the association was not significant for Caucasians. SIS2 was negatively associated with general unprotected sex, and SES was positively associated with the number of vaginal sex partners. Findings suggest that ethnicity plays an important moderating role in the relationship between sexual traits and risky sexual behaviors.

%B Arch Sex Behav %V 41 %P 1231-9 %8 2012 Oct %G eng %N 5 %R 10.1007/s10508-012-9904-z %0 Journal Article %J Exp Clin Psychopharmacol %D 2011 %T The effects of acute alcohol intoxication, partner risk level, and general intention to have unprotected sex on women's sexual decision making with a new partner. %A Purdie, Michele Parkhill %A Norris, Jeanette %A Davis, Kelly Cue %A Zawacki, Tina %A Morrison, Diane M %A George, William H %A Kiekel, Preston A %K Acquired Immunodeficiency Syndrome %K Adult %K Alcohol Drinking %K Alcoholic Intoxication %K Alcoholism %K Breath Tests %K Central Nervous System Depressants %K Cognition %K Computers %K Condoms %K Decision Making %K Dose-Response Relationship, Drug %K Ethanol %K Female %K HIV Infections %K Humans %K Intention %K Models, Psychological %K Risk %K Risk-Taking %K Sexual Behavior %K Sexual Partners %K Software %K Unsafe Sex %K Young Adult %X

Women account for a quarter of all new HIV/AIDS cases, with approximately 65% having contracted the infection via heterosexual contact. Few experimental studies have examined interactions among background, partner, and situational characteristics in predicting women's sexual decisions. The Cognitive Mediation Model provides a useful theoretical framework for assessing likelihood of unprotected sex. Female social drinkers (n = 230) who had answered questions related to their general intention to have unprotected sex were randomly assigned to an experimental condition based on partner risk level (unknown, low, high) and beverage (control, placebo, low dose, high dose). Participants projected themselves into a story depicting a sexual situation with a man and answered questions about their cognitive appraisals, assertive condom request, and likelihood of unprotected sex. Alcohol effects on appraisal of sexual potential differed by partner risk condition. In the unknown and low risk conditions, placebo and alcohol participants appraised the situation as having greater sexual potential than controls whereas in the high risk condition, only those who consumed alcohol did so. Sexual potential appraisals in turn predicted impelling cognitions about having sex, which in turn predicted assertive condom request and unprotected sex intentions. General intention for unprotected sex independently predicted cognitive appraisals and outcomes. These findings highlight the need for prevention programs that focus on teaching women how to pay attention and consider sexual risk cues presented by potential partners, particularly when under the influence of alcohol.

%B Exp Clin Psychopharmacol %V 19 %P 378-88 %8 2011 Oct %G eng %N 5 %R 10.1037/a0024792 %0 Journal Article %J Child Abuse Negl %D 2010 %T Childhood sexual abuse in males and subsequent risky sexual behavior: a potential alcohol-use pathway. %A Schraufnagel, Trevor J %A Davis, Kelly Cue %A George, William H %A Norris, Jeanette %K Adult %K Alcoholism %K Child %K Child Abuse, Sexual %K Humans %K Male %K Risk-Taking %K Surveys and Questionnaires %K Unsafe Sex %K Washington %K Young Adult %X

OBJECTIVE: Childhood sexual abuse (CSA) among boys has been associated with a variety of subsequent maladaptive behaviors. This study explored a potential connection between CSA and an increased likelihood of risky sexual behavior in adulthood. Further, the study examined whether or not alcohol use may contribute to this relationship.

METHOD: As part of a study on alcohol and sexual decision-making, 280 heterosexual men completed multiple background questionnaires pertaining to past and current sexual experiences and patterns of alcohol use. CSA history was obtained and severity ratings were made based on type of contact reported.

RESULTS: CSA was reported by 56 men (20%). Structural equation modeling revealed that CSA positively predicted number of sexual partners directly as well as indirectly, through its effect on alcohol use. Specifically, greater CSA severity predicted significantly lower age of first intoxication, which in turn predicted greater current alcohol consumption, followed by greater use of alcohol before sexual intercourse, leading to an increased number of reported sexual partners. The reported frequency of condom use was not predicted by CSA severity or the alcohol-use pathway.

CONCLUSIONS: These findings suggest that CSA influences risky sexual behavior via multiple pathways and that more severe CSA may lead to elevated sexual risk indices. Moreover, these results suggest that men may elevate their risk of sexually transmitted infections via high numbers of sexual partners versus irregular condom use.

PRACTICAL IMPLICATIONS: These results highlight the need for adequate assessment and early interventions in order to mitigate the effects CSA may have on subsequent alcohol use and risky sexual behavior. Secondly, ensuring that male CSA victims understand the inherent risks of high numbers of sexual partners may be an effective strategy to interrupt the path toward risk-taking.

%B Child Abuse Negl %V 34 %P 369-78 %8 2010 May %G eng %N 5 %R 10.1016/j.chiabu.2009.08.013 %0 Journal Article %J J Am Coll Health %D 2010 %T College women's sexual decision making: cognitive mediation of alcohol expectancy effects. %A Davis, Kelly Cue %A Norris, Jeanette %A Hessler, Danielle M %A Zawacki, Tina %A Morrison, Diane M %A George, William H %K Adolescent %K Alcohol Drinking %K Cognition %K Condoms %K Decision Making %K Female %K Health Behavior %K Health Knowledge, Attitudes, Practice %K Humans %K Models, Psychological %K Multivariate Analysis %K Psychological Tests %K Psychometrics %K Risk Assessment %K Risk-Taking %K Sexual Behavior %K Statistics as Topic %K Unsafe Sex %K Washington %K Young Adult %X

OBJECTIVE: Alcohol has been linked to a variety of risky sexual practices, including inconsistent condom use. Due to the high rates of alcohol consumption among underage college women, greater understanding of the role of alcohol in young women's sexual decision making is warranted.

PARTICIPANTS AND METHODS: Female underage (18- to 20-year-old) social drinkers (N = 94) participated in an experiment in which they projected themselves into a written hypothetical sexual situation with a new partner. One half of the situations portrayed alcohol consumption; one half did not involve alcohol consumption. Their appraisals of the situation's sexual potential, impelling and inhibiting cognitions, and sexual behavior intentions were assessed.

RESULTS: Results revealed that alcohol's expectancy effects on young women's unprotected sexual intentions were mediated by their cognitive appraisals of the situation.

CONCLUSIONS: These findings indicate that alcohol expectancies and their influence on women's sexual decisions should be incorporated into sexual risk reduction efforts.

%B J Am Coll Health %V 58 %P 481-9 %8 2010 Mar-Apr %G eng %N 5 %R 10.1080/07448481003599112