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

ABSTRACT

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; M_age = 25.01, SD_age = 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.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded by the National Institute of Alcohol Abuse and Alcoholism (NIAAA): 2R01AA016281 (PIs: Davis & George). Manuscript preparation was also supported by grants from NIAAA: K08AA028546 (PI: Jaffe) and K99AA028777 (PI: Blayney), and the National Institute of General Medical Sciences (NIGMS) (P20GM130461; Rural Drug Addiction Research Center). This content is solely the responsibility of the authors and does not necessarily represent the official views of the NIAAA or NIGMS.