Factors influencing the relationship between alcohol consumption and risky sexual behaviour among young people: A systematic review

Figures & data

Table 1. Type of research article

Article type	Amount	Authors
Empirical article	45	Abbey et al. (2005); Abby et al. (2007); Adams et al. (2014); Bailey et al. (2011); Brown and Vanable (2007); Charnigo et al. (2013); Connor et al. (2013); Foster and Neighbors (2013); Griffin et al. (2012); Gullete and Lyons (2006); Khasakhala and Mturi (2008); King et al. (2012); Kogan et al. (2010); LaBrie et al. (2011); LaBrie, Pedersen, Neighbors, and Hummer (2008); Langer et al. (2001); Lewis et al. (2014); Littleton, Breikopf, and Berenson (2007); Miller et al. (2003); Muchimba et al. (2013); Murry et al. (2013); Neighbors et al. (2007); Oei and Jardim (2007); Orchowski and Barnett (2012); Park and Grant (2005); Parks et al. (2008); Patrick (2013); Patrick and Maggs (2010); Quinn and Fromme (2010); Radanielina-Hita (2015); Randolph, Torres, Gore-Felton, Lloyd, and McGarvey (2009); Schraufnagel et al. (2010); Seth et al. (2011); Sonmez et al. (2006); Stappenbeck et al. (2013); Stuewig et al. (2015); Townsend et al. (2011); Townshend et al. (2014); Turrisi et al. (2000); Vivancos, Abubakar, Phillips-Howard, and Hunter (2013); Voisin et al. (2013); Walsh et al. (2014); Walsh et al. (2013); Wayment and Aronson (2002); Wetherill et al. (2010)
Review article	6	Cooper (2002); Cooper (2006); Kuntsche et al. (2005); Oei and Morawska (2004); Pithey and Morojele (2002); Vicary and Karshin (2002)

Table 2. Thematic domains

Thematic domain	Authors
1. Personal influences on alcohol consumption and risky sexual behaviour	Charnigo et al. (2013); Griffin et al. (2012); Gullete and Lyons (2006); LaBrie et al. (2008); Littleton et al. (2007); Miller et al. (2003); Murry et al. (2013); Oei and Morawska (2004); Quinn and Fromme (2010); Stuewig et al. (2015)
2. Social determinants of alcohol consumption and risky sexual behaviour	Abbey et al. (2005).The); Abby et al. (2007); Bailey et al. (2011); Connor et al. (2013); Khasakhala and Mturi (2008); King et al. (2012); Kuntsche et al. (2005); Lewis et al. (2014); Orchowski and Barnett (2012); Oei and Jardim (2007); Neighbors et al. (2007); Parks et al. (2008); Patrick (2013); Pithey and Morojele (2002); Seth et al. (2011); Stappenbek et al. (2001); Townsend et al. (2011); Turrisi et al. (2000); Vicary and Karshin (2002); Walsh et al. (2013)
3. Interpersonal factors related to alcohol consumption and risky sexual behaviour	Adams et al. (2014); Brown and Vanable (2007); Cooper (2002); Cooper (2006); Kogan et al. (2010); LaBrie et al. (2011); Langer et al. (2001); Muchimba et al. (2013); Park and Grant (2005); Patrick and Maggs (2010); Radanielina-Hita (2015); Randolph et al. (2009); Schraufnagel et al. (2010); Sonmez et al. (2006); Townshend et al. (2014); Vivancos et al. (2013); Voisin et al. (2013); Walsh et al. (2014); Wayment and Aronson (2002); Wetherill et al. (2010)

Table 3. Personality influences on alcohol consumption and risky sexual behaviour

Author	Focus of research	Age cohort and sample composition	Area/context	Method	Framework
Charnigo et al. (2013)	Elucidate the joint contribution of sensation seeking and impulsive decision-making, to HIV = STD risk behaviours among young adults	n = 2,386 young adults aged 18–26 years Various ethnic groups	Data utilised from a larger study from two cities: Lexington, Kentucky, and Knoxville, Tennessee (Zimmerman et al., 2007)	Quantitative (survey)	Five-factor model of personality (Zuckerman, 1994)
Griffin et al. (2012)	Examined the extent to which high-risk drinking and sexual behaviour clustered together	Sample 1: ninth-grade mean age = 14.6 years Sample 2: adult assessment, mean age = 22.8 years (N = 692)	Participants were part of a larger school-based drug abuse and violence prevention trial	Quantitative (self-reported questionnaire—initial; telephonic interview—adult assessment)	None
Gullete and Lyons (2006)	Examined the relationships of sexual sensation seeking, self-esteem and self efficacy in condom use, and alcohol consumption to HIV risk-taking behaviours	n = 3,000 college students, 18–43 years	Participants were located at a university in the southern US.	Quantitative (this study was a descriptive and correlational survey)	Transtheoretcal Model of Behavioral Change
LaBrie et al. (2008)	Examines the role self-consciousness plays in the experience of alcohol-related consequences	n = 1,168 student members of 20 campus organisations between 18 and 21 years 1% older	West Coast University (USA)	Quantitative (online survey)
Littleton et al. (2007)	Examined the associations between a history of physical or sexual abuse and recent sexual risk behaviours among adult women	1,428 women aged 18–40 years old, who visited one of two clinics offering comprehensive reproductive healthcare	A low-income community in Southeast Texas	Quantitative (survey)
Miller et al. (2003)	Explores the relations between the Five Factor Model of personality and a variety of risky sexual behaviours	n = 242 men and n = 239 women Mean age = 21		Quantitative (questionnaires)	Five Factor Model of personality
Oei and Morawska (2004)	Develops a cognitive model using the key constructs of alcohol expectancies and drinking refusal self-efficacy to explain the acquisition and maintenance of binge drinking	Adolescents and young people Literature on binge drinking		Literature review	Alcohol Expectancy Theory
Quinn and Fromme (2010)	Examined whether self-regulation was a protective factor against heavy episodic drinking, alcohol-related problems and unprotected sex among emerging adults	n = 1,136 completed both surveys Survey 1: 17–19 years Survey 2: mean age 21–75 years	University of Texas at Austin	Quantitative (longitudinal study; survey)	Self-regulation and sensation seeking
Stuewig et al. (2015)	Investigates the role of individual competence factors as modifiers of the risk for adult substance and alcohol abuse in relation to living in high- or low-income areas	Study 1: n = 80, fifth graders (ages 10–12) Study 2: 68% re-interviewed (ages 18–21)	Nine public elementary schools in a suburban Washington DC	Longitudinal study	None

Table 4. Social determinants of alcohol consumption and risky sexual behaviour

Author	Focus of research	Age cohort and sample composition	Area/context	Method	Framework
Abbey et al. (2005)	Examines the effects of alcohol consumption on condom use	195 females 103 males aged between 21 35 years	Large urban university	Quantitative (self-reported questionnaire)	None
Abby et al. (2007)	Explores alcohol use and risky sexual behaviour among young adults in a low-income community in Cape Town	n = 143 (18–25 years)	An impoverished community on the Cape Flats in the Western Cape, South Africa	Quantitative descriptive correlational design	None
Bailey et al. (2011)	Describes an example of the use of latent variable modelling to create measures of complex phenotypes and environments that illustrate the utility of the general versus specific conceptualisation	Fifth-grade students (N = 765) = 49% female, 51% male, ethnically diverse 95% (752) retained at age 24	Seattle Social Development, a longitudinal study of the development of positive and antisocial project behaviours	Secondary data from a longitudinal study	None
Connor et al. (2013)	Informing potential interventions to reduce sexual risk behaviours among university students, in particular, and young people, in general	n = 5,770 students aged between 17 and 25 years	8 New Zealand campuses	A cross-sectional web-based survey .
Khasakhala and Mturi (2008)	Examines factors that may predispose unmarried and unemployed out-of-school youth to risky sexual behaviour	n = 6,129 male and female unmarried and unemployed out-of-school youth aged between 15 and 24 years	Based on data gathered from the Behaviour Surveillance Survey, Kenya	Quantitative (structured questionnaire)
King et al. (2012)	Associations between substance use disorder symptoms and high-risk sexual behaviours change across young adulthood	Seattle Social Development Project, recruited in 1985 from 18 elementary schools drawn from high-crime neighbourhoods at ages 21, 24, 27 and 30 years	High-crime neighbourhoods	Quantitative = longitudinal study	State- and trait-level theories
Kuntsche et al. (2005)	Reviews evidence of adolescent and young adult drinking motives and their relation to possible consequences over the last 15 years	Include articles published only in English The literature search was restricted to publications from 1989 onwards, age group of 10 to 25 year olds	Predominantly North America	Systematic review	The motivational model
Lewis et al. (2014)	Examining Spring Break-specific normative perceptions of sexual risk behaviour and the role that these perceptions and taking a trip with a friend or with a romantic partner have on Spring Break sexual behaviour	N = 1,540 students Caucasian and Asian with a mean age of 20.3 years	A large public northwestern university	Quantitative (online survey)
Murry et al. (2013)	Identifies mechanisms that forecast rural African-American males’ susceptibility to risk behaviours over time	Approximately 78% of the original sample was maintained across five waves (W1:10.5 years; W5: 20 – 21 years). N = 889 African-American families in Iowa and Georgia N = 411 families with male youth were included	Iowa and Georgia	Quantitative (questionnaires)	Conceptual model (family and economic stress theories and problem behaviour theory)
Oei and Jardim (2007)	Determines whether alcohol expectancies (AE) and DRSE predict alcohol consumption in Asian students	Caucasian (n = 98) and Asian (n = 92) student samples Mean age = 21.18 years	First-year psychology class	Quantitative (questionnaire)	AE and DRSE
Orchowski and Barnett (2012)	Explores the relationship between alcohol use and experience of alcohol-related sexual consequences (ARSC) during the transition from high school to the first year of college	447 men and 606 women with a mean age of 18.4 years and varied ethnicity	New England colleges/universities	Quantitative (web survey)
Neighbors et al. (2007)	Evaluates the relative contribution of social norms, demographics, drinking motives and alcohol expectancies in predicting alcohol consumption and related problems among heavy drinking college students	17–21 years 818 (57.6% women) first year undergraduates	West Cost university (USA)	Quantitative (web-based assessments)
Parks et al. (2008)	To assess the rates of risky sexual behaviour among women bar drinkers, as well as differences in predictors of risky sexual behaviour, based on partner type—new or regular	18–30 years 241 women Various ethnic groups	Women bar drinkers	Quantitative (interviews)
Patrick (2013)	The extent to which Spring Break drinking and sexual behaviours are related	18–21 years, n = 263; 55% women	Students planning on going on a Spring Break trip	Quantitative (web survey)
Pithey and Morojele (2002)	Focus on how alcohol misuse increases the occurrence of sexual risk behaviour in South African communities	Articles on alcohol use and risky sexual behaviour in South Africa	South Africa	Review of literature
Seth et al. (2011)	Examined the relationship between alcohol use at non-abuse levels and risky sexual behaviours and sexually transmitted infections (STIs) among young adult African-American women	18–29 years, n = 979, 86.6% completed baseline assessments, 78.9% and 79.4% completed 6 and 12 months follow-up, respectively	Members from three Kaiser Permanente Centers having the greatest number of African-Americans in Atlanta, GA.	Quantitative (audio computer-assisted survey interview)
Stappenbek et al. (2001)	To identify patterns of alcohol use behaviours and alcohol expectancies among women who are non-problem drinkers and to examine how these patterns are associated with indices of sexual risk	18–35 years, 758 women, various ethnic groups	USA	Quantitative (questionnaire—various scales)
Townsend et al. (2011)	The aim of this study was to examine the relationship between binge drinking, “reflection impulsivity” alcohol-related expectancies and unplanned sexual behaviour in a sample of young social drinkers	18 and 34, n = 92 (43 males and 49 females)	Cape Town, South Africa	Quantitative (questionnaire)
Turrisi et al. (2000)	The nature of the relation among drinking beliefs, drinking tendencies and behavioural consequences	Mean age of 18.24 years, n = 266	US: a moderately sized northwestern university	Quantitative (battery of questionnaires)
Vicary and Karshin (2002)	This article reviews the extent of the current alcohol problem as well as a historical perspective	n = 2,000, college students aged 18–24 years	US Colleges and universities	Review survey of literature	None
Walsh et al. (2013)	Test a path model that included perceived sexual control, sex-related alcohol expectancies and likelihood of risky sexual behaviour when drinking as mediators between CSA and adult substance facilitated rape	n = 546 female college students Mean age = 18.7 years	All female students enrolled in an introductory psychology course over three consecutive semesters	Quantitative (anonymous surveys)	Traumagenic dynamics theory

Table 5. Interpersonal factors related to alcohol consumption and risky sexual behaviour

Author	Focus of research	Age cohort and sample composition	Area/context	Method	Framework
Adams et al. (2014)	Explores alcohol use and risky sexual behaviour among young adults	n = 143, aged 18–25 years	An impoverished community on the Cape Flats, Western Cape, SA	Quantitative (descriptive correlational design)	None
Brown and Vanable (2007)	Clarify the impact of partner type on the alcohol-risky sex association	N = 547 mixed race, with a mean age of 19 years, 67% female	Introductory psychology courses	Quantitative (self-administered questionnaire)	Myotopia Theory
Cooper (2002)	To evaluate the empirical associations between alcohol use and risky sex at two levels of analysis	Published in the past 10 years and using event level methodology or random sampling were emphasised	Published articles	Review	Myopia Theory and Expectancy models and spurious model
Cooper (2006)	Reflects multiple underlying processes of relationship between AU and RSB that are both causal and non-causal	Articles based on theories trying to explain the relationship between alcohol use and risky sexual behaviour	Published articles	Review of literature
Kogan et al. (2010)	Examined the protective influence of several variables hypothesised either to reduce unprotected intercourse or improve the influence of risk factors	African-Americans aged 18–21 years, not attending high school or enrolled full-time college or university	Seven counties in central Georgia	Quantitative (audio computer-assisted self-interviews)	Ecological and self-regulatory theories of risk behaviour
LaBrie et al. (2011)	Examined the extent to which PBS mediated the influence of drinking motives	N = 1,592 with a mean age of 19.94 years; 76.9% Caucasian	Two universities (public and private)	Quantitative (online surveys)	Mediational Model
Langer et al. (2001)	Understanding of the risk and protective factors on which many prevention programmes	N = 388 aged between 17 and 27 years, 72.0% Hispanic	Urban university in South Florida	Quantitative (285-item questionnaire)
Muchimba et al. (2013)	Examined alcohol use frequency in adolescence as a predictor of HIV sexual risk behaviour in adulthood	Initial assessment: 15–18 years Second assessment: mean time between assessments = 8.3 years Varied ethnicity distribution	Colorado	Quantitative (questionnaires)
Park and Grant (2005)	Examine the influence of alcohol consumption, gender and psychological risk and protective factors on college students’ experiences of negative and positive consequences	84 men, 97 women; varied ethnicity mean age = 19	University of Connecticut	Quantitative (questionnaire)
Patrick and Maggs (2010)	Person-centred associations in motivations across motivations for alcohol use and sexual behaviour	18–20-year-old first year students and US citizens or permanent residents	US, northeastern university	Quantitative (web surveys)
Radanielina-Hita (2015)	Parental mediation and critical thinking—that may influence the decision-making process	N = 658 aged between 18 and 21 years	Northwestern American university	Quantitative (online questionnaire)	Message Interpretation Model
Randolph et al. (2009)	To assess the role of gender and ethnicity in the relationship between alcohol use and risky sexual behaviour	18–34 years, n = 425 (265 females and 160 males)	A southern university, USA	Quantitative (questionnaire)
Sonmez et al. (2006)	How cognitive and affective attitudes, personal normative beliefs, social determinants, expectations and pacts influence intentions of excessive alcohol consumption and casual sex	N = 534, age = 18–25 years	One northeastern and one southwestern university	Quantitative (cross-sectional—questionnaire)	The Theory of Interpersonal Behavior
Townshend et al. (2014)	Dynamics of social relationships in which alcohol use and risky sexual behaviours occur	N = 421 men aged 18–62 years	One of the poorest suburbs in South Africa	Mixed-methods (quantitative survey and in-depth interview)
Schraufnagel et al. (2010)	Explored a potential connection between CSA and an increased likelihood of risky sexual behaviour in adulthood	n = 280 males aged between 21 and 35 years	The greater Seattle	Quantitative (self-reported questionnaire)
Vivancos et al. (2013)	To quantify the effectiveness of school-based sexual education on risky sexual behaviour and STI acquisition in adulthood	n = 711 between 18 and 29 years	University students	Quantitative (online survey)
Vivancos et al. (2013)	To quantify the effectiveness of school-based sexual education on risky sexual behaviour and STI acquisition in adulthood	n = 711 between 18 and 29 years	University students	Quantitative (online survey)
Walsh et al. (2014)	Testing a model specifying that traumatic intrusions after early abuse may increase risk for alcohol problems, which may increase the likelihood of engaging in RSB	1,169 racially diverse college students with a mean age of 20.7 years	Large, public, urban southeastern university	Quantitative (questionnaires)
Voisin et al. (2013)	Examined associations among multiple theoretically informed risk and protective factors on unsafe sex	African-American aged 15–21, were not married, currently pregnant or attempting to get pregnant	Three comparable STI clinics in Atlanta, Georgia	Quantitative (generalised estimating equation models)	Ecological Model
Wetherill et al. (2010)	Tested the influence of sexual values and perceived awareness and caring, or beliefs about how much parents and peers know and care about student’s behaviour on sexual behaviour	N = 1,928 between 17 and 19 years old	United states (high school and college)	Internet-based surveys	None
Wayment and Aronson (2002)	A path model tested in order to assess specific hypothesised predictors of risky sexual behaviour	n = 95 sexually active white female college students aged between 18 and 30 years	University in the southwestern US	Quantitative (questionnaire)	Health belief model

Figure 1. Article search and appraisal process

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