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Try out PMC Labs and tell us what you think. Learn More. We differentiated effects of alcohol on likelihood of sexual activity versus use of protection against STDs or pregnancy on intercourse occasions by testing a multilevel multinomial model with four outcomes no sex, oral sex without intercourse, protected intercourse, and unprotected intercourse. At the within-person level, effects of alcohol were hypothesized to be conditional upon level of intoxication i.
We also tested effects of four between-person moderators: gender, typical length of relationship with sexual partners, and two facets of self-control effortful control and reactivity. Consistent with our hypothesis, low-level intoxication was associated with increased likelihood of engaging in oral sex or protected intercourse relative to no sex but was not related to likelihood of unprotected intercourse. The effect of intoxication on unprotected versus protected intercourse was an accelerating curve, ificantly increasing likelihood of unprotected intercourse at high levels of intoxication.
Between-person factors moderated associations between intoxication and sexual behavior. Effects of intoxication on both protected and unprotected intercourse were diminished for individuals with more familiar sexual partners. Effortful control exhibited a protective effect, reducing the effects of intoxication on likelihood of unprotected intercourse.
Hypothesized effects of reactivity were not supported. Intoxication was a stronger predictor of oral sex and protected intercourse but not unprotected intercourse for women relative to men. highlight the inherent complexities of the alcohol-sexual behavior nexus.
Experimental research indicates that alcohol may foster greater sexual arousal George et al. In respect to sexual behavior, sexual approach cues are often most salient, especially during heightened arousal, whereas concerns about potential negative consequences e.
For example, Hensel and colleagues found no association between either alcohol or marijuana use and condom use in a sample of adolescent females ages 14— Similarly, Scott-Sheldon and colleagues did not find a main effect of alcohol consumption on condom use in a college student sample. Patrick and colleagues found ificant effects of alcohol consumption and several sexual outcomes e. In contrast, Neal and Fromme found event-level effects of intoxication were specific to risky sex. Dual-process models of self-control posit two competing systems underlying self-regulation Lieberman, ; Wiers et al.
The effortful or reflective system is conceptualized as more deliberate and slower acting Lieberman, ; Wiers et al. For example, Abbey and colleagues found that executive cognitive functioning acted as a buffer, reducing the effects of intoxication on unprotected sex intentions in an alcohol administration study. Grenard and colleagues found that working memory was inversely related to associations between implicit risky sex associations and sexual risk behavior in a cross-sectional de.
However, the hypothesis of moderating effects of reactivity on sexual risk outcomes has received less support Simons et al. Few studies that have tested effects of effortful control and reactivity on within-person associations between intoxication and sexual outcomes have used experience sampling methods. Nonetheless, men tend to exhibit higher rates of hazardous alcohol use and sexual risk behaviors Dawson et al.
For example, Owen and colleagues found stronger longitudinal effects of alcohol on casual sexual encounters for women. Findings on the moderating effects of gender on associations between alcohol and condom use have been mixed. Kiene and colleagues found drinking in women increased the likelihood of unprotected sex with a casual partner but exhibited the opposite pattern with steady partners.
We add to the literature by testing effects of gender on within-person i. Cooper identified relationship as an important contextual factor that may have conflicting effects on sexual risk behavior. Conversely, risk promoting factors such as impulsivity exhibit the strongest effects in first sexual encounters and in the context of low relationship commitment Cooper, Extending this to risk promoting situational factors, Patrick and colleagues showed that drinking exhibited stronger within-day associations with sexual behavior for individuals who were single rather than in casual or committed relationships.
Research on the effects of relationship on within-person associations between drinking and unprotected sex has produced mixed findings. However, there is also support for the converse. Scott-Sheldon and colleagues found that, for women, alcohol has inverse effects on condom use only with more established partners. Finally, there are also null effects. For example, in a sample of young-adult women, Walsh and colleagues found that condom use varied as a function of partner relationship, but partner relationship did not moderate the effects of alcohol consumption on condom use as expected.
We aim to extend these findings to examine moderating effects of partner relationships on daily associations between intoxication and multiple sexual outcomes. Although college students tend toward higher consumption per drinking episode than their peers not in college Substance Abuse and Mental Health Service Administration, b , the typical of drinks per drinking day is relatively low. For example, the median of drinks per drinking day among college students in the NSDUH was 3 Substance Abuse and Mental Health Service Administration, a , a level unlikely to have substantial behavioral effects.
event-level research has mixed findings. Studies show a positive relationship between drinking and the likelihood of unprotected sexual intercourse with casual partners Kiene et al. Walsh and colleagues found that the likelihood of condom use did not vary across non-drinking, drinking, or heavy episodic drinking events. However, within drinking events there was a negative association between of drinks and condom use. Hence, we propose to test nonlinear effects of intoxication on sexual behavior that may for both positive and negative effects of intoxication and test whether negative effects of intoxication on protected intercourse occur primarily at high levels.
The current study was deed to address several gaps in the literature regarding associations between alcohol and sexual behavior in the natural environment. First, we test associations between alcohol and four outcomes no sex - no oral sex or intercourse, oral sex but no intercourse, protected intercourse, and unprotected intercourse. This de enables the study to distinguish predictors of sexual activity from use of protection against STDs and pregnancy.
Related to this, we test curvilinear effects of intoxication. Alcohol, socialization, and dating are tightly integrated among young adult college students. Hence, alcohol consumption was hypothesized to co-occur with sexual opportunities. However, low-level alcohol intoxication does not cause substantial impairment in judgment and decision-making.
We hypothesized therefore that effects of alcohol on sexual risk are non-linear, exhibiting the most pronounced negative effects at higher, less frequent, levels of intoxication. A second emphasis was to analyze person-level moderators. We hypothesized that effortful control buffers effects of intoxication on sexual behavior. In contrast, reactivity was hypothesized to predict stronger within-person associations between intoxication and sexual risk outcomes. We also examined partner relationships as a person-level factor.
We treated this construct as a between-person variable in order to assess effects across each outcome e. Here, we propose that alcohol intoxication has a stronger effect on sexual behavior among individuals who tend to have newer relationships with their sexual partners cf. Cooper, ; Kiene et al. Finally, we tested effects as a function of gender to evaluate whether intoxication has stronger effects on sexual behavior for women relative to men Kiene et al. Participants were young adults who reported at least one instance of sexual activity during the experience sampling study.
This is a subset of young adults in the parent study see Simons et al. Women comprised Three percent were Hispanic or Latino. The participants were a subset of sexually active participants in a sample of individuals whose data were analyzed and reported in four publications Simons et al. The standardized mean of the three variables i.
Sexual behavior was assessed in the retrospective morning assessments. The outcome is a nominal indicator of no sexual activity i. Undergraduates who drank at least moderately i. Invited participants provided informed consent for the study, completed a set of baseline questionnaires, and were then trained in the use of the PDA.
In addition, participants completed a self-initiated assessment each morning shortly after waking, which included assessments of sexual behavior not likely to be captured by the random prompts. The longitudinal burst de was structured such that participants did the experience sampling in six measurement bursts over the course of three semesters. The first burst was two weeks long, and each of the remaining bursts was one-week duration. Additional detail is in Simons, Wills, and Neal We tested a multilevel multinomial regression analysis in Mplus 7.
The outcome was a 4-category nominal variable reflecting sexual behavior each night no sex no oral sex or intercourse , oral sex oral sex but not intercourse , protected intercourse, unprotected intercourse. We included participants who reported at least one instance of oral sex or intercourse. Six orthogonal day of the week indicators, elapsed days days since beginning the study , and nighttime intoxication were Level 1 daily level predictors. Effortful control, reactivity, average partner relationship, gender, and university site were Level 2 person level predictors. We included a quadratic term for nighttime intoxication to test hypothesized curvilinear effects.
Finally, cross-level interactions of effortful control, reactivity, partner relationship, and gender on the within-person intoxication effects were included to test hypothesized moderating effects. Continuous L1 predictors were centered at the person-mean and all L2 predictors were centered at the grand mean. Random variance in the elapsed day and intoxication slopes was evaluated. However, there was not evidence of substantial random slope variance and hence the slopes were treated as fixed effects. The outcomes had random intercepts, which were allowed to freely covary.
Model diagnostics e. Compliance with the experience sampling protocol was good. Participants in the analysis sample provided an average of Participants reported having oral sex on 9. Participants did not use protection from STDs or pregnancy on Participants reported drinking on Table 1 contains summary statistics. Between-person correlations are presented in Table 2. Consistent with expectation, effortful control was inversely associated with degree of intoxication and positively associated with mean length of relationships with sexual partners.
In contrast, reactivity was associated with greater degree of intoxication and marginally correlated with tending to know partners less i. Other associations between self-control traits and sexual behavior were not ificant. Heavier drinkers reported having oral sex and intercourse on a higher proportion of days.
Sexual activity and use of protection were modestly inversely associated. Male gender was positively associated with drinking level, but was not associated with any of the sexual behavior variables. Intoxication, partner relationship, oral sex, intercourse, and protection are the person-means across days. In contrast to the analysis, Oral sex in this context refers to all instances of oral sex irrespective of engaging in intercourse. We tested the multilevel multinomial regression model described in the analysis plan. The analysis includes 6, days nested in persons. This resulted in retaining only the effortful control and reactivity effects on the intoxication quadratic term.
The final model are in Table 3. Table 4 presents a reparameterization of the model, to show effects on the contrast of protected vs. Day of the week, elapsed day, and site are included as covariates but not depicted due to space limitations. are mutually exclusive. The oral sex category refers to nights that oral sex but no intercourse occurred.
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