Forced Sex, Alcohol Use, and Sexual Consent Among College Women

Abstract

<h2>Paper Presentation</h2><h3>Objective</h3> To explore the association between a history of forced sex and sexual consent awareness, attitudes, and beliefs and examine the relationship between alcohol use and misuse and history of forced sex. <h3>Design</h3> Cross‐sectional, web‐based survey. <h3>Setting</h3> A large public university in the Northeast United States. <h3>Sample</h3> Inclusion criteria included the following: college women age 18 to 25, enrolled full‐ or part‐time, currently or previously sexually active, and English speaking. The final sample included 972 women. <h3>Methods</h3> After Institutional Review Board approval, an e‐mail invitation was sent to enrolled female students. A web link to the informed consent and inclusion criteria was provided. Students who met study criteria could proceed to the survey. Survey questions were guided by concepts from the theory of planned behavior, including sexual history questions from the Centers for Disease Control and Prevention, the Alcohol Use Disorders Identification Test–Consumption Items (AUDIT‐C), and the Sexual Consent Scale–Revised (SCS‐R). A history of forced sex was measured by a dichotomous (yes/no) response to the question, "Have you ever been forced to have sex when you didn't want to?" adapted from the Abuse Assessment Screen for violence. Completion of the survey implied consent. <h3>Results</h3> Forced sex was reported by 22% of participants. More than one half (59%) of participants reported alcohol use prior to sexual activity, and approximately 25% reported drinking two or three times per week. Women with greater awareness of sexual consent were significantly more likely to report a history of forced sex (odds ratio [OR] = 1.553, <i>p</i> < .000, CI [1.324, 1.820]), and women who utilized more nonverbal, indirect approaches to sexual consent negotiation were less likely to report a history of forced sex (OR = .683, <i>p</i> = .002, CI [.537, .870]). <h3>Conclusion/Implications for Nursing Practice</h3> Communication of sexual consent between partners has the potential to be misinterpreted if not clear and direct. Concurrent alcohol use may lead to difficulty refusing sexual activity and a poorly communicated refusal that could be misinterpreted. Providers need to understand all characteristics that contribute to sexual risks and forced sex among college women and have individualized discussions about sexual risk behaviors that address coercion and violence.