How Does Alcohol Use Relate to Sexual Consent? A Scoping Review

ObjectiveTo test whether acute alcohol intoxication and alcohol expectancy affects how accurately women remember consensual and non-consensual sexual activity that occurred during an interactive hypothetical dating scenario.DesignA balanced placebo randomized study that varied alcohol dose (mean Breath Alcohol Content; BrAC = 0.06%) and alcohol expectancy prior to participants encoding a hypothetical interactive rape scenario was implemented. Participants could elect to consent to sexual activity with a male partner in the hypothetical scenario. If they stopped consenting, non-consensual sexual intercourse (i.e., rape) was described. Seven days later, participants’ memory for consensual and non-consensual sexual activity in the scenario was tested.Main outcome measuresMemory accuracy, confidence, and feelings of intoxication.ResultsA total of 90 females (M age = 20.5, SD = 2.2) were tested regarding their memory accuracy for the consensual and non-consensual sexual activities in the scenario. A multi-level logistic regression predicting memory accuracy for the perpetrator’s behaviors during the rape indicated no effect of alcohol intoxication. However, a main effect of alcohol expectancy was found, whereby participants who expected to consume alcohol, compared to those who did not, recalled the perpetrator’s behaviors during the rape more accurately. A second regression predicting memory accuracy for consensual sexual activity found no main effects for alcohol intoxication or alcohol expectancy. Participants recalled consensual sexual activity with a high degree of accuracy. Calibration analyses indicated that accuracy increased with confidence level, regardless of intoxication level or alcohol expectancy condition, but that women tended to be overconfident in general.ConclusionThis study provides an important test of how accurately women remember consensual and non-consensual sexual activities. The accuracy of this information is important for forensic medical examinations and police investigations following an allegation of sexual assault. Increased memory accuracy was found for offence details when participants expected to consume alcohol, suggesting there may be important differences in attentional processes (e.g., hypervigilance) depending on whether threat is present. Further research is necessary to investigate memory for sexual violence in real-world settings and to test methods for ascertaining the most complete and reliable accounts.

External consent communication and internal consent feelings may be influenced by alcohol consumption. However, whether the way someone communicates sexual consent differs when alcohol is or is not involved is not well understood. The goal of this study was to assess the within- and between-person effects of alcohol use, gender, and sexual identity on internal and external consent. Young adults (n = 375) completed a 10-minute web-administered survey about their internal and external consent in a recent alcohol- and non-alcohol-involved sexual encounter. External consent included five different behaviors to communicate consent. We conducted a repeated-measures analysis of variance to assess the within- and between-person effects of alcohol use, gender, and sexual identity on internal and external consent. Internal consent did not differ across sexual experiences or identities. In alcohol-involved encounters, there was a decreased use of implicit communication. Heterosexual women used more verbal communication during alcohol encounters than during sober encounters. Compared with men, women used more nonverbal and implicit communication across encounters. Alcohol use did not influence internal consent and was associated with a reduced use of implicit communication. The disinhibiting effects of alcohol may lead people to feel more confident and open about expressing their sexual desires. Affirmative consent initiatives can use findings to encourage more clear communication and continue to educate on gender differences in sexual consent.

College students frequently combine alcohol and sexual activity, often perceiving these encounters as consensual. However, alcohol use is also a significant risk factor for sexual assault. Recognizing that alcohol is implicated in both consensual and nonconsensual sexual activity, in this study we aimed to assess the relational and social dynamics of alcohol-involved, consensual sexual activity. We recruited 29 students from a large Midwestern university for interviews focused on alcohol and sexual decision-making. The interviews were analyzed using reflective thematic analysis. Participants relied heavily on “trust” to determine if they perceived an alcohol-involved sexual experience as consensual. They reported that they trusted their sexual partners not to harm them, with trust often based on contextual cues such as interacting with a potential partner at a party before having consumed alcohol or having a prior or current relationship with the potential partner. Additionally, college students reported trusting their friends to reduce harm during alcohol-involved sexual experiences and assist with deciphering their and/or their potential sexual partner’s ability to consent. Overall, our participants seemed to use trust as a potential harm reduction strategy to navigate alcohol-involved sexual experiences so that they are consensual. Relying on others to assist in these moments can be beneficial and aligns with a community-based approach to preventing sexual assault. However, participants did not always acknowledge that their trusted friends or partners might also be intoxicated, potentially impairing their ability to assist. Our findings highlight the complexity of relying on intoxicated peers and partners for judgment in these contexts.

Sexual consent may be associated with women’s sexual satisfaction and correlates of sexual satisfaction; however, this relationship is understudied. We conducted a review of research assessing women’s internal consent (i.e., feelings related to the decision to consent to sex), external consent communication, and their potential relationship with sexual satisfaction or correlates of sexual satisfaction. Relationship status may influence women’s internal consent, external consent communication, and sexual satisfaction. Women’s internal consent feelings, but not their external consent communication, appear related to sexual satisfaction. However, external consent communication used by women’s sexual partners is related with women’s own internal consent feelings. While preliminary findings from studies indicated that women’s internal consent feelings and their partners’ communication may influence their sexual satisfaction. Moving forward, researchers may consider more directly investigating the associations these consent constructs have with women’s sexual satisfaction. Research should also adopt more advanced and purposeful methodological designs to assess the relationship sexual consent has with sexual satisfaction.

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

Female college students, aged 18-25 years, are at high risk for sexual violence compared with women of other age groups. Lack of clear consent is a preceding and defining component of forced sex and sexual violence. This study explored the association between sexual consent awareness, attitudes, and beliefs and a history of forced sex among a sample of college women. In addition, the level of alcohol use among this group was examined. A cross-sectional electronic survey was sent to approximately 5900 female students enrolled at a large public university in the northeastern United States. Sexual consent was measured with the Sexual Consent Scale-Revised, and alcohol use was measured with the Alcohol Use Disorders Identification Test-Consumption Items. Logistic regression models were used to examine the differences in sexual consent scores based on a history of forced sex. The final sample included 925 students. Twenty-two percent of participants reported a history of forced sex; more than half (59%) reported alcohol use before sexual activity. Women with greater awareness of sexual consent were significantly more likely to have a history of forced sex. Women who utilize more nonverbal, indirect approaches to communicating sexual consent were significantly less likely to have a history of forced sex compared with women with no history of forced sex. These findings highlight high rates of forced sex and alcohol use in a sample of college women and explicate sexual consent awareness and communication behaviors associated with a history of forced sex.

Substance use can occur prior to nonconsensual and consensual sexual activity and affect how sexual consent is communicated and felt. Yet, researchers’ understanding of how substance use relates to these sexual experiences is still developing. Few researchers examine these behaviors among the intersection of sexual minority (SM) identity and gender. The goal of this study was to assess if experiences of nonconsensual and consensual substance-involved sexual activity, consent communication and feelings varied by the intersection of SM identity and identifying as a woman. Participants were recruited from a Prolific Academic panel to complete a survey about their substance use, sexual experiences, and sexual consent. SM persons and SM women reported more nonconsensual and consensual substance involved sexual experiences than heterosexual participants and SM men. Consent communication and feelings did not differ by across groups. Prevention initiatives for substance use and sexual activity may want to take an intersectional approach that addresses why different subgroups are at elevated risk to coalesce these two behaviors. Because consent feelings and communication did not differ by SM identity and gender, consent initiatives should expand their discussion to be inclusive of SM as these initiatives are often presented within a heteronormative framework.

Associations between internal and external sexual consent in a diverse national sample of women

Sexual satisfaction is an important part of sexual health. Recently, efforts have been underway to better understand what factors contribute to positive sexual experiences among young adults. One factor may be sexual consent. This study aimed to explore individual and interactive effects of two distinct, but related dimensions of sexual consent – internal consent and affirmative external consent – on young adults’ feelings of sexual satisfaction following their most recent sexual intercourse experience. Participants were 294 young adults (ages 18–25, M age = 23.7; 59% women) recruited from Amazon’s MTurk. Results showed that each dimension of consent had a significant, unique relationship with satisfaction, and that the two dimensions of consent alone accounted for half of the variance in satisfaction. Additional analyses showed that there are specific components of both internal and affirmative external consent (e.g., safety/comfort; arousal; consent/want; communicator/initiator cues) that may be most influential in driving this relationship. As both consent dimensions greatly contribute to positive sexual experiences, researchers attempting to promote sexual wellbeing may be wise to attend to both internal and external consent.

Sexual violence victimisation is common in college and first year presents a significant period of risk due to the navigation of alcohol, drugs and engaging in sexual intimacy. Cross-sectional data were analysed from 1,778 first-year college students, aged between 18 and 25 years. Experience of different forms of sexual violence victimisation and perpetrator tactics used were explored, along with the reported alcohol and drug use habits of victims. Results found that sexual violence through incapacitation was the most frequently reported tactic among all students. Hazardous alcohol consumption was significantly associated with higher rates of experience of all forms of sexual violence since beginning college among female students, and significantly associated with an increased likelihood of experiencing unwanted sexual touching for male students. There were gender differences in the associations between drug types and forms of sexual violence experienced. All drugs assessed predicted an increased risk of experiencing rape among female students, while cocaine, ecstasy and ketamine were associated with an increased risk of rape among male students. Further investigation is required into the context and environments in which different drug types are taken. The findings provide a strong rationale for including alcohol and drug use education as part of future sexual health and consent education programmes for college students. PRACTICE IMPACT STATEMENT This study has implications for the promotion of positive sexual health and the reduction of sexual violence victimisation among college students. In order to understand the forces at play regarding sexual consent practices among students it is necessary to recognise the contexts in which these incidents occur. This research informs third-level institutions (i.e. universities, third-level colleges) on the importance of including alcohol and drug use as part of effective sexual consent education programming due to the frequent overlap of substance use and sexual experiences among this particular cohort.

There is growing awareness about issues of sexual consent, especially in autonomy-compromising or “non-ideal” contexts, including sex involving alcohol. Understanding the conditions needed for consensual sex to occur in this emergent milieu is critically important, especially for young men (ages 18–30 years) who normatively combine drinking alcohol with sex and are most often perpetrators of sexual violence. This study offers a discourse analysis of young men’s alcohol use and sexual consent. Data are drawn from qualitative interviews with 76 young men (including gay, bisexual, queer, and straight men) in Vancouver, Canada, from 2018 to 2021. Informed by Kukla’s non-ideal theory of sexual consent and critical and inclusive masculinities, this analysis identified three discursive frames: careful connections, watering it down, and blurred lines. In careful connections young men discussed their efforts to actively promote sexual and decisional autonomy for themselves and their sexual partners when drinking. Yet, in watering it down young men invoked discourses of disinhibition, deflection, and denial to normalize alcohol use as being somewhat excusatory for sexual violence, downplaying the role and responsibility of men. Lastly, men operationalized blurred lines through a continuum of consent and of “meeting (masculine) expectations” when discussing sexual violence and victimization while intoxicated. Together, these discursive frames provide insights into the gendered nature of sexual violence and the extent to which idealized notions of sexual consent play out in the everyday lives of young men who use alcohol with sex. Findings hold philosophical and pragmatic implications for contemporary efforts to scaffold sexual consent.

During times of imprisonment, inmates have limited opportunities to relieve sexual urges. Nearly all sexual behaviors (e.g., coerced, consensual, masturbation) are restricted or outright banned in most prison systems. The restriction on sexual behavior is implemented, in part, to maintain control and limit possible violence. However, the policies set forth by prisons restricting sexual behavior do not remove sexual urges and, by some estimates, between 2% and 60% of inmates engage in consensual sexual activities during incarceration. This study explores 51 Department of Correction (DOC) policies on sexual behavior in prisons and examines how DOCs define and punish consensual sexual activity. Findings indicate that most DOCs have policies, which do not differentiate between consensual and nonconsensual behaviors and allow for the punishment of consensual and nonconsensual sexual activity with the same penalties. These findings are evaluated considering current research, and policy implications are discussed.

For 28 days, 113 participants (MAge = 29.2 years, 57.5% women, 70.8% White) responded to three surveys per day on their personal devices. At time points when participants reported having engaged in partnered sexual activity, they were asked to report their alcohol use, cannabis use, internal consent feelings, and external consent communication. Across 1189 partnered sexual events, 31.5% involved alcohol, cannabis, or both. Sexual events that involved combined use were associated with diminished feelings of safety/comfort and feelings that the sexual act was consensual, compared with events that involved neither substance. Greater levels of alcohol consumption were descriptively associated with lower ratings of internal sexual consent. We found that combined use of alcohol and cannabis may lead to lower internal sexual consent than using either substance alone - potentially due to greater levels of impairment associated with polysubstance use. Sexual health education programs should consider more nuanced approaches to teaching people how to navigate substance use and sexual consent.

Research suggests that a history of childhood sexual abuse, and previous experiences of sexual coercion, may predict sexual coercion victimization and perpetration. More recently, sexual motivation has been found to correlate with both consensual and non-consensual sexual activity. However, sexual motivation has not been examined in association with previous experiences of abuse and sexual coercion. The aim of this study was to investigate childhood sexual abuse, previous sexual coercion experiences, and sexual motives of both partners as possible risk factors for current sexual coercion victimization and perpetration within a sample of 209 mixed-sex couples. This study examined whether power, stress relief, partner pressure, and imposition motives contributed unique variance to the prediction of sexual coercion beyond that accounted for by past childhood sexual abuse and sexual coercion events. Using hierarchical logistic regressions, four predictive models were examined for both male and female sexual coercion perpetration and victimization. Results show that childhood sexual abuse was only a significant predictor of female sexual coercion perpetration, whereas male sexual coercion victimization and perpetration were predicted by sexual coercion victimization and perpetration in previous relationships. Power motives were also significant predictors of sexual coercion perpetration, and imposition was a significant predictor of sexual coercion victimization for both genders.

The pervasiveness of sexual assault among college women prompted examination of college students' sexual-consent expectancies using sexual scripting theory as a framework. We aimed to understand how personal beliefs, experiences with sexual violence, and dominant cultural gendered sexual scripts in music media inform sexual-consent expectancies among a sample of primarily White heterosexual college students at a northwestern university (n = 364). Participants viewed music videos with sexual and objectifying content and reported their perceptions of how women were portrayed. Linear mixed modeling with Maximum Likelihood with interactions by biological sex revealed associations between past sexual victimization and lower expectancies to adhere to a sexual partner's consent wishes. Men with a history of perpetrating sexual violence had lower expectancies to ask for consent, and women with more traditional sexual stereotypes had lower expectancies to seek consent or refuse unwanted sex. Having lower expectancies to adhere to a partner's consent wishes was associated with holding more traditional sexual stereotypes for both men and women. Participants who perceived women as powerlessness in viewed music videos had lower expectancies to ask for consent from a sexual partner, to refuse unwanted sexual advances, and to adhere to a decision regarding sexual consent. Through the lens of sexual scripting theory, results advance understanding of how the intersection of biological sex, experiences of sexual violence, gendered beliefs, and cultural scripts in music media inform young adults' sexual expectancies and potential for sexual risk. Implications for prevention include addressing gendered sexual scripts to reduce ambiguity around sexual consent among college students. Media-based interventions are discussed as a strategy toward this end.