Sex-related Alcohol Expectancies Research Articles

Impulsivity, sex-related alcohol expectancies, alcohol use, and sexual risk-taking among bisexual women.

According to the acquired preparedness model, personality traits, such as impulsivity, may influence the learning process, contributing to heightened expectations surrounding risky behaviors (i.e., alcohol use, sexual risk-taking). As bisexual women demonstrate heightened risk for hazardous alcohol- and sex-related behaviors, the present study examined a sequential pathway, whereby the relation between impulsivity and sexual risk-taking is mediated through sex-related alcohol expectancies and alcohol use. Data were collected from 225 self-identified cisgender, bisexual women between the ages of 18 and 30 years (M = 22.77, SD = 3.45), who participated in an online survey. Participants reported on impulsivity, sex-related alcohol expectancies, alcohol use, and experiences of sexual risk-taking. Results revealed that sex-related alcohol expectancies and alcohol use sequentially mediated the relation between impulsivity and sexual risk-taking. Thus, greater impulsivity was related to greater sexual risk-taking through heightened sex-related alcohol expectancies and elevated alcohol use. Findings from this study highlight mechanisms associated with risky drinking and sexual behaviors among this at-risk population. Such information could aid the development of more efficacious prevention and intervention programs aimed at reducing consequences associated with alcohol use and sexual risk-taking among bisexual women. Bisexual women are at heightened risk for alcohol-related problems, including sexual risk-taking. Findings from the current study identify impulsivity and sex-related alcohol expectancies as independent and integrative predictors of such risky behaviors. Incorporation of these constructs may aid in the development of more efficacious clinical methods aimed at bettering health outcomes among bisexual women.

(075) Partnered Sexual Desire Influences Sex-related Alcohol and Drug Expectancies and Subsequent Sex-linked Substance Use

Abstract Introduction The use of recreational substances in a sexual context (sex-linked substance use) is common among young adults, with up to a third indicating that that they used alcohol, cannabis, or both during their recent partnered sexual activity (Willis et al., 2021; Herbenick et al., 2018). Sex-linked substance use (SLSU) is associated with a variety of positive and negative clinical outcomes including increased sexual pleasure, but also greater risk for condomless sex. Expectations of how one will behave and feel during sex while under the influence have been shown to predict SLSU habits. Contextual factors like relationship status may contribute to these expectancies, with studies finding that young women who are casually dating have more positive sexual expectancies of alcohol compared to women who are not dating or are in a long-term relationship (e.g., Patrick et al., 2014; Pedersen et al., 2009). Given the relationship between SLSU, relationship status, and sexual expectancies, it is likely that other contextual factors of a relationship, like partnered sexual desire, may play a role in sexual outcomes of women’s substance use. However, little is known about how partnered sexual desire is related to either substance sex-related expectancies in college-aged women. Objective To investigate how relationship status and partnered sexual desire is related to differences in alcohol and drug sexual expectancies and SLSU. Methods We surveyed 512 women (mean age 20.09, SD = 1.56) in the Midwestern US. Participants completed the Brief Comprehensive Expectancies of Alcohol and Drug scales, assessing their alcohol and drug expectancies, including sex-related expectancies (e.g., “to be a better lover” and to “enjoy sex more”); the Sexual Desire Inventory, assessing partnered and solitary sexual desire; and reported their relationship status, frequency of SLSU, and demographics. Using independent sample t-tests and multivariate general linear models, we examined how relationship status and partnered & solitary sexual desire interacted to predict differences in alcohol and drug sex-related expectancies and SLSU. Results Contrary to previous research findings, relationship status alone was not related to either alcohol or drug sex-related expectancies or SLSU. However, there was a marginally significant interaction between relationship status and sexual expectancies in predicting women’s SLSU. Specifically, the association between more positive sexual expectancies and higher frequency of SLSU was relatively stronger in partnered women. Moreover, regardless of relationship status, women who reported higher levels of partner desire reported more positive sexual alcohol and drug expectancies. Additionally, women who reported more positive sexual alcohol and drug expectancies reported more frequent SLSU. In contrast, solitary sexual desire was not a significant predictor of either substance-related sexual expectancies. Conclusions Our results indicate that partnership and partnered desire may interact with alcohol and drug sexual expectancies to predict women’s SLSU. These findings question the predominant assumption that women’s use of substances in sexual settings is primarily in casual sexual contexts and points to the need for targeted interventions to address the functions of SLSU in the context of women’s long-term relationships. Clinically, these findings reinforce the value of including our patient’s partner when addressing sexual dysfunction secondary to substance use. Disclosure No

Occasions of Alcohol and Cannabis Use and Associated Risk for Sexual Assault Among College Women With Higher Sexual Risk Alcohol Expectancies

College women report high rates of sexual assault. Research focused on women's risk factors for sexual assault remains necessary to assist women in reducing their risk. Previous work has shown alcohol use and cannabis use to be associated with sexual assault. The current study examined whether individual difference variables moderated women's risk for sexual assault during occasions of alcohol use and cannabis use using ecological momentary assessment (EMA). Participants were 18- to 24-year-old first-year undergraduate women (N = 101) who were unmarried and interested in dating men, consumed three or more alcoholic drinks on one occasion in the month before baseline, and engaged in sexual intercourse at least once. Baseline individual difference variables included sex-related alcohol expectancies, alcohol problems, decision skills, and sexual attitudes. EMA reports, collected three times per day over 42 days, included items regarding alcohol and cannabis use and sexual assault experiences. Among women who experienced sexual assault during the EMA period (n = 40), those with higher sexual risk expectancies had a higher probability of sexual assault during occasions when they were using alcohol or cannabis. Several modifiable risk factors for sexual assault and individual differences factors may exacerbate risk. Ecological momentary interventions may be useful to reduce sexual assault risk for women with high sexual risk expectancies who use alcohol or cannabis.

Occasions of Alcohol and Cannabis Use and Associated Risk for Sexual Assault among College Women with Higher Sexual Risk Alcohol Expectancies.

College women report high rates of sexual assault (SA). Research focused on women's risk factors for SA remains necessary to assist women in reducing their risk. Previous work has shown alcohol and cannabis use to be associated with SA. The current study examined whether individual difference variables moderated women's risk for SA during occasions of alcohol and cannabis use using ecological momentary assessment (EMA). Participants were 18-24-year-old first-year undergraduate women (N=101), who were unmarried and interested in dating men, consumed three or more alcoholic drinks on one occasion in the month before baseline, and engaged in sexual intercourse at least once. Baseline individual difference variables included sex-related alcohol expectancies, alcohol problems, decision skills, and sexual attitudes. EMA reports, collected three times per day over 42 days, included items regarding alcohol and cannabis use and SA experiences. Among women who experienced SA during the EMA period (n=40), those with higher sexual risk expectancies had a higher probability of SA during occasions when they were using alcohol or cannabis. Several modifiable risk factors for SA and individual differences factors may exacerbate risk. Ecological momentary interventions may be useful to reduce SA risk for women with high sexual risk expectancies who use alcohol or cannabis.

Predictors of moderate to high risk of alcohol harm among site-based South African construction workers

Alcohol consumption is an accepted part of many social and cultural practices, but excessive alcohol consumption is a global public health concern. Aside of its detrimental effects on health, it is linked to HIV-related health behaviours such as unprotected sex, multiple/concurrent sexual partnerships, and lower levels of HIV testing. Little is known about the association between alcohol use and HIV-related heath behaviours in construction. Using data from 450 workers drawn from 18 construction sites in the Western Cape, the Alcohol Use Disorders Identification Test (AUDIT) was used to predict alcohol risk of harm as a function of demographic characteristics and sex-related behaviours among workers. Binary logistic regression determined factors associated with increased risk of alcohol harm. The most proximal factor predicting risk of alcohol harm was the frequency of alcohol or drug use before and/or during sex, followed by attitude towards condom use, education, and HIV testing behaviour. Future research efforts should develop a better appreciation of the role of sex-related alcohol expectancies in explaining harmful alcohol use, and intervention management practices should focus on this.

Women's Response Performance in Sexually Risky Situations: Associations With Disinhibited Sex-Related Alcohol Expectancies.

This study evaluated the effects of sexual victimization history, alcohol-related problems, psychological distress, and disinhibited sex-related alcohol expectancies on the effectiveness of women's response performance in hypothetical social situations depicting risk for sexual victimization. Two hundred and forty-five undergraduate women first listened to audiotaped descriptions of the hypothetical social situations and imagined that they were the woman depicted in each scenario. They then were given a response to each situation deemed in prior work by experts in the sexual victimization research area to be effective at reducing risk for sexual victimization and asked to provide each response verbally while being videotaped. Participants then completed measures assessing prior victimization history, alcohol-related problems, psychological distress, and disinhibited sex-related alcohol expectancies. Experts in the sexual violence research area rated participants' responses with respect to how effective each response was in decreasing their risk for having an unwanted sexual experience, defined as an experience in which the woman may be verbally or physically coerced into having a sexual contact of any kind with a man. Structural equation modeling analyses revealed that disinhibited sex-related alcohol expectancies were associated positively with women's response performance, indicating that women who endorsed greater disinhibited sex-related alcohol expectancies provided more effective responses to risky hypothetical situations. Findings suggest possible interventions aimed at reducing women's risk of sexual victimization.

Cannabis and Alcohol Co-Use and Condomless Anal Sex Among Men Who have Sex with Men Living with HIV: An Event-Level Analysis.

Men who have sex with men (MSM) account for more than two thirds of new HIV diagnoses annually. Sexual behavior that increases risk for onward transmission of HIV is associated with both alcohol and cannabis use. However, little is known about the influence of cannabis and alcohol co-use on engagement in condomless anal sex (CAS). The current study explored daily associations between substance use and CAS among HIV-positive MSM using a 42-day timeline followback interview (N = 101). Generalized estimating equation (GEE) logistic regression models were used to examine the association between cannabis and alcohol co-use and CAS at the sexual event while controlling for study site, condition, adherence to antiretroviral therapy, sex-related alcohol expectancies, and partner type. Participants provided data for 1052 sexual activity days, 60.7% of which involved CAS. Of 638 CAS days, 9.1% involved no substances, 72.0% involved either cannabis or alcohol use, and 18.9% involved cannabis and alcohol co-use. Results indicated that the odds of engaging in CAS were higher for sexual events in which cannabis and alcohol co-use occurred (aOR 2.98; 95% CI 1.27, 6.97) compared to events in which no substance use occurred (p = 0.012), but this relationship was no longer significant when cannabis and alcohol co-use was compared to single substance use (aOR 1.57; 95% CI 0.85, 2.90; p = 0.15). Future research should identify specific substance use (e.g., quantity) and partner characteristics (e.g., level of intoxication) that may uniquely influence the relationship between cannabis and alcohol co-use and condomless sex.

The relationship between sex-related alcohol expectancies and hazardous drinking among persons with HIV disease

ABSTRACT Hazardous drinking is a clinically significant problem among persons with HIV (PWH) disease, and is associated with a number of poor outcomes. Hazardous drinking among PWH is associated with risky substance use and sexual behavior, but little work has examined factors that may be associated with greater hazardous drinking and subsequent risky sexual behaviors among PWH. Research among the general population suggests that sex-related alcohol expectancies, defined as drinking to enhance sexual experience, increase sexual risk-taking, and disinhibition of sexual behavior, are associated with greater hazardous alcohol use and risky sexual behavior, but these relations have not been explored among PWH. Therefore, the current study examined the associations of sex-related alcohol expectancies with hazardous alcohol consumption, dependence, and problems among 146 PWH (Mage = 50.99, SD = 9.41) \\ enrolled in a clinical trial examining a personalized feedback intervention to reduce hazardous drinking in primary HIV care. Results showed that only sexual disinhibition-related alcohol expectancies were significantly associated with the criterion variables, such that greater drinking alcohol for sexual disinhibition was associated with greater hazardous drinking behaviors. These results sit on the backdrop of a larger literature documenting the links between disinhibition and hazardous alcohol use and provide explanatory specificity to PWH who are hazardous drinkers.

Perceived risk of the harmful use of alcohol among young adults in the context of HIV&AIDS in Kenya

ABSTRACT Background: This study examined factors associated with perceived risks for the harmful use of alcohol among young adults in the context of HIV and AIDS. This is the alcohol use that affects physical and mental health and has social consequences. Informed by the protection motivation theory and the social cognitive theory, the study focused on the motivational and cognitive factors that influence risk perception, which includes knowledge, self-efficacy, and outcome expectancies. Methods: Data were gathered through a self-administered survey among young adults (n = 402) who were recruited using the intercept method (Median = 22 years, Mean = 22.5 years). Results: Key findings show a low level of risk perception for the harmful use of alcohol and a high level of alcohol-related self-efficacy. Participants had moderately high knowledge about HIV and AIDS, low HIV-related risk perception but high HIV-related self-efficacy. There was a correlation between alcohol risk perception and perceived risk of HIV and AIDS. Significant determinants of alcohol risk perception included sex-related alcohol expectancies, HIV risk perception, and HIV self-efficacy. Sex-related alcohol expectancies were correlated with risk perception for HIV infection and the harmful use of alcohol. Conclusion: The study provides insights on factors that public health and communication specialists must consider when communicating about the harmful use of alcohol. Enhancing risk perception and self-efficacy for the harmful alcohol use and communicating in the context of HIV and AIDS in high-risk environments is crucial. Furthermore, addressing sex-related alcohol expectancies may lower the risk of HIV and other sexually transmitted infections among alcohol consumers.

Does Alcohol Use in Large Group Contexts Mediate the Association Between Sex-Related Alcohol Expectancies and Rape?

Women who hold positive beliefs about alcohol's role in sexual experiences may be more likely to drink alcohol in large group contexts such as bars and parties than other women. These contexts may confer risk for rape. In the current article, we examined the association between sex-related alcohol expectancies and rape during college, and whether drinking in large group contexts mediates this association. College women completed surveys for seven consecutive semesters. Contrary to previous cross-sectional research, women with more positive sex-related alcohol expectancies at the start of college and women who drank alcohol more frequently in large groups at the start of college were no more likely to experience rape during college. Longitudinal research is critical to identify risk factors that may be targeted for prevention.

Adolescents’ Sex-Related Alcohol Expectancies and Alcohol Advertisements in Magazines: The Role of Wishful Identification, Realism, and Beliefs about Women’s Enjoyment of Sexualization

In the United States, approximately one in five sexually active teens report alcohol or drug use before their last sexual encounter. The co-occurrence of alcohol with sex increases risky behaviors, such as having unprotected sex. Magazines that target adolescents often feature alcohol advertisements with sexual innuendo and female objectification. Such advertisements may inform adolescents’ expectancies that alcohol can facilitate sex. With an experimental design and path analysis, we examined 874 adolescents’ (ages 15–17, M = 16.05) exposure to objectifying alcohol ads, their perceptions of the ads, and their attitudes about women’s sexualization in relation to sex-related alcohol expectancies. For female adolescents we assessed their enjoyment of sexualization, and for male adolescents, we assessed their perceived enjoyment of sexualization among women. Teens’ perceptions that alcohol ads promote the co-occurrence of alcohol with sex mediated the effect of ad exposure and perceived realism of the ads on sex-related alcohol expectancies. The enjoyment of sexualization construct mediated the effect of wishful identification and perceived realism on sex-related alcohol expectancies. Wishful identification also directly related to sex-related alcohol expectancies. Results challenge the alcohol industry’s compliance with advertisement regulations and suggest media literacy as a strategy to promote healthy sex-related alcohol expectancies among adolescents.

Mental representation of self in relationships indirectly affects young Black women’s engagement in risky sexual behaviors through psychosocial HIV/STI risk factors

ABSTRACTBlack females are disproportionately affected by human immunodeficiency virus (HIV)/sexually transmitted infections (STIs), though individual-level sexual risk factors do not appear to explain racial/ethnic HIV incidence rate disparities. The current study examined the roles of attachment representations, working models of self and others, with psychosocial risk factors related to population-level sexual network features in association with risky sexual behaviors. A total of 560 Black emerging adult females (M age = 20.58, SD = 1.89) enrolling in a behavioral HIV prevention intervention trial completed the baseline assessment used in the current analyses. A series of multiple mediator models examined indirect effects of working models of self and others on sexual risk engagement through the following psychosocial HIV/STI risk factors: (a) partner communication self-efficacy, (b) fear of condom negotiation, (c) peer norms for risky sexual behavior, (d) partner trust and (e) sex-related alcohol expectancies. Results indicated an indirect effect of working model of self on the following: condom use with boyfriend/main partner through peer norms for risky sex (ab = .08, 95% CI [.02, .17]), any alcohol use prior to sex through peer norms for risky sex (ab = −.06, 95% CI [−.12, −.02]) and alcohol use prior to sex through sex-related alcohol expectancies (ab = −.13, 95% CI [−.21, −.05]). Findings provided evidence of a direct association between working model of self and each psychosocial HIV/STI risk factor included in the mediation models. Working model of self may help identify Black females at elevated risk for HIV/STI through these psychosocial risk factors.

STI-protective self-efficacy and binge drinking in a sample of university students in the United Kingdom

ObjectiveAlcohol use has consistently been shown to be related to sexual risk-taking behaviours. To assess what factors may contribute to the sexual risk decision-making process, this study examined the relationships among alcohol use (frequency, quantity, and binge drinking), cognitive appraisals of sexual risk taking, sex-related alcohol expectancies, and STI-protective self-efficacy. Method138 sexually-active university students who drink alcohol completed scales measuring alcohol consumption, appraisals of consequences, sex-related alcohol expectancies, and items regarding STI-protective self-efficacy. ResultsIncreasing levels of binge drinking were negatively associated with STI-protective self-efficacy. A moderated mediation analysis revealed that for binge drinkers, stronger appraisals of the positive consequences for having sexual intercourse while intoxicated predicted lower STI-protective self-efficacy indirectly through increasing rates of sex-related alcohol risk expectancies. ConclusionFindings provide evidence of a need to target binge drinkers and increase their STI-protective self-efficacy by shifting their focus from positive consequences to negative risk consequences of engaging in sexual intercourse while intoxicated.

The Role of Sex-Related Alcohol Expectancies in Alcohol-Involved Consensual and Nonconsensual Sex Among Women of Asian/Pacific Islander and Women of European Race/Ethnicity

Alcohol-involved sexual experiences, including incapacitated sexual assault and alcohol-involved sex, are major public health concerns among college women. Further, racial/ethnic diversity among college students is increasing, particularly with regard to increases in college students of Asian/Pacific Islander (API) race/ethnicity. Of relevance, evidence suggests differences in sexual assault rates across ethnicities and cultures; however, no known study to date has examined differences by ethnicity and first language in expectancies and experiences specifically surrounding alcohol and sex. The current study sought to examine differences in incapacitated sexual assault, alcohol-involved sex, and heavy episodic drinking, as well as differences in sex-related alcohol expectancies among native English-speaking college women of European (EU) race/ethnicity, native English-speaking women of API race/ethnicity, and non–native English-speaking women of API race/ethnicity (NNES-API). EU reported higher frequency of heavy episodic drinking, alcohol-involved sex, and incapacitated sexual assault compared to API and NNES-API. In addition, API reported more frequent alcohol-involved sex and incapacitated sexual assault compared to NNES-API, in part due to API’s stronger endorsement of sexual disinhibition–related alcohol expectancies (indirect effects: β = −.04, p = .04, and β = −.07, p = .04, respectively). Findings highlight the important role of expectancies in acculturation and influence on actual alcohol-involved sex and sexual assault.

Impulsivity and Problem Drinking in College: Examining the Mediating Role of Sex-Related Alcohol Expectancies and Alcohol Use at Sex

ABSTRACTBackground: Dispositional impulsivity has been consistently implicated as a risk factor for problem drinking among college students and research suggests that this relationship may be explained in part by alcohol expectancies. A subset of alcohol expectancies, sex-related alcohol expectancies, is particularly linked to problem drinking among college students. The acquired preparedness model of risk postulates that people with dispositional impulsivity develop stronger sex-related alcohol expectancies, are subsequently more likely to drink at problematic levels in sexual situations, and thus, engage in more problem drinking. Objectives: Using this model, the current study examined whether sex-related alcohol expectancies and alcohol use at sex mediated the relationship between impulsivity and problem drinking among college students. Methods: College students (N = 101) completed self-report measures of alcohol use, sex-related alcohol expectancies, and five dimensions of impulsivity: negative urgency, positive urgency, sensation seeking, lack of premeditation, and lack of perseverance. Results: Two facets of impulsivity—sensation seeking and lack of premeditation—provided unique contributions to problem drinking. Sex-related alcohol expectancies significantly mediated the effects of lack of premeditation and sensation seeking on problem drinking. In support of the acquired preparedness model, the relationship between the impulsivity traits and problem drinking was serially mediated by sex-related alcohol expectancies and alcohol use at sex. Conclusions: Results suggest that sensation seeking and lack of premeditation continue to be areas of intervention for problem drinking among college students, and implicate sex-related alcohol expectancies as an area of intervention for alcohol use at sex and problem drinking.

Using Sex-Related Alcohol Expectancies to Predict Condom Use Among a General Sample of Men and Women in the United States

Sex-related alcohol expectancies (SRAE) are known to moderate the relationship between alcohol use and risky sexual behavior in high risk populations; however, SRAEs have not been thoroughly explored in populations traditionally viewed at lower risk for HIV and/or STI. Participants (n = 649) were recruited through internet-based direct marketing in the United States. Predictors of SRAE vary by gender. Controlling for alcohol use and other predictors, age predicted condom use among women, and SRAE was correlated with condom use for men. Sexual health programming geared towards non-traditionally identified high-risk populations is necessary and provides unique opportunities to increase condom usage.

Interactive Relationships Between Sex-Related Alcohol Expectancies and Delay Discounting on Risky Sex.

Sex-related alcohol expectancies reflect the degree to which a person believes alcohol will affect her or his sexual behavior. Sex-related alcohol expectancies have been found to be predictors of drinking in sexual situations and engagement in risky sexual behavior after drinking. However, less is known about individual characteristics that may moderate these associations. Building upon recent evidence that steep delay discounting is associated with alcohol-related sexual risk taking, this study aimed to test the hypothesis that the associations between sex-related alcohol expectancies and alcohol-related sexual risk taking would be stronger among individuals who discount delayed rewards more steeply. The current sample comprised 126 Emergency Department patients (Mage =27.37; 55% male) who reported high-risk alcohol use and sexual behavior during the past 3months. Sex-related alcohol expectancies were assessed in 3 behavioral domains: increased riskiness, decreased nervousness, and enhanced sexuality. All 3 expectancy domains were associated with quantity and frequency of alcohol use, as well as percentage of alcohol-related condomless sex. Delay discounting moderated 2 of these relationships, such that the associations between expectancies for alcohol-induced sexual risk taking and the enhancement of sexuality and percentage of alcohol-related sexual risk-taking were significantly stronger in individuals who exhibited steeper delay discounting. These findings suggest that individuals who both discount delayed rewards more steeply and hold strong sex-related alcohol expectancies are a particularly high-risk population. Such individuals may benefit from a combination of novel preventive strategies targeting sex-related alcohol expectancies and impulsive decision making.

Precollege Predictors of Incapacitated Rape Among Female Students in Their First Year of College.

The first year of college is an important transitional period for young adults; it is also a period associated with elevated risk of incapacitated rape (IR) for female students. The goal of this study was to identify prospective risk factors associated with experiencing attempted or completed IR during the first year of college. Using a prospective cohort design, we recruited 483 incoming first-year female students. Participants completed a baseline survey and three follow-up surveys over the next year. At baseline, we assessed precollege alcohol use, marijuana use, sexual behavior, and, for the subset of sexually experienced participants, sex-related alcohol expectancies. At the baseline and all follow-ups, we assessed sexual victimization. Approximately 1 in 6 women (18%) reported IR before entering college, and 15% reported IR during their first year of college. In bivariate analyses, precollege IR history, precollege heavy episodic drinking, number of precollege sexual partners, and sex-related alcohol expectancies (enhancement and disinhibition) predicted first-year IR. In multivariate analyses with the entire sample, only precollege IR (odds ratio = 4.98, p < .001) remained a significant predictor. However, among the subset of sexually experienced participants, both enhancement expectancies and precollege IR predicted IR during the study year. IR during the first year of college is independently associated with a history of IR and with expectancies about alcohol's enhancement of sexual experience. Alcohol expectancies are a modifiable risk factor that may be a promising target for prevention efforts.

Sex-related alcohol expectancies and high-risk sexual behaviour among drinking adults in Kampala, Uganda

ABSTRACTAlcohol consumption, a risk factor for HIV transmission in sub-Saharan Africa, is considered high in Uganda. A cross sectional study was conducted to determine whether sex-related expectations about the effects of alcohol explain the association between alcohol use and risky sexual behaviours in a population-based sample of adults in Kampala. Associations between alcohol use (current and higher risk drinking) and high-risk sexual behaviours (multiple regular partners and casual sex) were tested. In age–sex-adjusted models, having multiple regular partners was associated with current drinking (odds ratio [OR] = 2.76, 95% confidence intervals [CIs] = 1.15, 6.63) and higher risk drinking (OR = 3.35, 95% CI = 1.28, 8.71). Associations were similar but not statistically significant for having a causal sex partner. Sex-related alcohol outcome expectancy was associated with both alcohol use and high-risk sexual behaviour and attenuated relationships between multiple regular partners and both current drinking (OR = 1.94, 95% CI = 0.57, 6.73) and higher risk drinking (OR = 2.44, 95% CI = 0.68, 8.80). In this setting sexual behaviours related with alcohol consumption were explained, in part, by sex-related expectations about the effects of alcohol. These expectations could be an important component to target in HIV education campaigns.

"Such Behaviors Are Not in My Home Village, I Got Them Here": A Qualitative Study of the Influence of Contextual Factors on Alcohol and HIV Risk Behaviors in a Fishing Community on Lake Victoria, Uganda.

In Uganda, elevated HIV prevalence in fishing communities along Lake Victoria have been attributed in part to heavy alcohol use, but qualitative research is needed to understand the contextual factors influencing alcohol and sexual risk. Eight focus group discussions were conducted (n = 50; 23 male, 27 female) in Gerenge, Uganda with five occupational groups: fishermen, fishmongers, alcohol-sellers, commercial sex workers, and restaurant owners. Data was analyzed using content analysis. Alcohol use was prevalent and said to influence risky sex. Sex-related alcohol expectancies and occupational factors influenced individuals to drink during sex and structural factors related to the built environment, economy, and policy were identified as key contributors to both alcohol use and sexual risk in general. The findings highlight alcohol reduction as an important component of HIV/AIDS prevention and suggest structural interventions should be prioritized in this context.