Protective Behavioral Strategies and Alcohol-Related Sex Among College Students

Adverse sexual outcomes (e.g., sexual regret, sexual risk, and sexual assault) are a common experience among college students. In particular, regretted sex is reported by a third of college students and may result in psychological harm. Previous literature has found that alcohol is involved in approximately one third of regretted sex experienced by college students. A gap exists in the literature identifying who is more susceptible to experiencing a regretted sexual experience. Previous research has shown that students who implement protective behavioral strategies (PBS) while drinking are able to reduce alcohol-related negative consequences, including regretted sexual experiences. Three sub-types of PBS exist: Stopping/Limiting Drinking (SLD), Manner of Drinking (MD), and Serious Harm Reduction (SHR). The current study examines associations between regretted sexual experiences, alcohol use, and PBS. Participants were a sample of college students (n = 349) who completed a series of online surveys that assessed drinking habits, alcohol-related negative consequences (e.g., regretted sex), and PBS use. A multi-group path analysis (grouped by gender) found that alcohol use was positively associated with regretted sexual experiences. One of the three PBS sub-types, MD, was negatively associated with regretted sexual experiences. This association was mediated by alcohol use. A different PBS subtype, SHR, yielded a direct negative relationship with regretted sexual experiences for women, but not for men. Lastly, the interaction of SHR and alcohol use was significantly associated with regretted sexual experiences and varied by biological sex. Among women, low SHR potentiated the positive association between alcohol and regretted sex; in contrast, high SHR attenuated this association. In order to inform future interventions and subsequently decrease the number of alcohol-related negative consequences, further examination of differences in relationships between PBS subtypes, alcohol use, and regretted sex for men and women is warranted.