Sex-related alcohol expectancies as moderators of the relationship between alcohol use and risky sex in adolescents

Objective: Alcohol is frequently identified as a potential contributor to HIV-related sexual risk taking. Drawing on alcohol expectancy explanations for postdrinking behavior, the present study tested the hypothesis that adolescents who drink alcohol on a given occasion will be more likely to engage in sexual risk-taking behavior to the extent that they believe that alcohol disinhibits sexual behavior or promotes sexual risk taking. Method: The combined effects of sex-related alcohol expectancies and alcohol use in sexual situations were investigated using interview data from a representative sample of 907 (476 male) sexually experienced adolescents (13 to 19 years) who had ever consumed alcohol. Results: Regression analyses on a composite measure of risk taking revealed that for two of three intercourse occasions examined alcohol use was associated with greater risk taking primarily among respondents who expected alcohol to increase risky sexual behavior. Conclusions: The results lend port to expectancy theories of alcohol's effects on sexual risk taking and raise the possibility that providing overly simplistic warnings that 'alcohol leads to risky sex' may paradoxically increase the likelihood that individuals will fail to act prudently when intoxicated. Preventive interventions might beneficially focus on weakening, rather than strengthening, individuals' expectancies with regard to the impact of alcohol on sexual behavior, so that self-protective behavior will be more likely to occur even during intoxication.