Alcohol use and protective sexual behaviors among high-risk adolescents

This study seeks to advance our understanding of moderating influences on the relationship between alcohol and condom use by examining their association at both the global and event levels of analysis using a prospective approach within a sample of high-risk adolescents. The following potential moderators were examined: sex-related alcohol expectancies, gender, relationship type, level of alcohol use, and impulsive sensation seeking.

Criminally involved adolescents (N = 300) completed measures of alcohol use, condom use, personality, and alcohol expectancies; 267 (89%) participants completed a behavioral assessment 6 months later.

At the global level of analysis, there was a significant moderating effect of alcohol-related sexual-enhancement expectancies, such that the relationship between alcohol and condom use was negative and significant only among individuals with higher sexual-enhancement expectancies. At the time-limited global level, impulsive sensation seeking at baseline was negatively associated with condom use at 6-month follow-up. At the event level, there was a Gender x Alcohol interaction such that alcohol use was unrelated to condom use among males but was strongly and negatively related among females.

This study makes a contribution to the understanding of the relationship between alcohol use and condom use by looking beyond main effects and conducting an empirically driven and multilevel examination of moderating variables. Results support the inclusion of situation-specific alcohol risk-reduction content in human immunodeficiency virus/sexually transmitted disease-prevention activities.