Since the ancient days of Bacchanalian celebratory worship of the Greek pantheon, the consumption of alcohol and risky sexual rites have gone hand in hand. Both drinking and sex are considered to be pleasurable activities, and conservative or religious portions of the population may consider them to be sinful or immoral on varying scales. Regardless of whether alcohol and sexual activities have a negative social stigma within a certain social group, peer group, or subculture, these activities are inevitably associated with some risk. Physical, emotional, and social well-being are put on the line when partaking in drinking or sexual modern rituals. The combination of these activities may increase the level of risk associated with them, and likewise they may also be contributing factors to the likelihood that the other will occur (e.g., drinking may increase the chance of sexual activity). However, despite the social stigma that may be associated with certain drinking and sexual behavior activities and patterns, there remains strong social and peer pressure to participate in both activities. It can be seen, for example, in the prevalence of sexual imagery that is used extensively in advertising, and in advertisements for alcoholic beverages in particular (Nilewide 2004), that there exists a strong cultural connection. The consumption of alcohol, sexual activity, and these behaviors happening concurrently begins at relatively young ages in our culture, and even children and young adolescents are affected. Studies have shown that alcohol certainly affects the sexual choices that are made by both men and women. The following review of literature explores research, statistics, postulation, and recommendations regarding the connection between sexual activity and alcohol. Specifically, high-risk sexual behavior among various age and social groups, will be addressed, including sexual rebellion and conformity, compulsive or uneducated choices, exposure to sexually transmitted diseases, and sexual assault, and the role which alcohol may play in each of these scenarios.
The University of Arkansas for Medical Studies has found that attitudes about appropriate sexual behavior, as well as those regarding appropriate alcohol consumption, are formed in youth at a very young age, and by the preteen years children have already developed a unique attitude regarding these subjects. A Thomson Healthcare Company (2004) report reveals that risky behavior may be minimized in adolescents and young adults if parents were to discuss standards and beliefs on sexual and other issues with children at a younger age, because relating these values to older children is not as effective. Alcohol use has been shown to lead to early initiation of sexual activity, as well as being related to the number of sexual partners that preteens and adolescents will have, particularly in high-risk groups. These high-risk youth groups include inner-city females, males in detention homes, and gay and bisexual males. Alcohol is not the only substance that is prevalent in these high-risk groups; marijuana is also associated with altered sexual statistics. Intervention treatment for youths to help curb consumption of alcohol may also help delay sexual activity, or decrease the number of sexual partners and overall risk associated with sexual activity, are encouraged as early as 9 to 12 years of age.
The link between alcohol and sexual behavior is not unique to preteens, adolescents, or young adults; this link appears to be consistent throughout the majority of the population according to most studies. Joseph LaBrie (2000) deals with the overall subject of alcohol consumption correlating with sexual behaviors in his Journal of Sex Research article, "Sexual Risk Behaviors and Alcohol." Researchers dealing with sexually transmitted diseases, in particular, are interested in finding a correlation between alcohol and sexual behavior in an attempt to isolate and eliminate as many high-risk factors as possible to reduce the overall occurrence of these diseases. Many studies have strongly confirmed the connection between these factors, while others have only been able to loosely connect them, or even failed to do so. However, base drinking rates and actual sexual behavior are very difficult to determine with certainty, which leads to inaccuracy in the results of studies. New evidence may show that base drinking rates are actually higher than previously believed, which could mean that the association between drinking and risky sexual behavior is even stronger than previously believed. Problems in collecting accurate data have to do with the private nature of sexual behavior, and because most studies rely on self-reporting methods for data collection, people may hesitate to answer truthfully about behaviors they believe might be looked down upon by others. So, in addition to drinking rates being underestimated by the majority of studies, the rates of high risk sexual behavior may also be higher than the statistics reveal. LaBrie's less intrusive form of data collection "revealed almost twice the percentage of persons engaging in risky sexual behavior after drinking as did the conventional self-report survey." (LaBrie 2000) His study also revealed that many people who participate in high-risk sexual behavior, such as not using a condom during intercourse, are reluctant to report this even when granted full anonymity because of the social stigma placed on this behavior. Drinking alcohol may lower a person's resolve to use condoms, or one might drink specifically to remove the responsibility of negotiating the use of or providing condoms for the encounter. When inebriated, one might also attempt to use a condom, but not use it properly. Therefore interventions should approach the fact that being under the influence of alcohol does not remove the safe sex responsibility in any way.
While the alcohol and risky sexual behavior correlation is applicable to everyone, it can be a particularly important issue to address with the adolescent because of the developmental significance of this age group. In a Perspectives on Sexual and Reproductive Health article by C. Coren (2003), specific patterns of substance abuse during adolescence were shown to be a predicting factor not only of the sexual behavior at that time, but also the future sexual behavior of the adolescent. More than 800 adolescents in Seattle were studied for a full decade, spanning the ages of ten years to twenty-one years, surveying the use of alcohol, cigarettes, marijuana, and other drugs at specific intervals throughout the teenage years. At the age of twenty-one, the participants were asked about their safe sex practices, sexual activity, age of first sexual encounter, and current relationship status. Seventy percent of those studied did not have any binge drinking at any time during the study, however binge drinking was an issue for thirty percent of the adolescents involved. Three percent of those had chronic binge drinking habits throughout adolescence. When, at age twenty-one, asked about the number of sexual partners with whom each participant was involved in the past year, those who had no alcohol binge drinking during the teenage years averaged the lowest number, 1.7 partners. Those with chronic binge drinking during adolescence reported the highest number of sexual partners, an average of 3 partners. Other substances, such as tobacco, marijuana, and hard drugs, did not show such a significant difference in the number of sexual partners. Additionally, ninety percent of those who had chronic binge drinking behavior during adolescence reported inconsistent use of condoms, and once again other drugs did not have nearly that significant of an impact on the sexual behavior. These results further emphasize the importance of specifically addressing alcohol consumption with youth in order to help prevent risky sexual behavior throughout adolescence and into adulthood.
While intoxicated by alcohol, an individual's perception of a situation and his or her own actions are altered, which leads to risky sexual behavior even if a person "knows better" when sober. A study reported in the Archives of Sexual Behavior (Maisto et al. 2004) revealed specific information about the attitudes and behavioral skills relevant to sexual health among young adult males when under the influence of alcohol. A total of 48 heterosexual males were involved in this study, which used a control, alcohol, or placebo condition for each over the course of two laboratory sessions. The experiment was designed to help determine the behavior such males would exhibit regarding "attitudes toward condom use, intention to engage in risky sex, and condom use negotiation skills. The results of this study were monumental, according to the authors of this article, not only because of the implications for intervention and sexual risk prevention, but also because it reveals information to help develop theories about the potential of controlled experiment settings to be used to explain the alcohol-sex relationship. The use of opinion surveys, videos, and role playing techniques were utilized for this study. The results showed that participants who consumed alcohol had poorer negotiation skills and greater intention to engage in risky sex compared to participants who did not drink alcohol. " (Maistro et al. 2004) Alcohol did not seem to affect the attitude of the individual male regarding condom use in general. However, attitudes regarding whether or not condoms would detract from the enjoyability of sex were affected by the consumption of…