Does drinking promote risky sexual behavior? A complex answer to a simple question

ABSTRACT—The present review argues that, popular lore notwithstanding, the well-documented association be-tween usual patterns of alcohol use and risky sex reflects multiple underlying processes that are both causal and noncausal (spurious) in nature. It is further argued that even alcohol’s acute causal effects on sexual behavior are morevariable than theyare commonlyassumed tobe.Drink-ing can promote, inhibit, or have no effect on behavior, depending on the interplay of factors governing behavior in a particular situation and the content of individually held beliefs about alcohol’s effects. KEYWORDS—alcohol; risky sex; condom use With the advent of AIDS, efforts to understand the causes of sexual risk-taking have assumed great urgency. In this context, alcohol and its potential disinhibiting effects have receive