Associations Between Drinking, Condom Use Resistance, and Condom Use Among College Students

Alcohol use and sexual intercourse are common behaviors among young adults in college. Drinking is considered a risk factor for unprotected sexual intercourse. Having condomless sex is associated with increased risk of contracting an STI or becoming pregnant unintentionally. Although correct and consistent condom use protects against such consequences, many individuals may resist condom use during sexual intercourse. As such, condom use resistance beliefs may be the factor through which alcohol reduces condom use. Evidence from Theory of Planned Behavior (TPB), Alcohol Expectancy Theory, and a body of evidence supports individual beliefs to be predictive of condom use intentions and behavior. However, limited research has explored the belief-behavior relationship within condom use resistance. Resistance beliefs and sex-specific alcohol expectancies may contribute to risky condom use. Thus, a theoretical model was proposed whereby the relationship between drinking and condom use behavior may be explained by both belief components (i.e., sex-related alcohol expectancies, condom use resistance norms, and condom use resistance self-efficacy) and intentions to resist condoms. Specifically, the aims of this study were to 1) examine the correlations between all model variables, 2) examine the direct effects in the conceptual model, 3) test each sequential mediation pathway from alcohol consumption to condom use and compare the relative strength of each mediation pathway from alcohol use to condom use, 4) examine potential gender differences in each sequential mediation pathway from alcohol consumption to condom use, and compare the relative strength of each mediation pathway from alcohol consumption to condom use within each gender. Results supported the application of TPB constructs in the context of condom use resistance and condom use. Sex-related alcohol expectancies, condom use resistance norms, and resistance self-efficacy were not supported as mediators. Additionally, the theoretical model was not found to differ based on gender. These results addressed gaps in the literature and contributed to the understanding of drinking as a risk factor for condom use resistance and thus, decreased condom use. Future research on the relationship between alcohol and condom use may benefit from event-level or ecological momentary assessment to parse apart belief and intoxication effects on condom use