College Students’ Perceptions of Positive and Negative Drinking-Related Sexual Experiences

Abstract

Objective:

During young adulthood, drinking and sexual behaviors are both normative and inextricably linked. While this association is well documented, little is known about how students define positive and negative drinking-related sexual experiences.

Methods:

Thirty-five undergraduates participated in a focus group about sexual experiences in the context of drinking. Thematic analysis was utilized to identify themes in the data.

Results:

Students’ descriptions of positive drinking-related sexual encounters included having a good time, feeling safe, maintaining control over alcohol, as well as feeling safe in drinking contexts where sexual partners are located. Students’ perceptions of negative experiences included specific consequences such as a damaged reputation, loss of control due to alcohol, and concern of engagement in sex when they or a partner was too intoxicated to consent.

Conclusion:

Gaining a better understanding of how college students view positive and negative drinking-related sexual experiences could inform interventions aimed at promoting student well-being.

Positive, consensual sexual experiences are an important part of healthy development during young adulthood.¹ Sex among college students is normative, with approximately half of college students reporting past month vaginal intercourse, and 62% of students reporting having a hookup since beginning college.² A hookup refers to a consensual sexual encounter (e.g., kissing, oral sex, vaginal sex) between non-romantic partners.^3–5 It is common for college students’ sexual encounters to occur in the context of drinking alcohol.⁶ For instance, 40% of sexually active college students reported consuming alcohol before sex at least once in the past two weeks.⁷ There are strong and persistent cultural beliefs among college students that alcohol use and sex go together, with expectations that alcohol loosens inhibitions and increases sexual pleasure.^8,9 Despite the intersection of alcohol use and sexual activity among college students, there has been limited research, particularly qualitative research, examining college students’ perceptions of the role of alcohol in sexual encounters.¹⁰ The current study aimed to add to the literature by examining students’ perceptions of both the positive and negative aspects of having sex or hooking up after consuming alcohol.

In the majority of studies examining sexual experiences among adolescents and young adults, sex is viewed as a risk behavior associated with a range of negative outcomes.^5,11 Indeed, researchers often only explore negative aspects of sexual and hooking up experiences.^4,12,13 Negative consensual sexual experiences can include negative emotional responses (e.g., regret, embarrassment), health outcomes (e.g., sexually transmitted infections), and social consequences (e.g., loss of reputation, relationship damage).^4,14–16 Negative sexual experiences appear common among adolescents and young adults. For instance, many sexually active college students describe having regretted a decision to engage in sexual activity,^5,15,17 with one study finding that 25% of college students experienced alcohol-related regretted sex in the past month.¹⁸

The use of alcohol by either sexual partner is a predictor of negative sexual experiences among college students. Not only does alcohol consumption increase the likelihood for ineffective communication about sex and misunderstanding about others’ sexual intentions,^5,10 but it is shown to increase the likelihood for unprotected sex,^7,19 unplanned sexual activity,²⁰ regrettable sexual encounters, ^{7,17,18, 21} and less sexual pleasure.²² Engaging in intoxicated sex also increases the risk for STIs and unplanned pregnancies.²³ Further, greater levels of drinking among perpetrators or victims is associated with greater likelihood for sexual assault.^24–26 Although there is extensive literature documenting the range of negative sexual experiences among college students, the majority of this research is quantitative in nature.

In contrast to viewing sex as solely a health risk behavior, some researchers suggest that it is beneficial to use a sex-positive framework for studying youth’s sexual experiences.¹ A sex-positive framework seeks to recognize sexual activity as a component of an individual’s well-being, and recognizes relational closeness, pleasure, well-being, feelings of competence, and self-esteem.^{1, 27} Overall, college students tend to hold positive perceptions about sexual behaviors and report positive or neutral affect following sexual encounters,²⁸ as well as high levels of satisfaction and intimacy.²² When it comes to understanding the role of alcohol in positive sexual experiences, college students associate drinking with positive sexual-related outcomes (e.g., arousal, pleasure, disinhibition), typically hold positive alcohol-related sexual expectancies, and associate alcohol with sexual opportunities.^29–31 In fact, overall, alcohol consumption is associated with more positive than negative hookup experiences among college students.^19,32,33 The limited qualitative research on this topic among students and young adults also suggests that people believe that alcohol use provides liquid courage to talk about sex, to initiate sex, as well to decline unwanted sexual advances,¹⁰ while also increasing feelings of attractiveness, adventurousness, and sexual pleasure.³⁴ Overall, however, although research suggests that drinking-related sexual encounters often lead to positive outcomes, less is known about how students define a positive drinking-related sexual experience.

Current Study

Past research suggests that the effects of alcohol use on sexual experiences are both positive and negative with a focus on the role of alcohol in negative experiences.^{7,10,19,22,23,34} Qualitative research exploring college students’ perceptions of both the positive and negative aspects of having sex while intoxicated is limited, and has focused on heterosexual, cisgender students’ perceptions of drinking-related sexual experiences.¹⁰ From the perspective of the Theory of Planned Behavior,³⁵ determining the most salient advantages and disadvantages of a behavior is seen as a crucial step to designing effective attitude and behavior change interventions; however, there is limited research addressing this issue.³⁶ A broader understanding of students’ perceptions of both the positive and negative aspects of sexual experiences in the context of alcohol use can help inform the development of integrated alcohol and sexual health interventions, including interventions that adopt a sex-positive approach. The current study involves a qualitative investigation of college students’ perspectives about both positive and negative drinking-related sexual experiences. We also address previous calls to include the perspectives of gender and sexual minority (GSM) students in research on this topic,¹⁰ with approximately 25% of our sample identity as GSM. The following research questions were explored:

RQ₁: What does a positive sexual experience in the context of drinking alcohol look like for college students?

RQ₂: What do college students perceive as the most salient negatives of drinking alcohol before hooking up or having sex?

Method

Procedure

Undergraduate student participants were recruited from two residential, four-year universities on the East Coast of the United States. All study procedures were IRB-approved, and random samples were drawn from a list of 18–24 year old undergraduates at each university, stratified by gender and class year. Students were invited via email to participate in a “study examining drinking and sexual behaviors in college.” To specifically recruit GSM participants, an email invitation was sent to students via a campus LGBTQ+ resource center mailing list. After providing consent, participants completed a 5–10 minute online screening survey assessing alcohol and sexual behaviors and beliefs. Following the survey, students were invited to participate in an in-person student group discussion about “drinking and sexual behaviors in college” and were asked to select a group session to attend. Participants were compensated with a $30 Amazon gift card for attending a focus group session.

Six 2-hour focus groups (two all-women, three all-men, and one GSM) were led by two of the authors. Each focus group had approximately 6 participants (range=3–10 participants). After participants provided informed consent to be audio recorded, facilitators discussed the importance of anonymity of in-group responses, and students were asked to use a fictitious name. Participants were told the discussion would focus on social situations where students get together and drink (i.e., parties, bars). A semi-structured focus group protocol was used which included a series of open-ended questions. The first open-ended question was, what does it look like for a college student to have a positive drinking and sexual experience when going out to parties and bars? What are some of the reasons why students might drink when hooking up or have sex? The second study question was, what are the reasons why students might decide not to drink heavily when hooking up or having sex? What are the possible downsides of hooking up or having sex while drinking? All group audio recordings were professionally transcribed.

Participants

In total, 171 students completed the online screening survey and of these, 69 students indicated they were both interested in and available to attend one of the scheduled focus groups. A total of 41 students (24.0%) participated in a focus group and transcripts were available for 35 students (M = 19.9 years, range 18 to 23 years). Most participants identified as White (62.9%), followed by Multiracial (20.0%), Asian (11.4%), and African American/Black (2.9%). In terms of ethnicity, 22.9% identified as Hispanic/Latinx. Overall, 57.1% of the sample identified as cisgender men, 34.3% as cisgender women, 5.7% as non-binary or genderqueer, and 2.9% as a transgender man. In regard to sexual orientation, 54.3% of participants identified as straight, 34.3% as bisexual, 5.7% as gay, 2.9% as questioning, and 2.9% declined to answer. With respect to alcohol use, 85.7% reported drinking on a typical week, with an average of 9.2 drinks per week. Further, 80.0% of students reported binge drinking (i.e., 5 or more drinks in a row for males and 4 or more drinks in a row for females) on at least one occasion in the past 90 days. About half the same (54.5%) described themselves as single, with 25.7% in committed relationships, and 17.1% had one person they were dating or hooking up with regularly. About 42.9% of participants had engaged in casual sex (i.e., vaginal, oral or anal sex) and 48.6% reported sex with a non-casual partner within the past 90 days.

Data Analysis

An interpretive analytic induction approach was used,³⁷ with thematic analysis used to identify common and descriptive themes and sub-themes.^38,39 An initial focus group transcript was reviewed independently by all team members. Manual, open coding was used to create generative themes. Each team member proposed groupings for their open codes. During a team meeting, members compared and contrasted themes. A preliminary codebook was created based on the team discussion with definitions for first and second order themes, along with excerpt examples from the transcript. Additional transcripts were reviewed and based on team discussions the themes and sub-themes were refined iteratively and the codebook was updated accordingly. Once all six transcripts were reviewed and the codebook was finalized, all qualitative data were manually coded by two trained graduate-level students. An auditor, with previous experience with qualitative data, met with the coders after reviewing each transcript to discuss and resolve any discrepancies until full consensus was established. Given that final codes were established with consensus, reliability statistics were not generated.

Results

Positive drinking and sexual experiences

Our first research question (RQ₁) examined how students define positive sexual experiences in the context of alcohol use. While students noted several characteristics of a positive experience, some noted it was hard to define. For example, one student stated, “Personally, I find it difficult to think of how to define it as a positive experience. More so the lack of negative experiences, whether it be extremes of sexual assault, blacking out... Rather, I find it much easier to define a good experience as a lack of those.” We identified two broad subthemes in students’ descriptions of positive experiences: students discussed (1) ideas relevant to sexual encounters themselves, but also (2) aspects of pre-sexual encounter behaviors and contexts that were necessary for feeling safe when locating a sexual partner.

Positive Sexual Encounters

When discussing sexual encounters themselves, three themes emerged related to being in control of alcohol use, feeling safe, and having a good time. A recurring theme across 66.7% of the groups was the desire to be in control of alcohol use in order to have a positive sexual encounter. While students recognized the benefits of alcohol use in terms of making “those [sexual] conversations pretty easy” due to decreased inhibitions, students noted that it was beneficial to avoid drinking to the point that communication and decision making were impaired. For example, a man highlighted the importance of “being fully aware of what you’re doing and really being able to think through your actions before doing anything.” Another man felt it was important that “all parties involved are cognizant of their behavior.” One woman mentioned “being aware of what that boundary is for you, and how much alcohol it might take to take you there.” Taken together, there seemed to be the perception of a “sweet spot,” such that students considered that a positive alcohol-related sexual experience was one where they had consumed enough alcohol to reduce their inhibitions, but not so much that they were not fully aware and in control of their decisions.

Feeling safe was considered a critical component of having a positive alcohol-related sexual experience. The importance of providing and obtaining consent was mentioned across all of the groups. A woman described a safe sexual context as one in which students would “not be afraid if they were to get a little bit tipsy or drunk that someone would take advantage of them in that state.” In order to obtain consent a man stated that “enthusiastic consent at all periods of time” is needed and that all parties “should be comfortable always and… actively make sure that everyone’s clear in what they want,” and another man described saying “Are you okay? Do you want to do this before it happens?” A man described getting consent as part of a positive experience: “I’m gonna go out and have a good time with my friends, and if I meet someone who I’m sexually attracted to, and there’s consent, then that would be a healthy way to do it.” Finally, another man added that “you wouldn’t want to drink as much if you had to make sure that there’s consent before it, maybe.” Here, students recognized that a positive alcohol experience involved having a partner that respected their sexual boundaries, and clear establishment of consent.

Having a good time was a key theme of positive experiences in 50.0% of the groups. Some students specified having a good time as not being worried and feeling natural. Others indicated individual differences in what constitutes a fun experience, for example, one student noted “It should be whatever you want to have to have a good time.” A man pointed to a situation in which “everybody is just there hanging out, having a good time. It’s easy to just talk to someone.” Overall, regardless of gender or sexual identities, students reported similar factors contributing to positive sexual encounters in the context of drinking.

Maintaining Safety in Party and Bar Settings

Students also mentioned several themes relevant to the boundaries that were necessary to ensure that they could interact with a potential sexual partner in a positive way at parties and bars, as well as avoid unwanted sexual contact in these settings. Safe physical boundaries were important for women who highlighted not being touched, having space, and feeling safe. The women in one session showed strong agreement with respect to their desire for safe physical boundaries. One woman pointed to “too many situations in which there is a guy being creepy on you, and it’s not somebody you know.” Another woman responded “Oh my God, yes!” Another woman felt that “guys just really are not aware. There’s always that one guy in a group of guy friends who always wants a hug. They’re like, ‘What, I don’t get a hug?’ Then you’re forced to hug.” In the same group a woman added the following:

There’s no girl who walks around the club grabbing guys’ waists. That doesn’t happen to them. They don’t know what it’s like. I’ve talked to my guy friends, [I’m] like. “Oh, this happened to me the entire time I was at the club.” They’re like, “What? I didn’t see that. I had no idea. That happens to you?” like “Oh, you have to watch your back if you walk home alone? What?” I’m like “yeah, that’s every day. I feel like girls just know that, no matter who you are. If you’ve been in any kind of party situation, or even just like in life…. it’s just more shared experiences.

A GSM student described feeling safe in a drinking environment as a situation in which people are not “encroaching on my space or trying to force me to drink more or being like, ‘I haven’t seen you in a while. Come give me a hug,’ that kind of thing. Definitely, when people are respecting my boundaries as a person, that’s when it’s good.” In these descriptions, students in the GSM and both the female-identifying groups shared similar desires about safe physical boundaries.

Feeling safe in one’s surroundings was particularly important for women. One woman described feeling that “it’s a little unsafe to go off campus” because it is “just more unpredictable.” Preserving personal boundaries was related to students’ sense of safe autonomy in their choices and behaviors and was important to all student groups. A man described a positive, safe drinking experience as one in which “if I want to go to a party and, say, not drink at all, then I can do that, or if I want to go out to a party and have x amount of drinks, I can do that. It’s up to personal choice for comfort level.” A student in the GSM group described a setting in which everybody is “smiling, dancing, not looking like they’re under pressure to be drinking or in some weird situation where somebody’s being creepy or something.” Feeling safe also included not being seen as a target. A GSM group participant described not being seen with “predatory eyes” or feeling “more vulnerable than usual.”

Finally, regardless of gender or sexual identity, in all of the groups participants reported that they regularly relied on friends to keep them safe in college drinking contexts. A student in the GSM group stated that “a positive experience is always going to be when I have a core group of friends around me that I feel safe with, and I know they’re checking in on me, and I’m checking in on them.” A man cited “safety in numbers.” Women commonly mentioned having a support friend group “so that people can watch out for you, and you watch out for them.” Women emphasized not going to parties alone, with one participant stating: “Yeah, going alone just, I guess personally, it sounds kind of scary. With a bunch of strangers, you don’t know what’s going to happen.”

Negative drinking-related sexual experiences

Our second research question (RQ₂) explored how students define negative sexual experiences in the context of alcohol use. We identified four themes including risks for negative sexual experiences (66.7% of groups), effects on their reputation (50.0% of groups), loss of control due to alcohol (83.3% of groups), and false accusations (16.7% of groups). Negative sexual experiences associated with alcohol use included risks for sexual assault, regretted sex, unplanned sex, and lower sexual gratification. One woman described the risk of intoxication and sexual assault:

If a girl or whoever gets really drunk that they’re on the verge of passing out or losing consciousness, then it’s just difficult for them to protect themselves. Also, they might think, “oh, this is a good idea” at the beginning, but then they might feel like, “oh, I want to stop, or I don’t want to go through with this,” but they don’t have the capacity to express that, or they do express that, but then it’s not enough to get the other person to stop.

A man described the link between drinking and regrettable sex: “That’s probably why people choose not to drink is that they know that they’re gonna do something they are gonna regret.” A student in the GSM group described engaging in unplanned sexual behaviors that “I wouldn’t do sober, but I’d do when I’m drunk. So many times, so many. I know that I wouldn’t do it because I know that I haven’t done it before, and then I do it, and I’m like ‘that was a mistake.’” Another student in the GSM group described lower sexual gratification: “I can’t feel things as much when I’m intoxicated. Quite literally, I think my vagina goes numb, and I’m like, ‘why am I even doing this?’ I can’t even feel anything.” Several students felt that alcohol was not necessary at all, expressing that they could have a good time without drinking. One man shared that “I don’t see [alcohol] as such a positive that it makes up for some of the risks.”

Reputation or judgment by others, either sexual shaming or eliciting a reputation as creepy, was a concern shared by many students and were often linked to heavy drinking-related sexual behaviors. Speaking about friend groups, one participant in the GSM group stated, “they’re very heavily slut-shaming me because of that hypersexuality phase where I couldn’t say no.” A man said “if you hook up with someone in a frat or sorority, there’s a good chance everyone in that frat, in that sorority knows about it. They all talk about it. From my own personal experiences, everyone knows, and you just feel like they all hate you or that they are all slut-shaming you or whatever.”

Just as maintaining control over alcohol use was seen as an important factor in a positive alcohol-related sexual experience, loss of control due to alcohol was seen as a primary perceived risk factor for negative drinking-related sexual outcomes. Both men and women described how alcohol impairs decision-making and described wanting “a little more control over what’s going on,” and how heavy drinking leads to “skewed” decision-making, “clouded” judgement, and being “less likely to make smart choices, which, a lotta times, you need in the process of having sex.” Students addressed a loss of control in communication, while other students shared opposing views. With the GSM group, one student felt that drinking “made having those [sexual] conversations pretty easy” due to decreased inhibitions while another student provided an example in which the partners were intimately involved for the first time: “both parties or one party is drunk, there’s difficulty conveying preferences or whatever.”

Among one of the male-identifying groups, risk for being involved in a sexual assault if one consumed too much alcohol emerged as a concern. Importantly, rather than recognizing that they had the potential to perpetrate sexual assault, due to not being aware of their partners level of intoxication, men were primarily concerned that someone might accuse them of sexual assault if they were involved in sexual activity with an intoxicated partner. For example, one man pointed to his “fear of being accused of wrongdoing, cuz obviously if you’re drunk, consent is a gray area. I feel like men are usually the ones that get assumed that they really want the situation beyond where it should be going.” Another man stated, “Because of how men are, oftentimes, seen as the dominant ones, just from that perception alone, we need to be careful with how we act.”

Discussion

The use of alcohol prior to sex is common among college students.^2,6,7,40 Few qualitative studies have examined college students’ perceptions of this association,¹⁰ and the current study adds to the literature by exploring college students’ perspectives of positive and negative drinking-related sexual experiences. Students described positive experiences in terms of having a good time, feeling safe, and maintaining control over alcohol. Students also described the importance of physical and personal boundaries at parties and bars that allowed them to interact with potential sexual partners in positive ways. Salient negative experiences were related to damaged reputation, loss of control due to alcohol, and false accusations. These findings offer important insights for informing integrated interventions seeking to provide a safe space for students to examine factors that facilitate positive outcomes or increase risks for negative sexual-related outcomes in college drinking contexts.

Consistent with prior research,^10,31 our findings highlight that students view alcohol as an effective facilitator of positive sexual experiences, including recognizing alcohol as an agent of decreased social and sexual inhibition. However, these views appear conditional upon moderate and controlled alcohol use, as opposed to heavy drinking, which was associated with enhanced risk among students. Indeed, the desire for control emerged as a key theme in both the description of positive and negative experiences. Students valued feeling in control of decision making and being able to communicate preferences and obtain consent. Teaching students the tenets of alcohol myopia theory—how heavy alcohol use impacts information processing such that intoxicated individuals attend to immediate, proximal cues (e.g., sexual arousal, social/partner interaction) and disregard less salient inhibitory cues (e.g., future potential consequences)—may enhance students’ understanding of the impact of heavy alcohol use on decision making.⁴¹ Appealing to students’ desire for control may be a key target for interventions aiming to encourage positive and healthy sexual experiences in the context of drinking.

Although students did mention having fun, their definitions of positive experiences often focused less on pleasurable experiences and more on safety and a lack of negative consequences. Indeed, some students noted the difficulty of defining a positive experience without referring to a lack of negative outcomes. This may reflect that students are exposed to educational efforts that talk about sex and alcohol as risk behaviors. Students may have less experience or comfort talking about sex in a positive way and that allows them to express ideas related to sexual pleasure, satisfaction, and well-being. It is also possible that in the context of the college hooking up culture, students commonly have sex and hook up for reasons other than to have satisfying sexual experiences (e.g., cope with negative emotions, peer pressure).⁴² Therefore, a positive sexual experience may be one that reflects autonomy and safety, rather than pleasure per se.

Students’ descriptions of positive experiences included feeling safe in contexts in which students might meet and interact with a partner prior to a sexual encounter. This finding is consistent with previous work that suggests that college students’ conceptions of sexual consent are complex and extend beyond communication that occurs immediately prior to sexual activities to include earlier interactions in bars and at parties ⁴³ The current findings suggest that college sexual health interventions might benefit from exploring students’ sexual communication and behaviors in these drinking contexts.

Women noted several factors that allowed them to interact in a party and bar environment without fear of unwanted sexual attention. Notably, bar-related victimization is common, with one study finding that 48.1% of women had experienced physical violence in a bar, and 32.6% had experienced an attempted or completed rape associated with drinking in a bar.⁴⁴ Fears of experiencing unwanted physical or sexual contact in a bar was expressed mostly among women, with some participants noting that unsolicited physical touching was predominantly an action men engaged in towards women. Further, women discussed the challenges of trying to communicate concerns related to safety to men who were often unaware of women’s experiences. Interventions that explicate how subgroups of students (e.g., women, GSM) experience safety in college drinking environments could help convey, to all students, the importance of providing safe spaces, respecting personal boundaries, and obtaining clear consent. Discussions about creating safety in party and bar environments that include all students on college campuses can help men to recognize what types of advances are unwanted, and empower other students to step in to help others who might be in an uncomfortable situation. Furthermore, interventions that emphasize respect for diversity and community goals effectively engage students to actively contribute to a safe environment as a collective.

Students report slut shaming as one negative aspect of drinking-related sexual experiences. While slut shaming is often used to refer to the disparaging of women based on presumed sexual activity,⁴⁵ in current study, women, men and GSM students all described experiences of slut shaming. Slut shaming of women is common among American college students, with both men and women perpetrating this behavior.⁴⁶ Slut shaming may contribute to a campus climate that hinders reporting of sexual violence.⁴⁷ Sex positive college programing that allows students to explore the role of gender norms and the use of slut shaming as a means of sexual and social control may be beneficial. To change campus cultures, bystander interventions that provide students with the skills to intervene when they observe slut shaming may also be needed.

It was notable that some men in this study reported a fear of being accused of sexual assault after engaging in sexual activity with an intoxicated partner. Despite false accusations of sexual assault being rare,^48,49 the current findings support past qualitative studies suggesting that false allegations of sexual assault are a salient concern for college men, particularly for sexual encounters that involve alcohol use.⁵⁰ This is not surprising given that one of the most common rape myths is that women lie about sexual assault.⁵¹ Given that rape myth acceptance is associated with sexual aggression and coercion,⁵² and may inhibit bystander intervention,⁵³ college students may benefit from interventions specifically challenging rape myths.

Limitations

Although the current qualitative assessment offers important insights, the small sample size precludes our ability to examine how drinking-related experiences may differ by a student’s current drinking and sexual behaviors. This may be an important area for future research given that prior research suggests that heavier drinkers report more positive evaluations of drinking than lighter drinkers.⁵⁴ Moreover, the facilitator-led focus group format may have contributed to students’ emphasis on safety when describing positive drinking-related sexual experiences while minimizing students’ views of alcohol as increasing sexual arousal as has been documented in prior survey research (31). Further, the current study focused exclusively on sexual behaviors that occurred in the context of social situations where students get together and drink. Students’ definitions of positive and negative experiences that happen outside of this social drinking context (e.g., drinking with just a partner) may be different. Finally, the recruitment methods may have introduced self-selection bias in that students with positive or neutral past sexual experiences may have been most willing to participate in a study involving “drinking and sexual behaviors.” Therefore, it should be noted that the current findings may underrepresent college students’ negative sexual experiences.

Conclusions

Students’ descriptions of positive sexual experiences while drinking included having a good time, but also feeling safe and maintaining control over alcohol use. Students in all groups, but particularly women and GSM students, emphasized the importance of safe boundaries and surroundings. The most salient perceived negative experiences were loss of control during a sexual encounter due to alcohol, concern about engaging in sexual activity when either partner is too intoxicated to consent, and damaged reputation. Students’ concerns about excessive alcohol use and awareness about the importance of moderate drinking point to the promise of harm reduction interventions targeting college student drinkers. Sex positive interventions that meet students where they are and recognize the benefits of light to moderate drinking in achieving positive, safe sexual experiences may be particularly impactful. Moreover, promoting healthy sexual development and behaviors in college populations calls for integrated programs that recognize sex as a normative part of sexual development during young adulthood. For example, sex positive interventions should recognize student’s goals related to positive sexual experiences and provide realistic strategies to help students achieve healthy, consensual sexual experiences in college contexts. A critical component of these efforts is addressing the unique sex-related risks faced by college women and GSM students in particular.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author, [LN]. The data are not publicly available in order to protect the privacy of research participants.