Feeling in control in sexual situations: Day-level associations with alcohol use and alcohol protective behavioral strategies.

Background: Feeling in control in a sexual situation may vary as a function of contextual factors, such as whether alcohol is used prior to a sexual experience. Alcohol protective behavioral strategies (PBS) reduce adverse alcohol-related outcomes and may promote greater sense of control in sexual situations. It was hypothesized that, at the day level, (1) greater alcohol use would be associated with lower likelihood of feeling in control in sexual situations, (2) more PBS would be associated with a greater likelihood of feeling in control, and (3) more PBS would weaken the negative association between alcohol use and sexual control.

Methods: For 28 days, daily data on feeling in control during sex, number of drinks, and PBS were collected from young adults who engage in high-intensity drinking (8+/10+ drinks in a sitting for women/men). A sample of 112 young adults (age 18-29, 61% female; 78.6% White; 9.8% Hispanic/Latino) reported sex after alcohol use at least once (n = 322 days total). Alcohol use, PBS (total as well as subtype: stopping/limiting drinking [SLD], manner of drinking [MD], and serious harm reduction [SHR]), and alcohol use by PBS interactions were tested as day-level correlates of sexual control via hierarchical generalized linear modeling.

Results: A significant interaction between alcohol and total PBS on control was observed. At low levels of PBS, more drinks were related to lower likelihood of feeling in control during sex. At high levels of PBS, number of drinks was unrelated to control. A similar pattern of results was observed when examining the PBS subscale of SLD. No main effects of daily PBS or alcohol use on control were observed.

Conclusions: Findings provide insight into feeling in control when drinking alcohol and engaging in sex, at varying levels of PBS. Interventions focused on harm reduction strategies have the potential to reduce risk of alcohol-related adverse sexual experiences.