Emotions, Risks, and Experiences During Sex: A Qualitative Investigation of College Men’s Conflicting Sex and Condom Use-Related Alcohol Expectancies

Alcohol use increases the likelihood of condomless sex, which is prevalent among college students and associated with detrimental health consequences. Both theoretical and empirical evidence have suggested that the perceived effects of alcohol on sex (i.e. sex-related alcohol expectancies [AE]) play a role in the association between alcohol and condomless sex; however, this association among college students has been inconsistent. Therefore, this focus group study aimed to provide in-depth evidence regarding the sex- and condom use-related AE college men held, and how those AE might influence their decisions to engage in condomless sex when intoxicated. Nineteen heterosexually active college men participated in this study. Using an inductive thematic analysis approach, results suggested that college men held diverse beliefs about how alcohol could influence their emotions, intimacy, sexual risk-taking, and sexual experiences. Interestingly, some participants believed alcohol could decrease the likelihood of condom use, whereas others were able to leverage the effects of alcohol to promote condom use. Evidence from this study suggests possible explanations of the inconclusive relationship between sex-related AE and condomless sex among college students identified in previous literature and provides important insights into how to design interventions to promote condom use among college men in alcohol-involved situations.