"I Just Wasn't Thinking": Strategic Ambiguity and Women's Accounts of Unprotected Sex

Heterosexual university students continue to endorse sexual scripts that preference men's desire and sustain gendered power imbalances in sexual relationships and encounters, leading women to risk pregnancy by engaging in unprotected sex. Because young women also endorse norms encouraging them to protect themselves and their partners from unintended pregnancy, women are caught in a bind between two often competing norms. We conducted semi-structured individual interviews with university women (n = 45) to examine how they navigate these competing norms. We found that women explained risky contraceptive decisions by saying they "just weren't thinking," thus employing strategic ambiguity, or vague language used to maintain social status, to navigate between competing norms. Our findings suggest that women were actually thinking about risks and making calculated decisions in the moment which often privileged men, putting themselves at risk and sometimes causing distress. To save face, women presented the idea that they "just weren't thinking" in different ways that conformed to traditional notions of romance and sexuality: being in the moment, love and trust for their partner, and deferring to the perceived or actual wishes of men. We conclude that there is a need to promote and achieve affirmative sexuality which includes women feeling empowered to express their own sexual needs - whether that be consent or refusal, contraception, pleasure, or all of these.

Can someone be both pro-life and pro-choice? Results from a national survey of US adults

"Pro-life" and "pro-choice" are closely associated with discussions about abortion; we refer to the extent that people identify with these terms as "abortion identity." Most polling measures present pro-life and pro-choice as mutually exclusive options, but there is a dearth of information about people who might simultaneously endorse both (or neither) labels.

METHOD

We administered a survey to adults in the United States (n = 580) that included two different formats for participants to select their abortion identity: a categorical item with response options ranging from strongly pro-choice to strongly pro-life (and "both" and "neither") and two separate items (sliders) that asked people the extent to which they identify with each term. We asked participants endorsing both pro-life and pro-choice to some extent on the slider items to explain their responses in an open-ended item. We used logistic regression to examine the relationship between participants' socio-demographic characteristics and the likelihood of dual identification slider scores; we analyzed open-ended data for content and themes.

RESULTS

On the sliders, more than 64% of participants identified as both pro-life and pro-choice to some extent. Variability existed between people's abortion identity on the close-ended items and their response to the open-ended questions. Among those with mixed abortion identities, participants described abortion as a serious and undesirable option but reflected positively on notions of personal choice and bodily autonomy.

CONCLUSIONS

Our findings demonstrate complexity in measuring people's endorsement of abortion identity labels. We recommend developing more nuanced and consistent measures to assess abortion attitudes.

Experiences of sexual assault and rape among college students with disabilities

Objective and Methods: The study examined sexual victimization among college students with disabilities (n = 187) using an online survey at a large southern university. Students reported one or multiple disabilities: physical disabilities, Attention Deficit Hyperactivity Disorder (ADHD)/Attention Deficit Disorder (ADD), learning disabilities, and emotional disabilities, with most students reporting more than one disability. Results: Overall, 71% of the sample experienced one or more types of lifetime sexual assault and/or rape, and 51% reported sexual victimization since attending the university. There were no significant differences in experiencing sexual assault and/or rape between students with one disability compared to students with more than one disability. Conclusions: Considering the high rates of sexual victimization among students with disabilities, and the dearth of research focusing on the context of sexual assault in this population, future research and research-based prevention initiatives are needed. Findings can inform future prevention efforts to address sexual violence among students with disabilities on campuses.

Psychological Symptoms Associated with Sexual Victimization Experiences: Differences as a Function of the Type and Number of Sexual Acts and Aggressive Tactics

Different types of sexual victimization are associated with different outcomes; for example, on average, physically forced sex is associated with worse psychological outcomes than verbally coerced sex. This study evaluated outcomes associated with sexual victimization as a function of sexual act and aggressive tactic, expanding upon the acts and tactics examined in prior studies. Participants who had experienced sexual victimization (N = 402) completed a survey about their most upsetting victimization experience, identifying the sexual act(s) and aggressive tactic(s) that occurred. They completed measures of PTSD, depression, anger, and trauma-related cognitions. Relationships between symptom severity and most upsetting act and tactic, as well as the number of acts and tactics, were analyzed. Related to the sexual act, non-penetrative sexual acts were associated with the lowest symptom severity on several measures. Related to the aggressive tactic, sex obtained through anger/criticism and physical force were associated with the greatest symptom severity on some measures. A larger number of tactics were associated with more severe symptoms on all measures, whereas number of acts only explained unique variance in PTSD symptom severity. The pattern of severity for outcomes differed from previous conceptualizations, suggesting that current hierarchies of victimization severity may require revision.

The Association of Acute Intoxication and Threats to Masculinity on Laboratory-Based Sexual Aggression

OBJECTIVE

Men's alcohol intoxication and perceptions of their masculinity as precarious (i.e., viewing masculinity as easily threatened) are independently related to men's perpetration of sexual aggression. Yet, the interactive effects of these constructs on sexual aggression are unclear. The goal of this study was to assess if precarious masculinity-measured as a static trait-and acute alcohol intoxication-measured in a laboratory setting-were positively associated with men's perpetration of laboratory-based sexual aggression after their masculinity is threatened.

METHOD

Cisgender heterosexual men (n = 120, ages 21-30 years) completed a self-report measure of precarious masculinity, were randomly assigned to consume an alcoholic or nonalcoholic beverage, and engaged in the Sexual Imposition Paradigm, which assessed laboratory-based sexual aggression perpetration toward a female confederate. Immediately before the Sexual Imposition Paradigm, all participants' masculinity was threatened via feedback from an ostensible personality test that indicated they are less masculine than other men.

RESULTS

Self-reported precarious masculinity and the Precarious Masculinity × Beverage Condition interaction were not associated with laboratory-based sexual aggression. However, intoxicated men showed higher levels of laboratory-based sexual aggression than sober men.

CONCLUSIONS

Acute alcohol intoxication facilitated men's sexually aggressive responding toward women when their masculinity was threatened. Consistent with pertinent theory and research, this effect suggests that acute intoxication facilitates men's focus on salient cues (i.e., threatened masculinity), which then may proximally motivate sexual aggression. Sexual aggression prevention programs should continue to address alcohol in their programming.

The Effects of Alcohol Intoxication on Perceptions of Consent and Refusal Indicators in a Fictional Alcohol-Involved Sexual Encounter

Alcohol intoxication may influence how bystanders interpret other people's consent and refusal cues. We examined the effects of alcohol intoxication on participants' perceptions of characters' consent and refusal indicators in a fictional vignette depicting an alcohol-involved sexual encounter. Young adults (n = 119, 52% women) participated in an alcohol administration experiment examining the influence of acute intoxication on bystander perceptions during a vignette depicting a character who is intoxicated and declines a sexual advance from another character, who ignores her refusal and continues to pursue sexual activity. Participants were randomly assigned to an alcohol or non-alcohol condition and then guided through a semi-structured interview in which we asked about the characters' consent and refusal cues. Interviews were analyzed using both inductive and deductive coding. Most participants eventually indicated the encounter was nonconsensual, but approximately 9% of participants described the encounter as entirely consensual and another 42% of participants described the interaction as initially consensual and then nonconsensual. Participants discussed nuanced accounts of consent and refusal cues, including indicators related to alcohol consumption. Disregarding intoxication and gender, participants eventually recognized the situation as nonconsensual and thus potentially risky. However, some participants recognized this risk earlier in the encounter than others. Consequently, bystanders who recognize risk later in a situation may have fewer opportunities to intervene before a situation escalates. We recommend sexual assault prevention educators take a more nuanced approach when discussing consent and refusal indicators, emphasizing contextual factors that may indicate risk.

How Do College Students Perceive Their Partner Responds to Them When They Refuse Sexual Activity?

Refusal communication is a dyadic process, with one person communicating a refusal and another person responding. To enhance our understanding of this process, we surveyed college students to assess their interpretation of their partners' responses when they declined vaginal-penile sexual activity. In an online survey, participants were prompted to describe their partners' reactions when participants refused their partner's vaginal-penile sex initiation. Through content analysis, three themes were present: (1) partner accepted the refusal, (2) partner experienced negative emotions, (3) partner ignored their refusals. Participants frequently reported their refusals were accepted. Sexual assault prevention initiatives should work to normalize refusal communication.

Analyzing Reddit Forums Specific to Abortion That Yield Diverse Dialogues Pertaining to Medical Information Seeking and Personal Worldviews: Data Mining and Natural Language Processing Comparative Study

BACKGROUND

Attitudes toward abortion have historically been characterized via dichotomized labels, yet research suggests that these labels do not appropriately encapsulate beliefs on abortion. Rather, contexts, circumstances, and lived experiences often shape views on abortion into more nuanced and complex perspectives. Qualitative data have also been shown to underpin belief systems regarding abortion. Social media, as a form of qualitative data, could reveal how attitudes toward abortion are communicated publicly in web-based spaces. Furthermore, in some cases, social media can also be leveraged to seek health information.

OBJECTIVE

This study applies natural language processing and social media mining to analyze Reddit (Reddit, Inc) forums specific to abortion, including r/Abortion (the largest subreddit about abortion) and r/AbortionDebate (a subreddit designed to discuss and debate worldviews on abortion). Our analytical pipeline intends to identify potential themes within the data and the affect from each post.

METHODS

We applied a neural network-based topic modeling pipeline (BERTopic) to uncover themes in the r/Abortion (n=2151) and r/AbortionDebate (n=2815) subreddits. After deriving the optimal number of topics per subreddit using an iterative coherence score calculation, we performed a sentiment analysis using the Valence Aware Dictionary and Sentiment Reasoner to assess positive, neutral, and negative affect and an emotion analysis using the Text2Emotion lexicon to identify potential emotionality per post. Differences in affect and emotion by subreddit were compared.

RESULTS

The iterative coherence score calculation revealed 10 topics for both r/Abortion (coherence=0.42) and r/AbortionDebate (coherence=0.35). Topics in the r/Abortion subreddit primarily centered on information sharing or offering a source of social support; in contrast, topics in the r/AbortionDebate subreddit centered on contextualizing shifting or evolving views on abortion across various ethical, moral, and legal domains. The average compound Valence Aware Dictionary and Sentiment Reasoner scores for the r/Abortion and r/AbortionDebate subreddits were 0.01 (SD 0.44) and -0.06 (SD 0.41), respectively. Emotionality scores were consistent across the r/Abortion and r/AbortionDebate subreddits; however, r/Abortion had a marginally higher average fear score of 0.36 (SD 0.39).

CONCLUSIONS

Our findings suggest that people posting on abortion forums on Reddit are willing to share their beliefs, which manifested in diverse ways, such as sharing abortion stories including how their worldview changed, which critiques the value of dichotomized abortion identity labels, and information seeking. Notably, the style of discourse varied significantly by subreddit. r/Abortion was principally leveraged as an information and outreach source; r/AbortionDebate largely centered on debating across various legal, ethical, and moral abortion domains. Collectively, our findings suggest that abortion remains an opaque yet politically charged issue for people and that social media can be leveraged to understand views and circumstances surrounding abortion.

People's knowledge of and attitudes toward abortion laws before and after the Dobbs v. Jackson decision

Although media response to the Dobbs v. Jackson Women's Health Organization decision was widespread in the United States, the extent to which people were aware of the Mississippi law leading to the decision, the Dobbs v. Jackson case, is unclear, as are the resulting effects of the decision on legal abortion. As such, we examined people's awareness of abortion legality prior to and after the Dobbs v. Jackson decision announcement, as well as the potential implications associated with the decision (i.e. overturning of Roe v. Wade). We also examined people's attitudes toward abortion legality, specifically focusing on 15 weeks' gestation to correspond with the Mississippi law that led to Dobbs v. Jackson. Data were collected across two studies at different times. In Study 1, a 15-minute survey was administered to IPSOS' KnowledgePanel (N = 1014) prior to the decision announcement. A shorter version of that survey was administered to a second sample using NORC's AmeriSpeak Omnibus panel (N = 1002). Nearly half of that sample (42.2%) completed the survey prior to the decision announcement. People were generally unaware of the Mississippi law, the Dobbs v. Jackson case, and implications associated with the decision (e.g. overturning Roe v. Wade). People generally endorsed abortion being legal at 15 weeks or later, but this varied by circumstance. We did not find meaningful effects of the decision announcement on people's knowledge and attitudes. Our findings suggest that the intense response to the decision from the media and people involved in the abortion movement may not represent the general public's reaction.

Examining the Moderating Role of Heavy Drinking Behaviors and Precarious Masculinity on Sexual Aggression Among Young Adult Men

OBJECTIVE

Men's heavy drinking behaviors are related to their engagement in sexual aggression and may be amplified by other factors, such as precarious masculinity (i.e., perceiving masculinity as tenuous in nature). Yet, researchers' understanding of how alcohol consumption, in combination with precarious masculinity, may increase risk of sexual aggression is lacking. The goal of this study was to assess if precarious masculinity moderated the relationship between men's heavy drinking and their sexual aggression.

METHOD

Young adult men (958 men, M age = 21.1 years, SD = 3.1) completed a web-administered questionnaire assessing sexual aggression, heavy drinking, and precarious masculinity.

RESULTS

We ran a logistic regression examining the association between heavy drinking, precarious masculinity, and their interactive effect on men's engagement in sexual aggression. Heavy drinking (odds ratio [OR] = 1.17) and precarious masculinity (OR = 1.73) were independently and positively associated with men's sexual aggression; however, the interaction was not significant.

CONCLUSIONS

In line with prior research, men's heavy drinking behaviors continue to be positively associated with sexual aggression. Building on masculinity literature, men viewing their masculinity as precarious and vulnerable appears to be associated with sexual aggression, potentially because engaging in sexual aggression can offset men's masculinity insecurities. Collectively, results suggest that both alcohol consumption and masculinity should be targeted in sexual assault prevention programs.

People's perception of changes in their abortion attitudes over the life course: A mixed methods approach

Research examining the extent that people's attitudes toward abortion vary across the life course is mixed. Some studies do not show a strong relationship between abortion attitudes and life stage, while others do find strong associations in both directions-older age associated with both more and less favorable attitudes toward legal abortion. Taken together, these findings suggest that individual attitudes toward abortion are static for some but malleable for others. Little is known about the prevalence, reasons, and directionality of attitude changes. This explanatory sequential mixed methods study investigates people's perceptions of whether, how, why, and for whom their abortion attitudes may have changed over their life course. We qualitatively investigated the reasons (e.g., experiences, life events) that triggered changes in respondents' abortion attitudes and quantitatively explored the sociodemographic factors associated with the perceived direction of those changes. The quantitative data come from a 2020 online survey completed by 1501 English and Spanish-speaking adults in the US. Qualitative data were collected from a subsample (n = 24) of the survey respondents who indicated interest in a follow-up in-depth interview. Our findings indicate that access to information and knowledge played an important role in changing abortion attitudes across a spectrum of support or opposition. For those who indicated becoming more opposed to abortion over time, experiencing parenthood was an important trigger for change and family/religious upbringing were key to shaping attitudes. For those who became more supportive of abortion over time, empathy for women was an important trigger for change and disagreeing with or distancing oneself from family/religious upbringing were key to shaping their attitudes. If attitudinal change occurs, becoming more supportive of abortion over the life-course is more common than becoming more opposed, however there are some nuances across age and gender. Understanding the different factors that influence attitudinal change regarding abortion has important implications for public opinion research and possible ramifications for abortion legality.

Perceptions of abortion access across the United States prior to the Dobbs v. Jackson Women's Health Organization decision: Results from a national survey

CONTEXT

Abortion is common in the United States (US), although access is becoming more difficult for some. In addition to restrictive policies that ban most abortion, limit the number of providers and increase costs, barriers to access also include less supportive cultural climates and stigma related to abortion. Prior to the Dobbs v. Jackson Women's Health decision of the United States Supreme Court, research suggested that people generally believed it was easy to access abortion, but this research did not examine the underlying factors that drive these perceptions.

METHODS

In 2019, using data from closed and open-ended survey questions, we examined differences in people's assessment of abortion access within the state they reside and factors that influence those perceptions. We recruited English- and Spanish-speaking US adults (N = 2599) from Qualtrics' national panel using quota-based sampling to participate in a web-based survey. We used multinomial logistic regression to examine predictors of access perceptions across demographic characteristics and thematic analysis to analyze open-ended responses.

RESULTS

Fifty-three percent of participants believed abortion was easy to access in their state. Spanish speakers and participants from legislatively "hostile" states were more likely to perceive access as difficult. Legality-related knowledge and pro-life identity were associated with perceiving abortion access as easy.

CONCLUSIONS

Prior to Dobbs, participants' interpretation of the ease or difficulty of accessing abortion were subjective. Misconceptions about state abortion laws and the prevalence of providers were common, suggesting a need for more education about abortion laws, policies, and access.

A Mixed-Methods Approach to Understanding the Disconnection between Perceptions of Abortion Acceptability and Support for Roe v. Wade among US Adults

The relationship between people's attitudes about abortion acceptability and the Supreme Court decision in Roe v. Wade-two distinct but related issues-has not been rigorously explored. The authors used a mixed-methods approach for analyzing in-depth interviews to better understand how participants' feelings toward abortion acceptability are related to perceptions of whether abortion should be legal. The authors then assessed (1) correlations between abortion acceptability and different measures of support for Roe v. Wade, and (2) how the phrasing of survey items related to Roe v. Wade may evoke different responses via an online survey fielded in 2018. The study's qualitative results highlight that there is a disjuncture between people's moral feelings toward abortion and their attitudes toward abortion legality. The study's quantitative results further demonstrate that correlations between abortion acceptability and support for Roe v. Wade are moderate, and the differences in responses to the phrasing of survey items related to Roe v. Wade are moderated by knowledge. The authors recommend that when researchers develop survey items, they avoid ambiguities of abortion as a general construct, especially when public opinion measures on abortion are employed for research and the design of social and health policy and practice.

Sexual and Gender Minority Men's Bystander Behaviors and Barriers in Response to Witnessing Minor Sexual Aggression

Objective

Sexual and gender minority (SGM) men experience sexual assault victimization. Encouraging people to become involved when they witness high-risk sexual situations as a prosocial bystander is one preventative mechanism to address sexual assault victimization. However, research assessing the extent that SGM men will intervene when they witness a concerning male-to-male sexual situation and barriers that prevent intervention is lacking. We sought to address these gaps.

Method

SGM men (n = 323, M_age = 39.4, range 18-77) completed a web-administered survey. Participants were asked if they had witnessed a high-risk sexual situation and, if so, to describe how they intervened; if they did not intervene, they were asked to explain why not. Data were analyzed using thematic analysis.

Results

Nearly 50% (n = 157) of participants reported witnessing a situation that may require intervention, of those men 40% reported involvement. When SGM men intervened, their behaviors included direct and indirect verbal and nonverbal strategies. Reasons for not intervening included not appraising the situation as risky, not viewing it as their responsibility to intervene, or lacking the self-efficacy to act.

Conclusion

SGM men reported similar barriers to intervention that heterosexual young adults encounter. Participants also provided a variety of intervention tactics that could be included in bystander intervention initiatives to increase their effectiveness and inclusivity. Additional efforts are needed to modify intervention initiatives at both the individual and community level.

Does Gender Inclusive Language Affect Psychometric Properties of the Illinois Rape Myth Acceptance Scale-Short Form? A Two-Sample Validation Study

The Illinois-Rape Myth Acceptance-Short Form (IRMA-SF) is a widely used scale measuring people's endorsement of rape myths. However, it uses heavily gendered wording and makes gender-based assumptions that may affect its generalizability to various subgroups of people, including sexual and gender minorities who may view gender constructs outside of the heteronormative gender binary. This study validates the psychometric properties of a modified form of the IRMA-SF that is gender inclusive. Participants were adults with a range of sexual orientations and gender identities. Two sets of data were merged and then the sample was randomly split with a 20/80 weight. Data in the 20% split were used for exploratory factor analyses. Data in the 80% split were used for confirmatory factor analyses. According to the exploratory factor analysis, we found a theoretically predicted one-factor model was best (41% variance explained). Further, we found acceptable absolute model fit according to the confirmatory factor analysis (RMSEA = .07, p < .001; SRMR = .06) but unsatisfactory incremental fit (CFI = .82). These model issues were likely due to a floor-effect of low item variability which may call into question the utility of this scale in determining differences in rape myth acceptance overall. Overwhelmingly, participants in this study rejected rape myths. Researchers should explore the use of gender inclusive wording with an updated rape myth scale for use with sexual and gender minorities and, perhaps the general population, as some of these statements may be lacking in cultural relevance.

An exploratory examination of attitudes toward illegal abortion in the U.S. through endorsement of various punishments

OBJECTIVES

We examined people's (1) attitudes about abortion using an item from Pew Research Center (i.e., whether abortion should be legal in all cases, legal in most cases, illegal in most cases, or illegal in all cases) and (2) support for different punishments if abortion were illegal in all cases for different people involved in the abortion-the pregnant person, their partner, an informant and the healthcare provider.

STUDY DESIGN

We administered a web-based survey to 2,204 U.S. adults using quota-based sampling. Post-stratification weights were applied to the data so that the sample was comparable to U.S. benchmarks for gender, race, Hispanic ethnicity, age, education, and political affiliation. We compared endorsement of various punishments for a pregnant person, their partner, informant, and healthcare provider. Additionally, we compared the endorsement of these punishments across response options of Pew's abortion legality item.

RESULTS

Overall, most of our sample indicated that abortion should be legal in most (34%) or legal in all scenarios (21%). However, if abortion were illegal in all circumstances, most of our sample supported some form of punishment for the pregnant person (72%-75%), their partner (65%-68%), and healthcare providers (70%-71%), but not informants (47%-49%). Among the endorsed punishments, therapy/education typically received the most support.

CONCLUSIONS

Because of the Dobbs v. Jackson Women's Health Organization decision and the subsequent overturning of Roe v. Wade, abortion is illegal in a significant number of states and a punishable offense. Our findings suggest that current punishments associated with many of these laws are counter to public sentiment.

Does Alcohol Consumption Influence People's Perceptions of Their Own and a Drinking Partner's Ability to Consent to Sexual Behavior in a Non-sexualized Drinking Context?

The purpose of this study was to examine the extent that alcohol consumption affected participants' perceptions of their own and their friend's ability to consent to sex in a non-bar drinking environment. We interviewed 176 people at tailgates in dyads about their own and their friends' alcohol consumption, intoxication symptoms, and ability to consent. Participants reported consuming a mean of 4.6 drinks and had a breath alcohol concentration (BrAC) of .075 on average, but few thought they or their friend had diminished cognitive function. Accordingly, 92.6% indicated they could consent to sex and 81.8% indicated their friend could consent to sex. Number of drinks people reported consuming, self-reported intoxication levels and symptoms, and BrACs were not significantly related to participants' perceptions of their own or their friends' ability to consent to sex. However, gender pairing of the dyad was significant; those in man-man pairs were more likely than those in woman-woman pairs to indicate their friend could consent and they would allow their friend to have sex if approached by an interested party. Participants also indicated that they did not perceive themselves or their friends to be "too intoxicated" as common reasons why they believed they and their friend could consent. Because alcohol-facilitated sexual assault is common among college students, we recommend sexual assault prevention educators focus on raising awareness regarding alcohol's negative cognitive effects, particularly related to consent communication.

Identifying accurate pro-choice and pro-life identity labels in Spanish: Social media insights and implications for comparative survey research

INTRODUCTION

Although debate remains about the saliency and relevance of pro-choice and pro-life labels (as abortion belief indicators), they have been consistently used for decades to broadly designate abortion identity. However, clear labels are less apparent in other languages (e.g., Spanish). Social media, as an exploratory data science tool, can be leveraged to identify the presence and popularity of online abortion identity labels and how they are contextualized online.

PURPOSE

This study aims to determine how popularly used Spanish-language pro-choice and pro-life identity labels are contextualized online.

METHOD

We used Latent Dirichlet Allocation (LDA) topic models, an unsupervised natural language processing (NLP) application, to generate themes about Spanish language tweets categorized by Spanish abortion identity labels: (1) proelección (pro-choice); (2) derecho a decidir (right to choose); (3) proaborto (pro-abortion); (4) provida (pro-life); (5) antiaborto (anti-abortion); and (6) derecho a vivir (right to life). We manually reviewed themes for each identity label to assess scope.

RESULTS

All six identity labels included in our analysis contained some references to abortion. However, several labels were not exclusive to abortion. Proelección (pro-choice), for example, contained several themes related to ongoing presidential elections.

DISCUSSION AND CONCLUSION

No singular Spanish abortion identity label encapsulates abortion beliefs; however, there are several viable options. Just as the debate remains ongoing about pro-choice and pro-life as accurate indicators of abortion beliefs in English, we must also consider that identity is more complex than binary labels in Spanish.

Bystander Intoxication and Appraisal of Sexual Assault Risk: A Field Study of Emerging Adult Bargoers

Emerging adults are especially vulnerable to experiencing alcohol-related sexual assault. While bystanders play a critical role in preventing sexual assault, little is known about how bystander alcohol intoxication affects the intervention process-particularly in naturalistic settings. We recruited 315 emerging adult bargoers ages 21-29 (46% women; 28% non-college attending; 81% White) from a high-density bar area to provide responses to a sexual assault vignette and complete a breath alcohol concentration test. In this field-based study, we found a negative direct association between intoxication and appraisal of risk in the hypothetical sexual assault situation. We also found a negative indirect relation of intoxication on perceptions of personal responsibility to intervene and confidence in the ability to intervene, statistically mediated through reduced risk appraisal. Findings add to the limited literature in laboratory-based settings suggesting that bystander intoxication interferes with sexual assault intervention and help inform effective bystander intervention programming for emerging adults.

Comparing Rates of Sexual Assault Between Panel Quota and Social Media Samples: Findings Across Sexual Orientation Categories

Sexual assault is prevalent and may be even more prevalent among sexual minorities. However, prevalence rates vary, in part, due to discrepancies in sampling methods. Given this, we assessed whether two popular non-probability sampling types (panel quota vs. social media recruitment) produced different sexual assault prevalence rates when holding all other methodological choices (definitions, measures, scoring) constant in a sample of lesbian, bisexual, queer, and heterosexual adults, excluding cisgender men. Two phases of data collection occurred-a panel quota sample (n = 1366), recruited from an online sample aggregator, and social media sample (n = 1102), recruited through lesbian, gay, bisexual, transgender, and queer (LGBTQ) social media sites. Participants were asked about sexual assault and rape experiences in both childhood and adulthood using a modified form of the Sexual Experiences Scale-Short Form Victimization. Both phases used the same definitions of sexual assault, prevalence measures, and prevalence scoring. Overall, the sample recruited via LGBTQ social media yielded statistically higher sexual assault prevalence rates for all four types of victimization experiences measured: lifetime sexual assault (LSA), rape-specific LSA, childhood sexual assault (CSA), and adulthood sexual assault. However, when parsing out subgroups, this finding only held for heterosexual participants who had rates > 30% higher in the social media sample compared with the panel quota sample. These findings suggest that researchers studying sexual assault in lesbian, bisexual, or queer adults may be able to use social media sampling techniques, which require less resources, without concern that the sampling technique is inflating prevalence when compared to panels.

Abortion vs. Sexual Assault: People's Perceptions of Kavanaugh's Nomination to the Supreme Court of the United States

Public reaction to Brett Kavanaugh's nomination to the Supreme Court of the United States initially centered around abortion. However, approximately two months after the nomination, sexual assault accusations against Kavanaugh were made public. We examined the extent that people's perceptions of Kavanaugh's stance on abortion and people's attitudes toward whether Kavanaugh committed sexual assault were associated with perceptions of Kavanaugh as a good Supreme Court justice. Data were collected from English- and Spanish-speaking participants (N = 2,883) in the United States via Qualtrics' panel. Using an exploratory hierarchical regression approach, we found that people's perceptions of whether Kavanaugh committed sexual assault was a stronger predictor of their attitudes toward Kavanaugh's quality as a Supreme Court justice [F(1,2855) = 1736.54, p < .001] than people's perceptions of him regarding abortion, after controlling for demographic characteristics and participants' abortion identity (e.g., identifying as pro-life, pro-choice). That sexual assault was a stronger predictor could suggest the importance of sexual assault regarding opinions of Supreme Court justices or potential over inflation of abortion as a salient issue. Researchers should investigate the saliency of sexual and reproductive health issues in relation to Supreme Court nominees.

Knowledge of and Attitudes Toward Roe v. Wade Among US Latinx Adults

This study examines knowledge of and attitudes toward Roe v. Wade among a sample of 779 US Latinx adults. Survey response patterns were examined in relation to generational status and choice of survey language as well as to several demographic variables previously shown to influence abortion attitudes (e.g., age, religiosity, political affiliation). Differences were found in knowledge of Roe v. Wade by generational status and survey language, with those with higher generational statuses and those taking the survey in English exhibiting greater knowledge. Finally, greater knowledge of Roe v. Wade and choosing to take the survey in English predicted more positive attitudes toward Roe v. Wade controlling for other demographic variables; no effect on attitudes of generational status was observed. These findings contribute to our understanding of abortion attitudes among US Latinxs as well as the relationship between political socialization, knowledge, and attitudes toward social issues.

An Assessment of the Cues College Students Interpret From a Sexual Partner to Determine They Are Refusing

The purpose of this study was to assess the cues college students use to determine a sexual partner is refusing vaginal-penile sex (i.e., refusal interpretations). As a secondary aim, we explored the influence of item wording (not willing/non-consent vs refusal) on college students' self-reported refusal interpretations. A sample of 175 college students from Canada and the United States completed an open-ended online survey where they were randomly assigned to one of two wording conditions (not willing/non-consent vs refusal); students were then prompted to write about the cues they used to interpret their partner was refusing. An inductive coding procedure was used to analyze open-ended data. Themes included explicit and implicit verbal and nonverbal cues. The refusal condition elicited more explicit and implicit nonverbal cues than the not willing/non-consent condition. Frequency results suggested men reported interpreting more explicit and implicit verbal cues. Women reported interpreting more implicit nonverbal cues from their partner. Our findings reflect prior research and appear in line with traditional gender and sexual scripts. We recommend researchers consider using the word refusal when assessing the cues students interpret from their sexual partners as this wording choice may reflect college students' sexual experiences more accurately.

Women's disclosure of college sexual assault: Greek-life status does not influence disclosure

Objective: Due to high prevalence rates of sexual assault among college-aged women and the benefits of disclosure (e.g., emotional well-being), it remains important to consider barriers to disclosure. The current paper aimed to examine if barriers to disclosure may be more salient to sorority women. Participants: We examined differences in rates of hypothetical willingness to formally disclose (N = 693) and actual formal/informal disclosure (N = 584) as well as mental health as a function of Greek-life status among college women. Method: Two separate online surveys were administered (October, 2016; January, 2017), respectively. Results: Findings suggest no significant differences in rates of hypothetical or actual formal/informal disclosure as a function of Greek-life status; however, Greek-life members reported lower mental health. Conclusion: Findings from the current studies suggest that institutional factors (e.g., campus climate) may serve as a barrier to disclosure. Limitations and future directions in this important area are discussed.

Assessing rigid modes of thinking in self-declared abortion ideology: natural language processing insights from an online pilot qualitative study on abortion attitudes

Introduction

Although much work has been done on US abortion ideology, less is known relative to the psychological processes that distinguish personal abortion beliefs or how those beliefs are communicated to others. As part of a forthcoming probability-based sampling designed study on US abortion climate, we piloted a study with a controlled sample to determine whether psychological indicators guiding abortion beliefs can be meaningfully extracted from qualitative interviews using natural language processing (NLP) substring matching. Of particular interest to this study is the presence of cognitive distortions—markers of rigid thinking—spoken during interviews and how cognitive distortion frequency may be tied to rigid, or firm, abortion beliefs.

Methods

We ran qualitative interview transcripts against two lexicons. The first lexicon, the cognitive distortion schemata (CDS), was applied to identify cognitive distortion n-grams (a series of words) embedded within the qualitative interviews. The second lexicon, the Linguistic Inquiry Word Count (LIWC), was applied to extract other psychological indicators, including the degrees of (1) analytic thinking, (2) emotional reasoning, (3) authenticity, and (4) clout.

Results

People with polarized abortion views (i.e., strongly supportive of or opposed to abortion) had the highest observed usage of CDS n-grams, scored highest on authenticity, and lowest on analytic thinking. By contrast, people with moderate or uncertain abortion views (i.e., people holding more complex or nuanced views of abortion) spoke with the least CDS n-grams and scored slightly higher on analytic thinking.

Discussion and conclusion

Our findings suggest people communicate about abortion differently depending on their personal abortion ideology. Those with strong abortion views may be more likely to communicate with authoritative words and patterns of words indicative of cognitive distortions—or limited complexity in belief systems. Those with moderate views are more likely to speak in conflicting terms and patterns of words that are flexible and open to change—or high complexity in belief systems. These findings suggest it is possible to extract psychological indicators with NLP from qualitative interviews about abortion. Findings from this study will help refine our protocol ahead of full-study launch.

Assessing models of concurrent substance use and sexual consent cues in mainstream films

ObjectiveCollege students may not view sexual consent communication while under the influence of substances (i.e., alcohol and drugs) as problematic if media models the co-occurrence of these behaviors. The purpose of this study was to assess the types of consent cues used by characters who are and are not under the influence of substances in mainstream films. Method: Four researchers inductively analyzed popular mainstream films (N = 50). Films were assessed for substance use and consent communication cues. Results: Characters using substances were depicted using implicit verbal and explicit nonverbal consent cues more than characters who had not used substances. Conclusion: Films may perpetuate cultural narratives that substance use can be part of the consent process and that consent is communicated differently when people have used substances. Prevention programs could include media literacy to address misleading messages college students may internalize about substance use and sexual consent communication.

Momentary versus Retrospective Sexual Consent Perceptions

Perceiving potential indicators of a person's willingness is an integral component of sexual consent. Preliminary qualitative evidence using vignettes suggested that consent perceptions can change over the course of a sexual scenario. In the present study, we extended previous research by directly comparing momentary and retrospective sexual consent perceptions using a quantitative study design. Employing a staggered vignette protocol, we examined participants' (n = 962; 72.0% female) momentary perceptions of fictional characters' sexual consent and compared them with participants' retrospective perceptions of the characters' consent. We hypothesized that participants would demonstrate a hindsight bias in that they would retrospectively indicate they thought the fictional characters were first willing to engage in sexual behavior earlier than when they did momentarily. We found that differences in participants' momentary versus retrospective perceptions of characters' sexual consent varied by the type of behavior. As we expected, participants demonstrated a hindsight bias for making out. Contrary to our hypothesis, participants were hesitant to retrospectively report that the characters were willing to engage in the other sexual behaviors (e.g., oral, vaginal, anal sex) at a point earlier than their momentary perceptions. That momentary and retrospective sexual consent perceptions significantly differ corroborates previous recommendations that sexual consent be conceptualized as an ongoing process.

Sexual Consent Perceptions of a Fictional Vignette: A Latent Growth Curve Model

Sexual consent can be conceptualized as a process of accumulating cues that build toward and continue throughout a consensual sexual encounter. How people perceive the cues of others during this process is an important aspect of consent. However, previous research has not investigated the trajectories of people's consent perceptions throughout such a process. Using a novel staggered vignette protocol, we examined participants' (N = 1218; 64.4% female) perceptions of fictional targets' sexual consent at 11 time points. We tested latent growth curve models using multilevel structural equation modeling to examine trajectories in consent perceptions over the course of the vignette. We hypothesized that mean differences and rates of change would be associated with several constructs relevant to sexual consent. We found that initial consent perceptions and trends over the course of the vignette varied by whether the participant was a university student, by an alcohol manipulation in the vignette, by the fictional target's sex, and by type of sexual behavior. Researchers should examine whether our findings on consent perceptions of a fictional vignette extend to people's actual sexual encounters, including potential associations between the three primary aspects of sexual consent: perceptions, feelings, and communication.

Associations between sexual precedent and sexual compliance: An event-level examination

Objective Most studies on agreeing to unwanted sex have assessed sexual encounters between people who have had sex before. Thus, we examined instances of sexual compliance with a novel sexual partner. Participants: A probability sample of college students at a university in the Midwest United States (N = 7,112). Methods: Participants completed an online survey based on measures from the National Survey of Sexual Health and Behavior. Results: Only 2.5% (n = 179) agreed to unwanted sexual activity at their most recent sexual encounter. People who were sexually compliant with a novel sexual partner frequently did so due to their own alcohol intoxication. Further, sexual compliance with novel sexual partners was less frequently associated with affectionate sexual behaviors or orgasm. Conclusions: Our initial findings regarding the effect of sexual precedent on sexual compliance warrant further research on instances when people agree to sex they don't want with novel partners.

Assessing the Within-Person Variability of Internal and External Sexual Consent

Sexual consent is often conceptualized as an internal willingness to engage in sexual activity, which can be communicated externally to a sexual partner. Internal sexual consent comprises feelings of physical response, safety/comfort, arousal, agreement/want, and readiness; external sexual consent includes communication cues that may be explicit or implicit and verbal or nonverbal. Most previous research on sexual consent has focused on between-person differences; little attention has been devoted to examining the within-person variation of sexual consent across time. We conducted a 28-day experience sampling methodology (ESM) study with a sample of adults (N = 113) to assess fluctuations in internal and external sexual consent across a given person's sexual events. We found that more than 50% and up to 80% of the variance in sexual consent scores could be accounted for by within-person variability. The type of sexual behavior participants engaged in during a sexual event predicted their internal and external consent. Further, internal consent feelings predicted external consent communication. Overall, our findings provided initial evidence regarding the extent that situational contexts are relevant for sexual consent. ESM study designs may be used to further investigate the potential contextual, intrapersonal, and interpersonal factors associated with internal and external sexual consent.

Assessing Young Adults' Internal Feelings Related to Refusing Sexual Behavior

Young people describe refusing sexual activity as difficult or embarrassing; however, what specific internal feelings young adults associate with refusing sexual activity is unclear. We assessed the positive and negative internal feelings related to refusing different sexual behaviors using sentiment analysis. We also examined if positive and negative internal refusal feelings varied by gender and the intersection of gender and racial/ethnic identity. Young adults (n = 574, 481 women, 93 men, M = 19.2, SD = 1.43) from Canada and the U.S. completed an open-ended survey about how they felt about their experiences refusing sexual activity. Using sentiment analysis, responses were coded as either positive or negative and overwhelmingly, feelings associated with refusing sexual activity were identified as negative. Women and women of color reported more negative feelings than men and White women. However, there were some distinct positive feelings noted from young adults (e.g., feeling respected, comfortable). Young adults appear to internalize negative feelings about their refusals which may relate to social and cultural norms. Moving forward, sexual health programs could focus on normalizing and destigmatizing refusals so that young adults do not feel negatively about refusing sexual activity, with a particular emphasis on helping women and women of color to feel confident and empowered in their refusals.

Evaluating Risk-Stratified HPV Catch-up Vaccination Strategies: Should We Go beyond Age 26?

BACKGROUND

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. HPV can cause genital warts and multiple types of cancers in females. HPV vaccination is recommended to youth age 11 or 12 years before sexual initiation to prevent onset of HPV-related diseases. For females who have not been vaccinated previously, catch-up vaccines are recommended through age 26. The extent to which catch-up vaccines are beneficial in terms of disease prevention and cost-effectiveness is questionable given that some women may have been exposed to HPV before receiving the catch-up vaccination. This study aims to examine whether the cutoff age of catch-up vaccination should be determined based on an individual woman's risk characteristic instead of a one-size-fits-all age 26.

METHODS

We developed a microsimulation model to evaluate multiple clinical outcomes of HPV vaccination for different women based on a number of personal attributes. We modeled the impact of HPV vaccination at different ages on every woman and tracked her course of life to estimate the clinical outcomes that resulted from receiving vaccines. As the simulation model is risk stratified, we used extreme gradient boosting to build an HPV risk model estimating every woman's dynamic HPV risk over time for the lifetime simulation model.

RESULTS

Our study shows that catch-up vaccines still benefit all women after age 26 from the perspective of clinical outcomes. Women facing high risk of HPV infection are expected to gain more health benefits compared with women with low HPV risk.

CONCLUSIONS

From a cancer prevention perspective, this study suggests that the catch-up vaccine after age 26 should be deliberately considered.

Effects of Typical and Binge Drinking on Sexual Consent Perceptions and Communication

Young adults frequently engage in sexual activity after consuming alcohol and, consequently, may try to communicate sexual consent while intoxicated. We aimed to assess how people's drinking behaviors relate to their consent perceptions and communication with their current sexual partners. Using aggregated data from a 30-day daily diary study, young adults (n = 86, 77.9% women, 86% in a monogamous relationship) reported instances of partnered sexual activity and their perceptions of whether that activity was consensual. For each partnered sexual event, participants reported what they said or did to perceive the sexual activity as consensual. Responses were coded as active consent communication (i.e., using verbal or nonverbal cues) or tacit knowledge (i.e., using context to understand consent). During an exit survey, participants retrospectively reported how many days they drank (i.e., typical drinking) during the 30-day study and whether they binge drank. Typical and binge drinking were associated with identifying sexual experiences as consensual. Participants who binge drank relied less on active consent communication and more on context compared with those who did not binge drink. Young adults who binge drink may rely more on tacit knowledge because alcohol impedes their ability to process complex stimuli-such as active consent cues.

Developing Valid and Feasible Measures of Sexual Consent for Experience Sampling Methodology

Preliminary evidence indicates that people's sexual consent (i.e., their willingness to engage in sexual activity and communication of that willingness) varies across time and context. Study designs that assess sexual consent at multiple time points (e.g., experience sampling methodology [ESM]) are needed to better understand the within-person variability of sexual consent. However, extant validated measures of sexual consent are not appropriate for ESM studies, which require shorter assessments due to the increased burden this methodology has on participants. As such, the goal of the present study was to develop ESM measures of sexual consent based on items that have previously been validated for use in cross-sectional surveys. We selected items that balanced face validity as evidenced by cognitive interviews (n = 10) and content validity as evidenced by experts' ratings (n = 6). To assess the construct validity and feasibility of these items, we administered the selected ESM measures of sexual consent in a seven-day pilot study (n = 12). The results suggested that the ESM measures developed in the present study were a valid and feasible assessment of people's experience-specific internal consent feelings and external consent communication. We conclude with recommendations for sex researchers interested in ESM.

Differences in Lesbian, Bisexual, and Heterosexual Women's Experiences of Sexual Assault and Rape in a National U.S. Sample

Lesbian and bisexual women experience significantly higher rates of sexual assault and rape compared with heterosexual women. Despite this, researchers have yet to distinguish whether sexual orientation itself or some other related social characteristics explain these higher rates. The objective of this study was to analyze women's rates of sexual assault and rape across sexual orientation status while accounting for other social characteristics (e.g., race, education, income, outness). Women (N = 1,366), who identified as lesbian (31%), bisexual (32%), and heterosexual (31%), completed a nationally distributed, cross-sectional online survey in 2016. Victimization and repeat victimization were assessed using a modified version of Sexual Experience Survey-Short Form Victimization. Overall, 63% of bisexual, 49% of lesbian, and 35% of heterosexual women reported experiencing rape in their lifetime. When holding all other social characteristics constant, sexual orientation remained a significant predictor in the model. Compared with the odds of heterosexual women experiencing sexual assault or rape, bisexual women (3.7 odds of victimization; 7.3 odds of repeat victimization) and lesbian women (3.2 odds of repeat victimization) were disproportionately victimized. Sexual orientation clearly plays a role in sexual victimization risk, independent of other measured sociodemographic indicators. Continued research is needed to explore possible mechanisms behind sexual assault and rape prevalence, as well as the influence of contextual factors of victimization risk among sexual minority men.

The Interaction of Rape Myth Acceptance and Alcohol Intoxication on Bystander Intervention

Bystander interventions for sexual assault promote third-party interference. People who endorse rape myths blame victims more and perpetrators less; consequently, rape myth acceptance (RMA) can impede helping behaviors toward sexual assault victims. Acute alcohol intoxication may exacerbate the effects of RMA on bystander intervention. In this study, we examined the influence of RMA-and potential moderating effect of acute alcohol intoxication-on predictors of bystander intervention. Young adults (N = 128) completed a survey in a lab setting, then consumed either an alcoholic or control beverage, read and listened to a fictional sexual assault scenario, and finally completed a semi-structured interview and postexperiment survey assessing their perceptions of the scenario. Using multivariate analysis of covariance (MANCOVA), we found people with higher RMA blamed the victim more and perpetrator less; they were also less likely to perceive responsibility to intervene for a sexual assault victim. Alcohol intoxication did not exacerbate these effects. That is, alcohol intoxication was not a context in which RMA was expressed more strongly. We recommend bystander programs continue to address RMA, specifically as a barrier to intervening.

Sexual Consent in Committed Relationships: A Dyadic Study

Sexual consent is a multidimensional construct that requires the participation of all involved in a sexual encounter; however, previous research has almost exclusively relied on one person's perspective. To address this, we collected open- and closed-ended data on sexual consent from 37 dyads in committed sexual relationships (N = 74). We found that relationship length was associated with sexual consent and couples who accurately perceived each other's consent communication cues reported elevated levels of internal consent feelings. Communicating willingness to engage in sexual activity remains important even within committed relationships. Preliminary findings suggest that further investigations of dyadic nuances of sexual consent are warranted.

Do college students feel confident to consent to sex after consuming alcohol?

OBJECTIVE

College students engage in consensual sexual activity after consuming alcohol, perhaps because they feel confident to do so. However, why students feel confident consenting to sex after consuming alcohol is unclear. We conducted a mixed-method evaluation of students' confidence consenting to sex after consuming alcohol; we examined individual (gender, relationship status, Greek life, alcohol and sex expectancies) and contextual (drinking behaviors) factors' association with confidence to consent to sex. We then qualitatively examined why students felt confident.

METHOD

232 college students completed a survey assessing alcohol and sexual activity.

RESULTS

Gender, Greek life involvement, and drinking behaviors were related to confidence to consent; open-ended responses suggested students had their own norms for combining consent and alcohol.

CONCLUSIONS

Students were confident consenting to sex after consuming alcohol. Sexual assault prevention educators may consider focusing on misunderstandings surrounding alcohol's effects on people's ability to consent.

Attitudes of US adults toward using telemedicine to prescribe medication abortion during COVID-19: A mixed methods study

OBJECTIVES

We explored public opinion about using telemedicine to provide medication abortion during the COVID-19 pandemic in 2020. We also investigated the associations between socio-demographic characteristics and support for using telemedicine in this context and explored factors that influenced respondents' attitudes on the topic.

STUDY DESIGN

In a nationally representative, web-based survey of US adults (n = 711), we asked open- and closed-ended questions about using telemedicine to prescribe medication abortion during COVID-19. We used multinomial logistic regression to assess the relationship between socio-demographic characteristics, endorsement of abortion labels, and political affiliation and support for telemedicine in this circumstance. Then, we conducted content and thematic analyses with the open-ended data to explore what influenced respondents' opinions.

RESULTS

Overall, 332 (44%) of respondents supported using telemedicine for medication abortion during the pandemic; 237 (35%) opposed and 138 (21%) were unsure. Respondents who identified as prochoice were more likely to support using telemedicine for abortion during the pandemic than those who identified as prolife were to oppose it in this context (RRR 2.95; 95% CI 1.31-6.64). Via our content and thematic analysis, we identified that concerns about safety, the legitimacy of telemedicine, and the belief that abortion should occur as early in the pregnancy as possible influenced respondents' beliefs about using telemedicine for medication abortion.

CONCLUSIONS

More respondents supported using telemedicine for medication abortion during COVID-19 than opposed it. Among respondents who expressed support, most thought that medication abortion was safe and that telemedicine was equivalent to the in-person provision of care.

IMPLICATIONS

There appears to be support among US adults for the provision of medication abortion via telemedicine during COVID-19. Policymakers may consider public sentiment as well as clinical evidence when considering legislation about abortion.

Alcohol's Effects on Bystander Intervention Strategies to Prevent Sexual Assault

Alcohol's effects on bystander responses to potential sexual assault situations are understudied. In this mixed-methods study, we examined quality of bystander responses in intoxicated versus sober people. Participants were 121 young adults (ages 21-29, 50% female) randomly assigned to consume alcoholic beverages or soda water. After drinking, participants listened to a sexual assault vignette and completed a semistructured interview assessing how they would respond if they had witnessed the situation. Nearly all participants reported they would directly intervene if faced with the situation. Intoxicated participants and men were significantly less likely to use high-quality bystander intervention strategies than were sober participants and women. Results suggest that alcohol intoxication may negatively impact the likelihood that bystander intervention efforts will be helpful.

"It prevents a fertilized egg from attaching…and causes a miscarriage of the baby": A qualitative assessment of how people understand the mechanism of action of emergency contraceptive pills

OBJECTIVE

The mechanism of action (MOA) of emergency contraceptive pills (ECPs) is frequently mischaracterized. Our objective was to identify how members of the general public understand the mechanisms of ECPs.

STUDY DESIGN

We recruited a convenience sample from social media for a survey about reproductive health attitudes and analyzed spontaneous descriptions of how ECPs work. We inductively coded responses to create themes and subthemes, and collapsed subthemes into three MOA categories based on previous research.

RESULTS

Among 1443 respondents, 533 mentioned an MOA in their description of ECPs. While nearly half of these responses (49.5%) stated that ECPs prevent pregnancy before fertilization occurs (in accordance with most biomedical ECP research), over 60% described a mechanism related to preventing implantation of a fertilized egg. Nine percent of responses described a postimplantation mechanism that would be considered abortion by mainstream medical standards. Some respondents conveyed significant confusion about the biological processes involved with pregnancy and pregnancy prevention.

CONCLUSION

Confusion about how ECPs work was common among our sample. The largest group of responses described a mechanism-preventing implantation of a fertilized egg-listed on the Food and Drug Administration (FDA)-approved ECP labels that does not reflect most relevant biomedical research. Mischaracterizations of ECPs' mechanisms have been used to limit access to EC. These misunderstandings were common in our sample and may reflect poor quality sex education and public information, and confusion introduced by the FDA-approved labels. Additional research should identify whether public perception of ECPs' mechanisms influences policy, health care provision, and use of ECPs.

Sexual Consent at First-Time Intercourse: Retrospective Reports from University Students in Canada and the United States

Objectives

We investigated whether the context of first-time intercourse (FTI) was associated with internal consent feelings and external consent communication at FTI.

Method

College students (n = 1020) from universities in Canada and the United States retrospectively reported on their FTI.

Results

Using structural equation modeling, we found that the context of participants' FTI (e.g. age, contraceptive use) predicted their internal consent, which in turn predicted their external consent communication.

Conclusions

Sexual health education should highlight these contextual correlates of sexual consent at FTI. Despite the cultural primacy of FTI, consent should also be prioritized for other early sexual experiences.

Internal and external sexual consent during events that involved alcohol, cannabis, or both

Background Substance-involved sexual activity is common. Even though people recognise that substance-related impairment can be a barrier to people's ability to consent to sexual activity, most do not believe that substance use automatically negates sexual consent. We extended previous work on substance-related effects on internal and external consent by investigating sexual events that involved alcohol, cannabis, or both.

METHODS

For 28 days, 113 participants (MAge = 29.2 years, 57.5% women, 70.8% White) responded to three surveys per day on their personal devices. At time points when participants reported having engaged in partnered sexual activity, they were asked to report their alcohol use, cannabis use, internal consent feelings, and external consent communication.

RESULTS

Across 1189 partnered sexual events, 31.5% involved alcohol, cannabis, or both. Sexual events that involved combined use were associated with diminished feelings of safety/comfort and feelings that the sexual act was consensual, compared with events that involved neither substance. Greater levels of alcohol consumption were descriptively associated with lower ratings of internal sexual consent.

CONCLUSIONS

We found that combined use of alcohol and cannabis may lead to lower internal sexual consent than using either substance alone - potentially due to greater levels of impairment associated with polysubstance use. Sexual health education programs should consider more nuanced approaches to teaching people how to navigate substance use and sexual consent.