title: Risky drinking, risky sex: a national study of New Zealand university students.
abstract: BACKGROUND
  Sexual risk taking and heavy alcohol use coexist in many populations of young people. A better understanding of the role of alcohol in sexual behaviors with health risks will inform preventive strategies. This study aimed to estimate the associations of risky sexual behavior with usual drinking pattern, with beliefs that alcohol will positively affect sexual experiences, and with drinking at the time of the sexual event.
  
  
  METHODS
  We conducted a cross-sectional web-based survey of randomly selected university students on 8 New Zealand campuses in April 2009. Event-level data (drinking, partner type, and condom use at last sexual intercourse) were collected along with contextual data (usual alcohol consumption [AUDIT-C score], history of binge drinking, alcohol-related sexual enhancement expectancies). Regression models were used to estimate associations and potential mediation.
  
  
  RESULTS
  The response rate was 50.6% (n = 2,921). After survey weighting, of those respondents who had ever had sex, 32% reported they had been drinking and 56% reported using a condom at last sex; 10.7% reported that their last sexual intercourse was with a nonregular partner and without a condom ("risky sex") (12.3% of men; 9.8% of women; p = 0.159). For both men and women, alcohol-sex expectancy scores and current drinking (AUDIT-C) scores were independently associated with amount of alcohol at last sex. For both men and women, the association of current drinking or expectancy with risky sex was mediated by alcohol at last sex.
  
  
  CONCLUSIONS
  Of the complex factors that contribute to risky sexual behavior and negative sexual health outcomes, heavy drinking appears to be important and is potentially modifiable. Addressing environmental determinants of hazardous drinking is likely to reduce negative sexual health outcomes among university students and other young people. Continuing promotion of condom use is also necessary, and further integration of health promotion activities in alcohol and sexual health is warranted.
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Jennie
authors.initials: J
authors.lastname: Connor
authors.forename: Rebecca
authors.initials: R
authors.lastname: Psutka
authors.forename: Kimberly
authors.initials: K
authors.lastname: Cousins
authors.forename: Andrew
authors.initials: A
authors.lastname: Gray
authors.forename: Kypros
authors.initials: K
authors.lastname: Kypri
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012309:Risk-Taking; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Alcohol Consumption; Sexual Behavior; Sexual Health; University/College Students