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Objective: In June 2022, the U.S. Supreme Court released a landmark decision in which they held that the right to abortion is not protected by the U.S. Constitution, ending almost 50 years of federally legal abortion in the United States. Because prior research demonstrates linkages between reproductive health and substance use at multiple socioecological levels, in this special section, we present studies that take a broad scope to understanding how addictive behaviors and reproduction-related behaviors, options, and access to care interrelate across a variety of contexts. Method: In this introduction, the guest editors detail the impetus for this special section, provide a brief overview of the present studies, discuss policy and intervention implications, and suggest future research directions. Results: The five studies presented in this special section span a wide range of populations, methods, and substance use and reproduction-related issues, including reasons for past abortions among women with opioid use disorder, alcohol effects on men's condom use resistance, considerations regarding alcohol-involved rape on implementation of "rape exceptions" to abortion bans, the role of early exposure to substance use and sexual abuse on reproductive health outcomes, and the effects of exposure to abortion-related media coverage on alcohol use intentions following the Supreme Court decision. Conclusions: The studies in this special section highlight the ways in which substance use and reproductive health are inextricably intertwined. Recent and future changes in reproductive health legislation and policy underscore the critical need for continued empirical inquiry into these intersecting public health concerns. [ABSTRACT FROM AUTHOR]

Objective: Sexual assault (SA) perpetration remains prevalent among young men, and emotion regulation (ER) is a prominent contributor to sexual assault perpetration among young men experiencing anger or sexual arousal. However, little is known about the specific ER strategies which men use when perpetrating. Thus, the present study used latent profile analysis to group men into profiles based on their in-the-moment use of several ER strategies during two hypothetical sexual situations: one which induced anger and another which induced sexual arousal. Method: In total, 187 single, young, and heterosexually active men from the United States provided responses to an online study, in which they projected themselves into two hypothetical sexual scenarios and answered questions regarding their use of ER strategies and intentions to perpetrate sexual assault after their hypothetical partner indicated she did not consent. Results: Participants were grouped into four profiles based on their use of different ER strategies. Men in the "high acting with awareness, low resignation" profile reported lower perpetration intentions than men in the "low acting with awareness" or "moderate all strategies" profiles following both scenarios. Conclusions: Men in the "high acting with awareness, low resignation" profile may have reported lower perpetration intentions because of the reduced cognitive load associated with acting with awareness relative to other ER strategies, and the increased self-efficacy to avoid sexual aggression associated with low resignation. Thus, future research should replicate the results with this profile in other contexts to determine its feasibility and effectiveness for reducing sexual assault in future interventions. [ABSTRACT FROM AUTHOR]

Objective: Sexual aggression research has recently expanded to include empirical investigations of coercion during condom negotiation and use. This scoping review presents and discusses peer-reviewed, quantitative, English language studies conducted on coercive condom use resistance (CUR) behavior and intentions. Method: Our systematic literature search yielded 20 articles that assessed coercive CUR perpetration behaviors or intentions and met other inclusion criteria. Data on rates and correlates of coercive CUR behavior and intentions were extracted. Results: Identified studies used varied methods including cross-sectional surveys, 3-month longitudinal studies, and alcohol administration experiments, primarily with young adult samples. Overall, results indicated that a substantial minority (up to 42.6%) of sampled individuals endorsed lifetime perpetration of coercive CUR, with men reporting higher prevalence of coercive CUR perpetration than women. The majority of studies (70%) assessed coercive CUR through the Condom Use Resistance Tactics Scale (Davis, Stappenbeck et al., 2014). Although correlates largely differed by gender, alcohol-related variables emerged as risk factors for both men and women. Conclusions: Burgeoning evidence indicates that coercive CUR is relatively common, and, particularly for men, risk factors are similar to those associated with sexual aggression more generally. Review findings demonstrate that continued research in this area is warranted and should expand to include more diverse populations, to consider other risk factors and sequelae, and to utilize novel methodological approaches. [ABSTRACT FROM AUTHOR]

Objective: Despite condoms' effectiveness at preventing sexually transmitted infections (STIs) and unplanned pregnancy, coercive condom use resistance (CUR; i.e., using coercive tactics to resist condom use with a partner who wants to use one) is relatively common. However, research has not examined how risk factors, including alcohol use, alcohol expectancies related to sexual coercion, and sensation seeking, may interact to predict coercive CUR. The present study used an alcohol administration experiment to assess sensation seeking and alcohol expectancies as moderators of the relationship between acute alcohol intoxication and intentions to perpetrate coercive CUR during a hypothetical scenario. Method: Single, young, heterosexual men (N = 313) were randomly assigned to a control, placebo, low (BrAC = .04%), or high dose alcohol condition (BrAC = .08%). Participants then read and projected themselves into a sexually explicit stimulus story and indicated the likelihood that they would perpetrate coercive CUR. Results: Findings indicated that intoxication interacted with expectancies and sensation seeking to predict coercive CUR intentions, such that alcohol intoxication was associated with greater coercive CUR intentions only among participants who reported greater sensation seeking and stronger alcohol expectancies. Conclusions: Both alcohol expectancies and myopia play a key role in coercive CUR intentions, especially among sensation seeking individuals. Thus, intervention programs should evaluate men's alcohol use, alcohol expectancies, and sensation seeking behaviors as possible targets to reduce the perpetration of coercive CUR. [ABSTRACT FROM AUTHOR]

Coercive condom use resistance (CUR) is a significant problem, associated with increases in sexually transmitted infections, unplanned pregnancy, feelings of betrayal, and a loss of sexual autonomy. Furthermore, young men are much more likely to perpetrate coercive CUR than young women. Thus, the present study sought to examine the past experiences, trait characteristics, and state emotions that may precede coercive CUR perpetration intentions, including alcohol intoxication, childhood emotional abuse, trait impulsivity, sexual sensation seeking, state impulsivity, and state anxiety, using an alcohol administration procedure. Young, single, nonproblem drinking, and sexually active men who have sex with women from the United States (N = 297; 66% White, 9.4% Black, 10.7% multiracial, 5.1% Asian, 1.0% Native American, 1.0% Pacific Islander, and 10.4% Hispanic or Latino) were recruited for participation. They were randomly assigned to either receive alcohol or remain sober before projecting themselves into a hypothetical sexual scenario with a woman who asked to use a condom. Results showed that greater levels of childhood emotional abuse were associated with increased trait impulsivity and sexual sensation seeking, and that sexual sensation seeking was associated with increased state impulsivity and subsequent anxiety during the scenario. Finally, alcohol intoxication moderated the relationship between state anxiety and coercive CUR such that state anxiety was positively associated with coercive CUR among intoxicated men only. Findings suggest that interventions targeting coercive CUR behavior may be improved by focusing on men who have experienced childhood trauma, as well as their alcohol consumption and in-the-moment experiences of impulsivity and anxiety. [ABSTRACT FROM AUTHOR]

Objective: Sexual aggression remains a significant public health problem, with the majority of sexual assaults involving alcohol. Founded upon an experimental medicine approach to behavior change, the current study used a proximal change experiment to target and test emotion regulation (ER) as a mechanism underlying alcohol-involved sexual aggression. Method: Heavy episodic drinking men aged 21-30 with a sexual assault perpetration history (N = 209) were randomly assigned to a brief, online, ER-focused cognitive restructuring or mindfulness intervention or to control. Intervention effects were evaluated during sober and intoxicated states through laboratory-based alcohol administration (target BrAC = .08%). Intoxicated and sober participants completed a proximal change protocol that included implementing ER skills during a sexual aggression analogue that assessed relevant emotions and intentions. Results: Path analysis demonstrated that relative to control, the cognitive restructuring intervention improved emotional modulation and emotional clarity, resulting in lower sexual arousal and anger, respectively, followed by decreased sexual coercion intentions. The mindfulness intervention yielded mixed results, predicting decreased sexual aggression intentions compared to control but also predicting stronger coercive tactic intentions in intoxicated men with more severe sexual aggression histories. Both interventions improved emotional acceptance relative to control, but only for sober men. Conclusions: Overall, the current study demonstrated that ER-focused interventions improved proximal ER skills associated with reduced sexual aggression intentions, signifying ER as an important mechanism for changing sexually aggressive behavior. Because intervention efficacy varied by intoxication state, further research is needed to assess the effectiveness of ER interventions targeting real-world alcohol-involved sexual aggression. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the rates, predictors, and associated sexual risk indices of young men's nonconsensual condom removal (also known as stealthing). Methods: Participants were 626 male inconsistent condom users aged 21–30 years recruited from an urban area in the Pacific Northwest. Participants completed survey measures assessing sexual aggression history, sexual aggression-related attitudes, sexually transmitted infection history, unplanned pregnancies, and nonconsensual condom removal experiences. Results: Almost 10% of the participants (n = 61) reported engaging in nonconsensual condom removal since the age of 14 years, with an average of 3.62 times (SD = 3.87) and range of 1–21 times (maximum possible). After controlling for condom use self-efficacy, men with greater hostility toward women (odds ratio = 1.47) and more severe sexual aggression history (odds ratio = 1.06) had significantly higher odds of engaging in nonconsensual condom removal behavior. χ2 analyses demonstrated that men who had a history of nonconsensual condom removal were significantly more likely to have had a sexually transmitted infection diagnosis (29.5% vs. 15.1%) or have had a partner who experienced an unplanned pregnancy (46.7% vs. 25.8%). Conclusions: Nonconsensual condom removal, which involves elements of both sexual risk and sexual aggression, confers multiple sexual risks to its recipients, thus meriting increased clinical and research attention. [ABSTRACT FROM AUTHOR]

This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M = 24.78, SD = 2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across 2 cohorts of women using multiple-group LCA: contact or attempted assault (17% of the sample), incapacitated assault (52%), and forceful severe assault (31%). Groups did not differ in their sexual risk/safety behavior. Women in the forceful severe category had higher levels of anxiety, depression, and trauma symptoms; higher proportions of incarceration and transactional sex; and more experiences with controlling and violent partners than did women in the other 2 groups. Women in the forceful severe category also reported a higher frequency of HED than women in the incapacitated category. Different types of assault experiences appear to be differentially associated with negative outcomes. Understanding heterogeneity and subgroups among sexual assault survivors has implications for improving clinical care and contributing to recovery. [ABSTRACT FROM AUTHOR]

Objective: In June 2022, the U.S. Supreme Court removed federal abortion protections, giving individual states the authority to enact abortion regulations. Since that ruling, many states have enacted abortion bans; however, several of these states allow "rape exceptions," theoretically providing rape victims who become pregnant access to abortion services. Notably, alcohol use by the rape victim and perpetrator is common. In this brief report, we describe findings from research on alcohol-involved rape that have the potential to impact the utility of rape exceptions., Method: In this synthesis of the research literature pertaining to alcohol-involved rape victimization and perpetration, we focus on key concepts detailed in extant research likely relevant to accessing abortion services through rape exceptions., Results: Victim alcohol intoxication may limit the use of rape exceptions to abortion bans by delaying rape acknowledgment, increasing victim blame, undermining victim credibility, and deterring rape reporting. Commensurately, perpetrator alcohol intoxication may increase the need for victims to access abortion services by reducing perpetrator condom use during rape and increasing other sexually aggressive acts such as nonconsensual condom removal., Conclusions: Research evidence suggests that alcohol-involved rape incidents present critical obstacles to utilizing statutory rape exceptions to banned abortion services beyond challenges that non-alcohol-involved rape survivors are also likely to experience. Rape survivors from oppressed communities (e.g., people of color, gender minorities, and/or sexual minorities) may be disproportionately impacted. Empirical investigations specifically examining how substance use during rape impacts reproductive health care accessibility are paramount for informing health care providers, law enforcement, legal practitioners, and policymakers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Cisgender men's condom use resistance (CUR), deliberate attempts to avoid using a condom with a partner who wishes to use one, may include coercive strategies, such as deception and force, and places their partners at risk for unintended pregnancy and sexually transitted infections (STIs). This investigation used an alcohol administration design to examine one distal (history of unintended partner pregnancy) and two proximal (acute alcohol intoxication, condom use rationale) contributors to men's intentions to engage in coercive CUR., Method: Nonproblem drinking, cisgender men ( N = 313) completed questionnaires, then were randomized to a beverage condition (control, placebo, low dose [.04%gm], and high dose [.08%gm]). Participants completed a sexual risk analog and reported their coercive CUR intentions after a hypothetical, female partner provided a condom use rationale (STI avoidance or pregnancy avoidance)., Results: Men who received the pregnancy condom use rationale reported higher intentions to engage in coercive CUR when they received a high alcohol dose relative to sober men. For men who had a history of unintended partner pregnancy, receiving a pregnancy condom use rationale was associated with greater intentions to have forced, condomless sex if they received a high alcohol dose relative to sober men., Conclusions: Intoxicated men may be more likely to engage in coercive CUR; this may indicate that when intoxicated, pregnancy risks are less salient relative to STI-related outcomes. As reproductive rights are being decimated, effective interventions targeting CUR, particularly when intoxicated, are needed in tandem with policies that affirm one's ability to prevent and terminate pregnancy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Women account for a quarter of all new HIV/AIDS cases, with approximately 65% having contracted the infection via heterosexual contact. Few experimental studies have examined interactions among background, partner, and situational characteristics in predicting women's sexual decisions. The Cognitive Mediation Model provides a useful theoretical framework for assessing likelihood of unprotected sex. Female social drinkers (n = 230) who had answered questions related to their general intention to have unprotected sex were randomly assigned to an experimental condition based on partner risk level (unknown, low, high) and beverage (control, placebo, low dose, high dose). Participants projected themselves into a story depicting a sexual situation with a man and answered questions about their cognitive appraisals, assertive condom request, and likelihood of unprotected sex. Alcohol effects on appraisal of sexual potential differed by partner risk condition. In the unknown and low risk conditions, placebo and alcohol participants appraised the situation as having greater sexual potential than controls whereas in the high risk condition, only those who consumed alcohol did so. Sexual potential appraisals in turn predicted impelling cognitions about having sex, which in turn predicted assertive condom request and unprotected sex intentions. General intention for unprotected sex independently predicted cognitive appraisals and outcomes. These findings highlight the need for prevention programs that focus on teaching women how to pay attention and consider sexual risk cues presented by potential partners, particularly when under the influence of alcohol.

An experiment tested the pathways through which alcohol expectancies and intoxication influenced men's self-reported sexual aggression intentions during an unprotected sexual encounter. After a questionnaire session, male social drinkers (N = 124) were randomly assigned to either an alcohol condition (target peak BAC = .08%) or a control condition. Upon completion of beverage consumption, participants read a description of a sexual encounter in which the female partner refused to have unprotected sexual intercourse. Participants then rated their emotional state, their intentions to have unprotected sex with the unwilling partner, and their postincident perceptions of the encounter. Structural equation modeling indicated that intoxicated men reported feeling stronger sexual aggression congruent emotions/motivations such as arousal and anger; however, this effect was moderated by alcohol expectancies. Intoxicated participants with stronger alcohol-aggression expectancies reported greater sexual aggression congruent emotions/motivations than did intoxicated participants with weaker alcohol-aggression expectancies. For sober participants, alcohol-aggression expectancies did not influence emotions/motivations. In turn, stronger sexual assault congruent emotions/motivations predicted greater sexual aggression intentions. Men with greater sexual aggression intentions were less likely to label the situation as a sexual assault and reported less concern about their intended actions. These findings underscore the relevance of both alcohol expectancies and alcohol intoxication to sexual aggression perpetration and highlight the importance of including information about alcohol's influence on both emotional and cognitive responses in sexual aggression prevention work.

Although drinking often precedes men's sexual activity, basic questions about alcohol's effects on men's sexual arousal remain unanswered. Inconsistencies in findings from studies examining subjective and physiological effects on erectile functioning suggest these effects are context specific, for example, dependent on whether a man wants to maximize or suppress his arousal. To address unresolved questions about alcohol and erectile functioning, the authors evaluated the effects of high blood alcohol concentrations (BACs) and arousal instructional demands on indices of penile circumference change and self-reported sexual arousal. In Study 1, a target BAC of .10% (vs. .00%) attenuated peak circumference change from a neutral baseline but did not affect mean change, latency to arousal onset (a 5% increase in circumference from baseline), latency to peak achieved arousal, or subjective arousal, which correlated moderately with physiological indices. In Study 2, instructions to maximize (vs. suppress) arousal increased peak and mean circumference change and interacted with a target BAC of .08% (vs. .00%) to influence latency to arousal onset. Sober men instructed to maximize showed a shorter latency to arousal onset than did those instructed to suppress arousal; however, intoxicated men did not show a differential pattern. Moreover, compared with intoxicated counterparts, sober men instructed to maximize arousal showed a marginally shorter latency to arousal onset. Overall, alcohol and arousal instructions had small but discernible effects. Findings highlight the importance of contextual factors in alcohol's impact on erectile functioning.

This study examined effects of alcohol consumption (control, moderate dose, high dose) and type of relationship (new, established) on women's responses to escalating male sexual aggression. The role of childhood trauma was also examined. After consuming a beverage, participants (N=220) projected themselves into a story portraying a social interaction with a man that depicted escalating sexual aggression. The story was paused 3 times to assess assertive, polite, and passive resistance as well as consent. Alcohol consumption increased consent and interacted with type of relationship to increase passive resistance and with level of sexual aggression to increase polite resistance. Assertive resistance increased and other responses decreased as the man's sexual aggression escalated. Childhood trauma lowered consent initially and increased passive resistance when rape was threatened.