Forced Sex, Sexual Consent, and Alcohol Use in a Sample of College Women

Objective: In the United States college women are at greatest risk for sexual violence. This study explored the association between a history of forced sex and sexual consent awareness, attitudes, and beliefs and examined the relationship between alcohol use and misuse and history of forced sex.  

Methods: After IRB approval, an email invitation with survey weblink was sent to enrolled female students, aged 18-25, at a large public university in the northeast United States. Survey questions included sexual history, alcohol use, and sexual consent. A history of forced sex was measured by a dichotomous (yes/no) response adapted from the Abuse Assessment Screen for violence.  

Results: Final sample included 972 women. Forced sex was reported by 22% of participants. More than half (59%) of participants reported alcohol use prior to sexual activity. Women with greater awareness of sexual consent were significantly more likely to have a history of forced sex (OR = 1.553, p<.000, CI = 1.324 to 1.820). Women who utilized more nonverbal, indirect approaches to communicating sexual consent were significantly less likely to have a history of forced sex (OR = .683, p=.002, CI = .537 to .870).    

Conclusions: Communication and awareness of sexual consent was associated with a history of forced sex. Concurrent alcohol use may lead to difficulty refusing sexual activity and a poorly communicated refusal that could be misinterpreted. Health care providers need to understand the spectrum of sexual risks for college students including the myriad of contextual, social, individual, and partner characteristics involved in forced sexual activity.