Testing Impulsivity and Sex as Moderators of the Association Between Young Adult Alcohol-Related Sexual Willingness and Behavior

Background: Young adult alcohol use is a public health concern due to both high prevalence and associations with negative consequences and related health-risk behaviors, such as risky sex. Research indicates individual differences such as impulsivity may be related to young adult health-risk behaviors and may differ based on biological sex. Purpose: This study examined longitudinal associations between willingness at baseline (i.e., openness to engaging in a behavior) and engaging in alcohol-related sexual behaviors (number of times consuming alcohol before or during sex and number of drinks consumed before or during sex) among young adults and tested impulsivity subscales (urgency, lack of premeditation, and sensation seeking) as moderators of the associations between willingness and alcohol-related sexual behaviors. Additional three-way interactions examining biological sex as a moderator of the associations between impulsivity and willingness were also conducted. Methods: Participants were young adults (N = 402; mean age 22.44) who participated in a longitudinal survey (baseline and 6-month follow-up) as part of a larger randomized controlled trial. Poisson regressions were conducted for both outcomes. Results: Findings indicate there were significant three-way interactions between willingness, biological sex, and urgency for both outcomes. The interaction between willingness, biological sex, and sensation seeking was also significantly associated with the number of times an individual drank before having sex. Conclusions: Findings indicate tailored interventions may be created for those with high impulsivity levels as well as based on biological sex to decrease risky sexual behaviors before or while driving.