Bryan Amanda E B, Norris Jeanette, Abdallah Devon Alisa, Zawacki Tina, Morrison Diane M, George William H, Davis Kelly C, Danube Cinnamon L, Stappenbeck Cynthia A
Alcohol and Drug Abuse Institute, University of Washington.
Department of Psychology, University of Texas at San Antonio.
Psychol Women Q. 2017 Mar;41(1):100-113. doi: 10.1177/0361684316668301. Epub 2016 Sep 16.
First-time sexual intercourse with a new male partner, relative to other sexual encounters, is associated with heightened risk to women for contracting sexually transmitted infections. Little is known, however, about women's condom-related decision-making processes during these first-time sexual encounters. In the present study, we surveyed a community sample of 179 women aged 18-30 about their alcohol consumption, desire to use a condom, perception of their partner's desire to use a condom, condom-insistence conflict, and condom-decision abdication and use during their most recent alcohol-involved first-time sexual encounter with a new partner. With structural equation modeling we tested a cognitive mediation model with various configurations of alcohol effects on abdication and condom use (direct, indirect, moderator). A moderated mediation model fit the data best. Women experienced elevated condom-insistence conflict when they wanted to use a condom and perceived their partner did not; conflict, in turn, was associated with higher likelihood of abdication and lower likelihood of condom use. Higher alcohol intoxication attenuated the associations of desire to use a condom, and perceived partner's desire to use a condom, with conflict. Results support an alcohol myopia-conflict inhibition-reduction model and emphasize the importance of sex education programs that teach young women not only about condom-related assertiveness and the effects of alcohol, but also prepare them to respond to experiences of conflict that arise during sexual encounters.
与新男性伴侣的首次性行为相较于其他性接触，会使女性感染性传播感染的风险增加。然而，对于女性在这些首次性接触中与避孕套相关的决策过程，我们却知之甚少。在本研究中，我们对179名年龄在18至30岁之间的社区女性样本进行了调查，询问她们的饮酒情况、使用避孕套的意愿、对伴侣使用避孕套意愿的认知、避孕套坚持使用的冲突、避孕套决策放弃以及在她们最近一次与新伴侣涉及饮酒的首次性接触中的避孕套使用情况。通过结构方程模型，我们测试了一个认知中介模型，该模型包含酒精对放弃使用避孕套和避孕套使用的各种影响配置（直接、间接、调节）。一个调节中介模型最能拟合数据。当女性想要使用避孕套但认为伴侣不想用时，她们会经历更高的避孕套坚持使用冲突；而这种冲突反过来又与更高的放弃使用避孕套可能性和更低的避孕套使用可能性相关。更高程度的酒精中毒会减弱使用避孕套的意愿以及对伴侣使用避孕套意愿的认知与冲突之间的关联。研究结果支持酒精近视 - 冲突抑制 - 减少模型，并强调性教育项目的重要性，这些项目不仅要教导年轻女性关于与避孕套相关的坚定自信以及酒精的影响，还要让她们做好应对性接触中出现的冲突经历的准备。
