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Objective: Retrospective reports of the association between drinking and high-risk sexual behavior can be biased by implicit theories of the effects of drinking or may represent post hoc justifications instead of accurate reports of behavior. Using data from a daily diary study, we compared daily reports of condom use when drinking and not drinking with the same participants' reports of these behaviors from a retrospective questionnaire administered after diary collection was complete., Method: Participants included adolescents (n=145), adult sexually transmitted disease clinic clients (n=167), college students (n=145), and men who have sex with men (n=147). All participants reported their alcohol consumption and sexual activity daily for 8 weeks and then completed a retrospective questionnaire about their behavior over the diary period., Results: Participants' retrospective judgments about whether they used condoms more or less when drinking were not significantly related to their behavior as reported in the diary. Fewer than two thirds of the participants were accurate in their recollection of the association of condom use and drinking. Teenagers and men who have sex with men were more likely to retrospectively overestimate the negative effect of alcohol on condom use., Conclusions: Retrospective questions about the association between drinking and condom use were consistent with actual behavior only among people who consistently either never or always used condoms. These individuals correctly reported that drinking had no effect on their condom use. For people whose condom use varies, questions about associations between drinking and sex may be difficult to answer, owing to their conditional nature, and may lead to error.

Although it is often assumed that drinking alcohol interferes with condom use, most studies on this topic do not meet the conditions required for causal interpretation. We examined the association of drinking to condom use using data from diaries of alcohol use and sexual encounters, collected over 8 weeks from college students and clients of a sexually transmitted disease clinic. This method establishes the temporal relationships between drinking and condom use and controls for individual differences by using a within-subjects analysis. Multilevel models that predicted condom use from alcohol use before the sexual encounter, partner type, and the use of other contraception showed that drinking before sex was unrelated to condom use. These results do not support the persistent notion that alcohol causes people to engage in sexual risk that they would avoid when sober; instead, people tend to follow their usual pattern of condom use, regardless of alcohol use.

Context: Alcohol consumption often has been cited as increasing adolescents' risk of HIV, and several studies have shown positive relationships between drinking and risky sexual behavior among adolescents. Because most of these studies used global measures of drinking and risky sex, and conducted comparisons across persons, they could not determine whether alcohol use was a cause of risky sex or simply a correlate., Methods: A sample of 112 U.S. adolescents completed daily diaries about their health behaviors, including drinking and intercourse, for eight weeks. In analyses using t-tests and hierarchical linear modeling, each respondent's rate of condom use after drinking was compared with his or her rate of use when not drinking, and predictors of condom use were examined, Results: Rates of condom use did not differ significantly between sexual events preceded by drinking (use in 54% of events) and those not preceded by drinking (use in 52% of events). Condoms were more likely to be used during sexual events with casual partners than in those with steady partners, less likely to be used on occasions when other birth control was used and more likely to be used when the sexual encounter was expected. In the multivariate analyses, the odds of condom use were not associated either with whether a teenager had been drinking before sex or with the quantity of alcohol consumed., Conclusions: These findings challenge the widely accepted hypothesis that drinking is a cause of sexual risk-taking. Rather, they underscore the need for interventions to increase teenagers'access to and ability to use condoms.

This research examined the applicability of the theory of reasoned action to school-age children. Using structural equation modeling, we longitudinally modeled children's attitudes, norms, intentions, and behavior with regard to drinking alcohol. Respondents were 1,061 children attending public schools in the northwestern United States. Attitude, norms, and intentions (measured when the children were in 6th, 7th, 8th, and 9th grades) were used to predict alcohol use 1 year later. Two modifications of the model improved the overall fit at each grade level: separating attitude into 2 dimensions (positive and negative), and adding a path from social norm to behavior. The theoretical and practical implications of these results are discussed. [ABSTRACT FROM AUTHOR]