Alcohol and Sexual Decision Making

What We Need To Know

There are some significant connections between alcohol use and sexual decision making. Although most college students aged 18-24 have had sex before entering college, it is during the college years that they are at the greatest risk for sexual health issues. When alcohol (or another drug) is added to a sexual situation, this risk drastically increases. Therefore, it's helpful to look at the facts and realize that sexual health issues affect all campuses.

As the following statistics show, many young people demonstrate misperceptions about STI (Sexually Transmitted Infection) and STD (Sexually Transmitted Disease) risk factors and testing. Comprehensive educational approaches can help young people protect themselves.


Despite this major health risk, 67% of surveyed adolescents (ages 13-24 years) believe that testing for Chlamydia is routine. However, routine STD and STI screening is generally not performed, unless requested by the patient.12

Young adults aged 18 to 24 years old are at higher risk for acquiring STD's for many reasons including the following.15


Recent estimates suggest that while representing 25% of the ever sexually active population, 15- to 24-year olds acquire nearly one-half of all new STDs.13

Among women in 2004, as in previous years, 15 to 24 year olds had the highest rates of gonorrhea compared to women in all other age categories. Among men, 20 to 24 year olds had the highest rate of gonorrhea.13

HIV/AIDS Data

There are an estimated 38.6 million people living with HIV/AIDS worldwide, a greater number than ever before.14

Young people ages 15-24 account for approximately half of new adult HIV infections and 28% of the global total of adults living with HIV/AIDS.14

HIV is the leading cause of death worldwide, among those ages 15-59.14

2.8 million people died of AIDS in 2005. Of these, over half a million were children.14

HIV/AIDS is a serious life threatening illness that can be avoided by abstinence, monogamy (sex with only one partner who has been tested), and the use of a condom or other protective barriers. Making the right choices in sexual situations will significantly decrease the chance of contracting HIV/AIDS.

Alcohol, Sex and Judgment

When looking at different aspects of sexual health, decision-making, and alcohol use, it is important to realize that there are choices involved. Some of the choices that we need to make in our sexual lives include:

Will I be sexually active, and if so, to what level?
How does this choice fit into my own boundaries and values?
If I choose to be sexually active, how can I stay physically safe?
The ability to and the process of evaluating these decisions rest in the part of our brain best referred to as the Judgment Center. In order to understand the impact of alcohol and sexual decision-making, we need to look at what happens during our thought process when we drink.

Because alcohol affects judgment and lowers inhibitions, we sometimes do things when we drink alcohol that we wouldn't do sober; this can include having sex when we normally would not. As a result, not only do we need to deal with the fact that when we sober up, we remember why we normally don't engage in this behavior, but also with the reality that we just exposed ourselves to a number of risks.

Physical and Emotional Risks

Many people think only of physical risks: contracting a sexually transmitted disease or infection, being infected with the HIV virus, or the chance of getting pregnant. These risks are certainly real. Obviously, the best way to avoid the physical risks is to choose abstinence. However, if you do choose to be sexually active, a condom or barrier should be used every time.

There are other risks that we sometimes don't talk about that certainly come into play when sex and alcohol are involved. It might be in terms of sexual violence, or an unwanted pregnancy, but sometimes the results can be emotional consequences. It might be a sense of regret about breaking your own sexual boundaries, perhaps hooking up with someone and thinking the next day "that's not who I am" or maybe "that's not who I want to be."

Sometimes it's regret at rushing a relationship; where people who were attracted to each other, had too much to drink, and acted on those feelings. Now you may feel awkward and uncomfortable around each other, sometimes resulting in a premature end to a potential longer-term relationship. Whether we are talking about physical or emotional risks, the key to achieving intimacy and a healthy sexual identity is not to let alcohol impair our sexual decision-making.