Convergent effects of alcohol and confluence model constructs on sexual aggression, sexual misperception, and coercive condom use resistance: a scoping review

Abstract

Several robust predictors of men’s sexual aggression perpetration include components of the confluence model, specifically alcohol consumption and constellations of attitudes referred to as hostile masculinity and impersonal sex. These constructs have also been found to predict sexual misperception, a frequent intermediary for sexual aggression, and coercive condom use resistance. Whether alcohol and hostile masculinity and impersonal sex operate independently or in concert to increase the likelihood of male sexual aggression perpetration and these related behaviours is unclear, and prior studies produced mixed findings. To address these knowledge gaps, we reviewed empirical studies that examine the impact of associations between alcohol and hostile masculinity and alcohol and impersonal sex on sexual aggression perpetration, sexual misperception, and coercive condom use resistance by men. We identified 19 studies of undergraduate and community men. There was support for a shared pathway from alcohol use and impersonal sex to sexual aggression and misperception, although potential causal mechanisms remain untested. There was limited evidence that alcohol intoxication interacts with hostile masculinity to predict sexual aggression perpetration, but further studies are needed to replicate and extend these findings. Critical gaps include limited studies of sexual misperception and condom use resistance and limited testing of competing hypotheses. PRACTICE IMPACT STATEMENT: This paper summarises knowledge of the synergistic effects of two risk factors for sexual aggression perpetration, alcohol and confluence model constructs, and highlights critical gaps in our understanding. This information can assist researchers developing etiological models and evidence-based interventions by providing information about potential mechanisms of alcohol and confluence model effects on sexual aggression perpetration.