The Role of Alcohol Expectancies in Sexual Risk Behaviors Among Adolescents and Young Adults in the Democratic Republic of the Congo

Emily A. Hurley, Heena Brahmbhatt, Patrick K. Kayembe, Michelle Alphonsine Fatuma Busangu, Ma Umba Mabiala, Deanna Kerrigan

Research output: Contribution to journalArticlepeer-review


Purpose Considering the increased risk of HIV among alcohol users, we explored the role of individual alcohol expectancies in risk behaviors among youth in the Democratic Republic of the Congo. Methods We surveyed 1,396 adolescents (ages 15–19) and young adults (ages 20–24) on alcohol and sexual behaviors in May, 2010. We assessed expectancies of alcohol use (1) leading to sex or positive sexual experiences; (2) diminishing one's ability to resist unwanted sex; and (3) diminishing one's ability to use or negotiate use of condoms. Adjusted logistic regression models assessed the association between alcohol use and alcohol expectancies with unprotected sex and multiple sex partners (MSP). Results Participants reporting alcohol use (36.8%) were more likely to have engaged in unprotected sex and MSP than nondrinkers (adjusted odds ratio [AOR]: 2.87, 95% confidence interval [CI]: 2.29–3.60; AOR: 3.73 95% CI: 2.94–4.72, respectively). Among alcohol users, after adjusting for drinking quantity, moderate expectancies of alcohol leading to positive sexual experiences were significantly associated with MSP among adolescent boys (AOR: 4.20, 95% CI: 1.49–11.86) and girls (AOR: 3.97, 95% CI: 1.36–11.60), whereas high expectancies were significant among young adult men (AOR: 2.70, 95% CI: 1.19–6.10). Among adolescent girls who used alcohol, adjusted odds of unprotected sex were elevated among those with expectancies of diminished ability to refuse unwanted sex (AOR: 5.13, 95% CI: 1.41–16.64) or to negotiate condom use (AOR: 16.22; 2.08–126.8). Conclusions HIV prevention efforts for youth should acknowledge the role of alcohol expectancies in sexual risk behaviors and tailor programs to address different roles of expectancies in males and females.

Original languageEnglish (US)
Pages (from-to)79-86
Number of pages8
JournalJournal of Adolescent Health
Issue number1
StatePublished - Jan 1 2017


  • Adolescents
  • Alcohol expectations
  • Alcohol use
  • HIV
  • Sexual behaviors
  • Sub-Saharan Africa
  • Young adults

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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