A Qualitative Investigation Comparing Psychosocial and Physical Sexual Experiences Related to Alcohol and Marijuana Use among Adults

Abstract

Alcohol and marijuana are two of the most prevalent psychoactive substances and each may result in distinct psychosocial and physical sexual experiences and different sexual risk behaviors. With marijuana becoming more accepted in the US along with more liberal state-level policies, it is important to examine and compare users’ psychosocial and physical sexual experiences and sexual risk behavior associated with these drugs. In this study, we interviewed 24 adults who recently used marijuana before sex. Participants were 50 % female and all self-identified as heterosexual and HIV-negative. Using thematic analysis, we compared self-reported psychosocial and physical sexual experiences of alcohol and marijuana. Participants described differences between drugs with regard to psychosocial (e.g., partner interactions and contexts before sex, partner choice, perceived attractiveness of self and others, disinhibition, and feelings of regret after sex) and physical sexual experiences (e.g., sexual dysfunction, dose effects, sensations of body/sex organs, length and intensity of sex, and orgasm). Alcohol use was commonly associated with social outgoingness and use facilitated connections with potential sexual partners; however, alcohol was more likely than marijuana to lead to atypical partner choice or post-sex regret. Both alcohol and marijuana had a variety of negative sexual effects, and the illegality of marijuana reportedly facilitated intimate encounters. While sexual experiences tended to be similar across males and females, we did find some variation by gender. Results can inform prevention and harm reduction programming that will allow us to design more realistic programs and to craft interventions, which guide potential users to make safer choices.

Making and Communicating Decisions About Sexual Consent During Drug-Involved Sex: A Thematic Synthesis

“…Three themes were constructed from the data. The first theme indicated that drug-taking changes a person's sexual norms (Bourne, Reid, Hickson, Torres-Rueda, & Weatherburn, 2014;Claire Van Hout & Brennan, 2011;Deimel et al, 2016;Eiserman, Diamond, & Schensul, 2005;El-Bassel, Gilbert, & Rajah, 2003;Green & Halkitis, 2006;Jerome, Halkitis, & Siconolfi, 2009;Jessell et al, 2017;Lim, Akbar, Wickersham, Kamarulzaman, & Altice, 2018;Liu & Chai, 2018;Lorvick et al, 2012;McElrath, 2005;Mullens, Young, Hamernik, & Dunne, 2009;Palamar, Acosta, Ompad, & Friedman, 2018;Palamar, Kiang, Storholm, & Halkitis, 2014;Skårner & Svensson, 2013). This theme contained two subthemes: (a) acute drug-taking increases a person's perceived sexual autonomy, and, (b) people who consume drugs are perceived as "sexually available".…”

Alcohol Use, HIV Treatment Adherence, and Sexual Risk Among People with a History of Injecting Drug Use in Vietnam

“…Alcohol use is typically associated with social outgoingness, and alcohol consumption is commonly associated with meeting random sexual partners and having unplanned sex [49]. A recent study reported that compared to marijuana, alcohol use was more likely to lead to atypical partner choices or post-sex regret [50]. Given the potential negative effects of alcohol on sexual behaviors, future HIV prevention and harm reduction programs should consider patterns of alcohol use, especially those living with HIV, to increase their awareness of the sexual risks associated with alcohol use and to guide them toward making safer sexual decisions.…”

Gender Norms, Roles and Relations and Cannabis-Use Patterns: A Scoping Review

“…In one qualitative study examining substance use and sexual experiences among young adults, alcohol was commonly used by young men for pursuing potential sexual partners, and young women reported being more accepting of sexual offers from men when using alcohol [42]. In contrast, when using cannabis, young women reported being more selective regarding sexual partners.…”

“…Women and men who used cannabis prior to a sexual experience reported greater post-sexual satisfaction compared to those who used alcohol before sex, while participants who drank alcohol reported greater regret following sex. Some participants reported that the illegal nature of cannabis occasionally meant more private use that sometimes facilitated sexual encounters [42].…”

“…While these gender relations have been observed in the context of illegal cannabis markets, the hidden nature of use and opportunities for privacy may diminish as cannabis use becomes legal, openly consumed, and socially normalized [42]. Nonetheless, it seems clear that the role of cannabis in intimate heterosexual relationships may be somewhat different than that of alcohol.…”