Does drinking promote risky sexual behavior? A complex answer to a simple question

The present review argues that, popular lore notwithstanding, the well-documented association between usual patterns of alcohol use and risky sex reflects multiple underlying processes that are both causal and noncausal (spurious) in nature. It is further argued that even alcohol's acute causal effects on sexual behavior are more variable than they are commonly assumed to be. Drinking can promote, inhibit, or have no effect on behavior, depending on the interplay of factors governing behavior in a particular situation and the content of individually held beliefs about alcohol's effects.