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Sexual risk taking among survivors of U.S. military sexual assault: Associations with PTSD symptom severity and alcohol use

APA Citation:

Blais, R. K., Tannahill, H. S., & Cue Davis, K. (2023). Sexual risk taking among survivors of U.S. military sexual assault: Associations with PTSD symptom severity and alcohol use. The Journal of Sex Research. Advance online publication. https://doi.org/10.1080/00224499.2023.2232803

Abstract Created by REACH:

Military sexual trauma (MST) is unwanted sexual contact experienced during one’s military service. MST has been linked with a variety of negative outcomes, including posttraumatic stress disorder (PTSD), risky sexual behavior, and higher alcohol use. 400 Service members and Veterans (SM/Vs; n = 200 women) who experienced MST – specifically, military sexual assault – reported their PTSD symptoms, sexual risk-taking behaviors (e.g., unprotected sex, sex with unplanned partners), alcohol use, and demographics (e.g., sex, race, military branch). Overall, SM/Vs who reported more severe PTSD symptoms tended to have higher alcohol use and, in turn, to engage in more sexual risk-taking. The link between alcohol use and sexual risk-taking was more pronounced among men than women.


Substance use
Mental health
Physical health

Branch of Service:

Air Force
Coast Guard
Marine Corps
Multiple branches

Military Affiliation:

Active Duty

Subject Affiliation:

Active duty service member


Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Quantitative Study


Blais, R. K., Tannahill, H. S., Cue Davis, K.


Sexual risk taking may be heightened among U.S. service members and veterans reporting military sexual assault (MSA) exposure. MSA increases the risk for posttraumatic stress disorder (PTSD), which is a common correlate of sexual risk taking among civilians. PTSD may relate to sexual risk taking through its association with alcohol use, which increases impulsivity and risky behavioral engagement. Male survivors may be at notably higher risk given greater overall alcohol use and engagement in sexual risk taking relative to female survivors. This study assessed whether higher alcohol use mediated the association between PTSD and sexual risk taking among MSA survivors, and whether this effect differed by sex. Participants included 200 male and 200 female service members and veterans (age: M = 35.89, SD = 5.56) who completed measures of PTSD symptoms, alcohol use, sexual risk taking, and a demographic inventory. In a moderated mediation analysis using linear regression, higher PTSD severity was associated with higher alcohol use, and higher alcohol use was associated with higher sexual risk taking. A significant indirect effect of alcohol use was observed, which was stronger among men. To reduce sexual risk taking among MSA survivors, it may be beneficial to target PTSD symptoms and alcohol use with sex-specific interventions. This line of inquiry would be strengthened by longitudinal studies that explore the fluidity of these experiences to identify periods of elevated risk. Studies that examine alcohol use expectancies and sexual delay discounting could expand our understanding of these associations.

Publisher/Sponsoring Organization:

Taylor & Francis

Publication Type:

REACH Publication

Author Affiliation:

Psychology Department, Arizona State University, RKB
Psychology Department, Utah State University, HST
Edson College of Nursing and Health Innovation, Arizona State University, KCD


risk taking, sexual assault, PTSD, alcohol use

View Research Summary:

REACH Publication Type:

Research Summary


Funding from this study was provided by Utah State University.

REACH Newsletter:

  December 2023

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