The Role of Alcohol-Related Protective Behavioral Strategies in the Relationship Among Facets of Trait Impulsivity, Alcohol Use Severity, and Risky Sexual Behavior Among College Students

Impulsivity and alcohol consumption are linked to increased risky sexual behaviors, but the role of protective behavioral strategies (PBS) in this relationship is underexplored. This study examined whether PBS moderates the relationship among trait impulsivity, alcohol use (AU) severity, and risky sexual behavior (RSB). A moderated mediation analysis was conducted using cross-sectional data from a study on a text-based intervention among college students (n = 524; Mage = 20.93, SD = 3.51; Female = 70.1%). Results showed that greater positive urgency and lack of perseverance were significantly associated with elevated AU. The negative association between perseverance and AU increased at high levels of PBS subfactor manner of drinking but decreased at high levels of serious harm reduction. Across all serious harm reduction levels, the AU-RSB association remained strong. Conditional indirect effects revealed that the indirect association between positive urgency and RSB via AU was significant at all serious harm reduction levels. The indirect effect of perseverance on RSB via AU was pronounced when serious harm reduction was low, and the manner of drinking was average to high, or serious harm reduction was average, and the manner of drinking was high, or serious harm reduction was high, and the manner of drinking was average. Findings highlight the role of PBS in mitigating alcohol-related harm among impulsive young adults. This implies that there is a need for carefully designed interventions that target the nuanced interplay among impulsivity traits, alcohol use severity, and risky sexual behavior by implementing specific protective behavioral strategies.