Population-Level Approach to Sexual Violence Prevention: A Review of Alcohol Control Policies

Sexual violence is a significant public health problem, affecting millions of individuals worldwide (Basile, Chen, Black, & Saltzman, 2007) and costing the nation billions of dollars each year (Miller, Cohen, Wiersema, 1996). Although many in the field continue to call for the development of sexual violence prevention strategies targeting higher ecological levels (author name removed for blind review, 2012), few evidence-based population-level strategies exist. One method to identify potential strategies involves examining approaches used for preventing other forms of violence and assessing their relevance for sexual violence prevention (author name removed for blind review, 2012).

Alcohol policies, which regulate the distribution, sale, and consumption of alcohol, have received considerable attention as a potential violence prevention strategy. These policies have been found to affect rates of homicide (Sanchez et al, 2011), assaults (Andreasson et al, 2006), and intimate partner violence (Middleton et al, 2010). These policies may also hold particular promise for sexual violence prevention given the considerable literature that connects the use of alcohol with an increased risk of sexual violence perpetration (Abbey, Zawacki, Buck, Clinton & McAuslan, 2003).

The presentation reviews theoretical and empirical evidence related to the impact of alcohol policies on sexual violence perpetration and associated risk factors. To understand the theoretical evidence, we present a social ecological model that emphasizes the critical role of social determinants of health in shaping the relationship between alcohol and sexual violence. Policies examined in the presentation include evidence based pricing strategies, and policies regulating the physical availability of alcohol, drinking environments, and alcohol advertisements.  Studies included were identified using a search process that examined research from across many disciplines, including economics, social sciences, and law. 

The results from this review have several implications for prevention researchers. First, we provide an overview of the potential impact of alcohol policies on sexual violence, highlighting possible population-level approaches to sexual violence prevention. Second, the presentation demonstrates the need for future evaluations of existing alcohol policies to incorporate sexual violence outcome measures. We describe several methodological challenges inherent in doing so and highlight opportunities to address these challenges.  The significant burden of sexual violence points to a critical need to identify and evaluate effective strategies to reduce its prevalence at the population-level.  Exploring the potential of alcohol policies for preventing sexual violence is an important next step towards achieving these large-scale reductions in violence.