Changes in women's sexual behavior following sexual assault.

Singh et al. (2008) tracked adult women after sexual assault. They watched how much the women drank and how much sex they had in the months that followed.

The team used a quasi-experimental design. They did not give an intervention; they simply measured real-life changes.

Women did not all react the same way. Some had more sex, some had less, and some stayed the same.

The key link: when a woman’s alcohol use went up, her sexual activity usually went up too. The authors call this a maladaptive coping path that can raise the risk of being assaulted again.

Whitehouse et al. (2014) seems to disagree. They found that adults with autism had less sexual knowledge and less sexual activity after victimization. The difference is the group: M et al. studied people with developmental disabilities, while N et al. studied neurotypical women. Less knowledge can lead to avoidance; more alcohol can lead to risk-taking.

Nosen et al. (2012) add a mechanism. They showed that positive feelings, not just bad ones, can spark alcohol craving when trauma cues are absent. This helps explain why some survivors drink more even when they look “fine.”

Smit et al. (2019) and Soylu et al. (2013) remind us to watch for ID-specific signs like self-injury or delayed disclosure. Those reviews do not contradict N et al.; they simply widen the lens to children and people with intellectual disabilities.

If you work with adult female survivors, add two quick items to your intake: “How much are you drinking?” and “Have you noticed any change in your sexual activity?” A jump in either flag calls for safety planning, brief alcohol counseling, or a referral. You do not need to wait for PTSD symptoms; the behavior change itself is the cue.