Gunby et al. BMC Public Health 2012, 12:216 http://www.biomedcentral.com/1471-2458/12/216 because they felt their own experiences were reflected within this hypothetical depiction (Table 3). These women were also less likely to believe that being drunk increased the likelihood of a false rape allegation, again a perception potentially borne from experience. The questionnaire identified 55 men who had experi- enced alcohol-related non-consensual sex demonstrating that sexual assault victimisation is not exclusively the domain of women. The small body of research which focuses on men as victims of sexual victimisation shows that men experience this form of violence from both men and women [55,56]. Reporting of non-consensual sex by men is typically inhibited by stigma and stereo- types which often results in the extent of men’s non- consensual sexual encounters being under-reported [57]. Here, compared to men who had sex with women, a greater proportion of men who had sex with other men in both homosexual and bisexual relationships had experienced alcohol-related non-consensual sex. Men who had experienced alcohol-related non-consensual sex were less likely to know that consent is about having the freedom to choose to have sex. They were also less likely to describe a situation where both parties are equally intoxicated and have sex as rape, or were unde- cided whether this was the case (Table 4). Further research on the victimisation of men is needed to help develop an understanding of these factors and elucidate their relevance to homosexual and bisexual men’s lives. Our study has several limitations. The cross sectional design means that it is not possible to ascertain a causal relationship between hazardous drinking and experien- cing alcohol-related non-consensual sex; it is possible that experiencing alcohol-related non-consensual sex resulted in increasing drinking levels. The study also relies on retrospective self-reported data. We used non- probability sampling to recruit our participants and are therefore not able to infer whether our results can be generalised to the wider student population. Further- more, the questionnaire included experiences that could have occurred before being a student. It is therefore not possible to use the results presented here as a measure of the prevalence of alcohol-related non-consensual sex among students. Finally, while the SES questions did provide definitions of alcohol-related non-consensual sex, we did not define what we meant by ‘sex’ through- out the remaining questions. Conclusion From over a thousand respondents, almost a third said they had experienced alcohol-related non-consensual sex. This demonstrates the role that alcohol plays in coerced sexual activity. Differences between men and women in their understanding of the law, their percep- tions of the relevance of sexual cues and their Page 10 of 12 understanding of the impact of alcohol on one’s ability to give informed consent may go some way towards explaining how alcohol-related sexual ‘misunderstand- ings’ may turn a potentially consensual situation into an act which constitutes a sexual offence. In particular, women were more likely to incorrectly believe that consent needed to be verbalised. The results detailed here support research conducted in the USA demon- strating a link between alcohol use and coerced sexual activity; a link which is likely to exist in other coun- tries given that globally students are high consumers of alcohol [58]. In response, there should be emphasis on promoting messages that focus on the use of alcohol-related strate- gies to procure non-consensual sex rather than surrepti- tious drug administration that has grabbed media attention but appears to occur much less frequently [59]. Here we show that both men and women are vic- tims of alcohol-related non-consensual sexual experi- ences suggesting that organisations that aim to raise awareness of alcohol-related non-consensual sex should focus upon both genders as victims. In light of the mis- understandings highlighted here in relation to the law of consent, its parameters and whether it must be verba- lised to be deemed legal, further dissemination of mes- sages around rape and the legal stance is necessary in order to make clear what is acceptable and unacceptable sexual behaviour. In particular, messages are necessary that emphasise that alcohol intoxication is not a defence to a charge of rape and that the consequences of not actively establishing whether consent is given could be significant if charged and found guilty. Educational mes- sages must also challenge the inaccurate belief that a significant proportion of rape allegations are false by providing factual information that can dispel such myths. While there is evidence from the USA that school-based educational programmes can be used to reduce dating violence among adolescents [60,61], in the UK any such initiatives are set against a backdrop where preloading (drinking before going out), binge drinking and drunkenness are the norm for a significant section of society [51,62], and where current national drinking guidelines could be interpreted to suggest infrequent drunkenness is acceptable [63]. Acknowledgements Funding for this research was provided by Liverpool John Moores University in order to fund a PhD student (Clare Gunby). We would like to thank all students who participated in this research. Author details 1School of Law, Liverpool John Moores University, John Foster Building, 98 Mount Pleasant, Liverpool L3 5UZ, UK. 2Centre for Public Health, Liverpool John Moores University, Henry Cotton Building, 15-21 Webster Street, Liverpool L3 2ET, UK.