Strangulation During Sex Among Undergraduate Students in Australia: Toward Understanding Participation, Harms, and Education

Abstract

Abstract Background Strangulation is becoming a more common sexual practice despite its potentially fatal consequences and associated short- and long-term sequelae. This research provides a preliminary examination of participation and perception toward strangulation during sex among Australian undergraduates. Methods This study utilized a confidential, cross-sectional online survey collected in 2022–2023. Analysis included 168 undergraduate students at an Australian University and explored their awareness of the harms of strangulation, understanding of criminalization, and the impact of education on these attitudes. Results In total, 56% reported ever being strangled during sex and 51% ever strangling a partner. Seventeen percent of participants reported being strangled and 13% strangling a partner during their last sexual experience. Higher frequency, wanting, and positive perceptions of strangulation were associated with more liberal sexual attitudes. However, there were differences depending on gender. Participants generally did not perceive strangulation to be harmful and had limited knowledge about its criminalization. Lastly, a brief education intervention on strangulation harms revealed reductions in positive perceptions of strangulation that were pronounced among women. Conclusions In this convenience survey, Australian university students commonly reported previously engaging in strangulation during sex but with limited awareness of the potential consequences. Our results indicate that education on these consequences could reduce positive perceptions of strangulation, particularly among women. Policy Implications Education on strangulation harms are likely more effective than criminalization alone in improving awareness of its consequences and changing perceptions of strangulation. These findings could help guide targeted policy and education on strangulation within sexual health contexts.