Drug-Facilitated Sexual Assault among University Students in Spain: Findings from a Cross-Sectional Study

Introduction: This study aims to enhance understanding of drug-facilitated sexual assault (DFSA) among Spanish university students. It provides data on the prevalence of victimization, characteristics of events regarding victim profiles, situational context, post-assault actions, emotional correlates, and relationships with substance use, problematic internet use (PIU), and risky online and sexual behaviors. Methods: A descriptive, cross-sectional study was conducted among Spanish university students using convenience sampling. A total of 1,947 students completed the survey, and 1,790 participants met the eligibility criteria and were included in the final analyses. Results: Of the participants, 73.5% were female, with a mean age of 20 years. A total of 10.6% reported experiencing DFSA at least once (12.7% female participants vs. 5.1% male participants). Among DFSA victims, 93.6% reported voluntary alcohol and/or drug consumption before the assault, 30.8% reported suspected or confirmed surreptitious substance administration, and 24.4% reported both. The mean age at the incident was 17.31 years, and only 25% occurred during university. Victims showed a significantly higher prevalence of moderate-to-severe depression ( χ 2 = 51.591; P < 0.001; odds ratio [OR] = 3.289; 95% confidence intervals [CI]: 2.343–4.617) and four times higher rates of suicidal ideation ( χ 2 = 71.401; P < 0.001; OR = 5.184; 95% CI: 3.415–7.868). In multivariable analyses, female sex, depressive symptoms, problematic alcohol and cannabis use, and sexual risk behaviors were independently associated with DFSA. In bivariate analyses, additional factors included PIU, sexting, meeting people online, and other sexual risk behaviors. Conclusion: The prevalence of DFSA among university students is concerning. The strong association with mental health issues, substance use, and risky behaviors underscores the need to address DFSA from a comprehensive public health perspective.