Association between expectancies, heavy episodic drinking and sexual risk among young adult men in Peru

Context: Alcohol use is frequently identified as a potential contributor to risky sexual behaviors. However, some studies found contradictory results with this association. Given this conflicting evidence, researchers have focused on other variables such as expectancies about alcohol's effects that might help explain the relationship between alcohol use and risky sexual behavior. Method: This study examine the association between heavy episodic drinking (HED), and separately, sex-related alcohol expectancies (SRAE) and sexual risk behaviors using cross sectional data from questionnaires implemented among 400 young adult men, ages 18 to 30 year old living in a shantytown located on the outskirts of Lima, Peru. Results: We found that HED was associated with an increase in having two or more sexual partners and having sexual intercourse with a casual partner during the last year (odds of 2.47-2.74). In addition, SRAE was also associated with high-risk sexual behaviors and with having unprotected sex during the last sexual intercourse (odds of 1.69-2.28). Conclusion: HED and SRAE are associated with risky sexual behaviors, but HED is not associated with unprotected sex. Also, SRAE has an independent effect on risky sexual behaviors after controlling for alcohol consumption level. SRAE is a factor that could contribute to explaining risky sexual behavior beyond the pharmacological effects of alcohol. These findings indicate that considerating alcohol use is important in order to design better prevention intervention programs. Interventions focusing on changing beliefs about alcohol's effects could reduce both the amount of consumption and risky sexual behaviors.