Alcohol, personality, and risky sex: A daily diary study of MSM

Background: Men who have sex with men (MSM) account for the majority of people receiving a diagnosis of HIV/AIDS. Previous research has been inconsistent regarding the link between alcohol consumption and sexual risk taking in this population, with some studies finding a positive association, some finding no association, and others suggesting that the link is best explained by personality. Methods: Daily reports alcohol consumption and sexual behavior were completed for up to 30 days by 98 HIV negative MSM recruited online, resulting in 526 recorded episodes of sexual behavior. Hierarchical Linear Modeling (HLM) was used to analyze the association between a composite sexual risk taking variable and alcohol consumption. Sensation Seeking and proneness to loss of sexual arousal due to fears of sexual consequences (SIS) were included as moderators. Results: Alcohol consumption showed a significant within-person association with sexual risk taking. SIS was a significant moderator of the association, but Sensation Seeking was not. Participants high in SIS showed almost no association between alcohol consumption and risky sex, while those who tended to be unaffected by fear of sexual consequences showed a strong positive association between alcohol and risky sex. Conclusions: Results are consistent with alcohol myopia theory. Individuals affected by the fear of sexual consequences may not show higher rates of risky sex when consuming alcohol because risk cues are more salient. Those unaffected by sexual consequence fears may find sexual arousal cues most salient when intoxicated, resulting in more risky sex.