Alcohol consumption, drug, and condom use among STD clinic patients

Research on the association between substance use and sexual risk behavior has yielded a complex pattern of findings; such inconsistent findings may reflect method variance, including factors such as sex of the participant, the nature of the sexual event, the partner characteristics, and the type of substance used. The purpose of this study was to investigate the association between substance use and unprotected sex independently for alcohol, drugs, or combined substance use; and to examine partner characteristics as a moderator of this association. Participants (N = 1,419; 48% women) were recruited from a publicly-funded STD clinic, and asked to complete an audio-computer-assisted self-interview regarding their most recent sexual experience, including the nature of the event, substance use, and partner characteristics. Analyses showed that alcohol use was related to condom use when gender and partner type were considered; thus, for women, but not men, partner type interacted with alcohol consumption such that condom use was less likely when alcohol consumption preceded sex with non-primary partners (drinking was unrelated to condom use with primary partners). Subsequent analyses examining partner substance use showed that women, but not men, who reported both they and their non-primary partners were drinking during sex were less likely to use a condom. At the event-level, alcohol consumption among STD clinic patients is associated with condom use, but this association differs by gender and partner characteristics. Findings suggest the need to strengthen substance use components in sexual risk reduction interventions for women and their partners.