Alcohol use and sexual risk behaviors in a population-based sample of gay or bisexual men in San Francisco

Background: Numerous studies have examined alcohol, drug use, and sexual risk in convenience samples of men who have sex with men (MSM). Few probability samples of MSM are available for characterization. The objectives of this analysis were to estimate the prevalence of moderate or heavy alcohol use among urban MSM and to estimate associations between alcohol use and sexual risk behaviors.

Methods: The 2002 Urban Men's Health Study was a household-based, stratified probability sample of men who have sex with men in San Francisco. The study used telephone interviews to obtain information on demographics, drug and alcohol use, HIV testing and status, sexual behaviors, childhood sexual abuse, and health-related beliefs and attitudes. Categorical methods were used to describe the sample, and statistic procedures were adjusted to account for sampling scheme.

Results: Of 710 respondents, 339 reported frequent light drinking (48%) and 47 reported frequent heavy drinking (7%). Frequent drinking was higher among men who reported having unprotected receptive anal intercourse (60% vs 52%, p=0.01) and among those who reported having unprotected insertive anal intercourse (61% vs 50%, p=0.02). Alcohol use increased with educational attainment (p=0.0001), and was lower among HIV-positive MSM (41% vs 60%, p=0.002). Alcohol use did not vary significantly by Hispanic identify (p=0.19) or use of sexual venues (p=0.24).

Conclusions: This analysis found that moderate and heavy drinking were prevalent among urban MSM. Multivariate regression will be used to estimate associations between alcohol use and sexual risk, and multiple imputation will be used to address missing data values.