Online Program

Differentiating the associations of binge (5+ drinks) and social (1-4 drinks) alcohol use with event-level sexual risk behavior by HIV-status among substance-using MSM

Tuesday, November 5, 2013 : 4:30 p.m. - 4:45 p.m.

Gordon Mansergh, PhD, Division of HIV/AIDS Prevention, CDC, Atlanta, GA
Beryl Koblin, PhD, Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY
David McKirnan, PhD, Department of Psychology, University of Illinois at Chicago, Chicago, IL
Sharon M. Hudson, PhD, Health Research Association, Los Angeles, CA
Grant Colfax, MD, AIDS Office, HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Background: Men who have sex with men (MSM) continue to be at high risk for HIV infection. Differentiation between social (1-4 drinks) and binge (5+ drinks) alcohol use is needed to better understand the potential dose-related association of alcohol and risk behavior at the sexual event level. Methods: We analyzed data from 1206 substance-using MSM randomized into Project MIX, a multisite HIV prevention intervention trial in Chicago, Los Angeles, New York, and San Francisco (2005-06). Multivariate analysis focused on event-level substance use and sexual behavior during respondents' most recent anal sex encounter. Results: Among HIV-negative men (n=599), 30% reported binge drinking, 27% reported social drinking, and 43% reported no alcohol use during their last anal sex encounter; 27% had unprotected receptive anal (URA) and 39% had unprotected insertive anal (UIA) sex during the encounter. Controlling for other drug use and demographic variables, binge drinking was associated with URA (OR=2.02, CI=1.29-3.15) but social drinking was not (p>.05). Alternatively, social drinking was associated with UIA (OR=1.54, CI=1.01-2.34) but binge drinking was not (p>.05). HIV-positive men (n=607) also reported binge drinking (22%), social drinking (32%), and no alcohol use (22%) during their last sex encounter. Binge or social drinking were not significantly associated with URA or UIA (p>.05). Conclusions: Social and binge drinking have differential associations with sexual risk behavior – especially for HIV-negative MSM. Future HIV prevention and research should assess for social and binge drinking in order to better understand and address the nuanced links of alcohol use and sexual risk.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe how social and binge alcohol use are differentially associated with unprotected receptive and insertive anal sex among HIV-positive and -negative, substance-using MSM.

Keyword(s): Alcohol Use, HIV Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a behavioral scientist on HIV prevention research at CDC for nearly 17 years, and was the project officer on this cooperative agreement project. My areas of expertise are HIV prevention and MSM, particularly substance-using MSM.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4401.0: HIV and substance use