Binge Drinking is associated with Sexual Risk Behaviors in MSM - 20 U.S. cities

Background: Men who have sex with men (MSM) represent over half of new HIV infections in the United States.  It is important to understand the factors associated with engaging in risky sexual behavior to develop effective prevention interventions.  Binge drinking (BD) is the most common form of excessive alcohol consumption. This study describes the association of BD with sexual risk behaviors among MSM.    

Methods: We examined data from the 2011 National HIV Behavioral Surveillance System, which recruited MSM through venue-based, time-space sampling in 20 cities.  The analysis included MSM who reported ≥1 male sex partner in the past year, drinking alcohol in the past month, and who did not self-report being HIV-positive.  Multivariate Poisson models with robust error variance were used to assess the association between BD (having >5 drinks at one occasion in the past month) and sexual risk behaviors.  Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) are presented.

Results: The prevalence of BD was 59% among MSM.  After controlling for confounding factors, BD was significantly associated with having unprotected anal intercourse with a partner of different or unknown HIV status at last sex (aPR=1.25, CI=1.07-1.46), having concurrent partners (aPR=1.10, CI=1.05-1.16), having exchange sex in the past year (aPR=1.27, CI=1.11-1.45), and using drugs at last sex (aPR=1.19, CI=1.07-1.32).          

Conclusions: BD was prevalent in our sample and was shown to be consistently associated with sexual risk behaviors among MSM.  This analysis suggests that HIV prevention interventions for MSM would benefit from addressing issues around excessive alcohol consumption.