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Alcohol and Sexual HIV Risk Behavior Among Problem Drinking Men Who Have Sex With Men: An Event Level Analysis of Timeline Followback Data

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While heavy drinking among men who have sex with men (MSM) has been shown to be associated with an increase in sexual risk taking, a temporal relationship between drinking and an increase in subsequent HIV risk behaviors among adult samples has been less obvious. This study used an event level analysis to examine this relationship among HIV negative problem drinking MSM. Within subjects analyses show a higher probability of unprotected anal intercourse after drinking. Post-hoc analyses of within subjects data indicate that drinking increases risk taking when engaging in receptive anal intercourse but not for insertive anal intercourse. Findings from this study support evidence that drinking is a factor that increases risk taking among HIV negative problem drinking MSM, particularly for receptive anal intercourse.

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REFERENCES

  • Avins, A. L., Woods, W. J., and Lindan, C. P. (1994). HIV infection and risk behaviors among heterosexuals in alcohol treatment programs. Journal of the American Medical Association, 271, 515–518.

    Article  PubMed  CAS  Google Scholar 

  • Bellis, M. A., Cook, P., Clark, P., Syed, Q., and Hoskins, A. (2002). Re-emerging syphilis in gay men: A case-control study of behavioral risk factors and HIV status. Journal of Epidemiology and Community Health, 56, 235–236.

    Article  PubMed  CAS  Google Scholar 

  • Burcham, J. L., Tindall, B., Marmor, M., Cooper, D. A., Berry, G., and Penny, R. (1989). Incidence and risk factors for human immunodeficiency virus seroconversion on a cohort of Sydney homosexual men. Medical Journal of Australia, 150, 634–639.

    PubMed  CAS  Google Scholar 

  • Calzavara, L., Burchell, A. N., Major, C., Remis, R. S., Corey, P., Myers, T., et al. (2002). Increases in HIV incidence among men who have sex with men undergoing repeat diagnostic HIV testing in Ontario, Canada. AIDS, 16, 1655–1661.

    Article  PubMed  Google Scholar 

  • Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M., and Weinhardt, L. S. (2001). Assessing sexual risk behavior with the timeline followback (TLFB) approach: Continued development and psychometric evaluation with psychiatric outpatients. International Journal of STDs and AIDS, 12, 365–375.

    Article  CAS  Google Scholar 

  • Catania, J. A., Osmond, D., Stall, R. D., Pollack, L., Paul, J. P., Blower, S., et al. (2001). The continuing HIV epidemic among men who have sex with men. American Journal of Public Health, 91, 907–914.

    PubMed  CAS  Google Scholar 

  • Centers for Disease Control and Prevention (2002). Unrecognized HIV infection, risk behaviors, and perceptions of risk among young black men who have sex with men—six U.S. cities, 1994–1998. Morbidity and Mortality Weekly Report, 51, 733–736.

    Google Scholar 

  • Chesney, M. A., Barrett, D. C., and Stall, R. (1998). Histories of substance use and risk behavior: Precursors to HIV seroconversion in homosexual men. American Journal of Public Health, 88, 113–116.

    PubMed  CAS  Google Scholar 

  • Colfax, G., Vittinghoff, E., Husnik, M. J., McKirnan, D., Buchbinder, S., Koblin, B., et al. (2004). Substance use and sexual risk: A Participant- and episode- level analysis among a cohort of men who have sex with men. American Journal of Epidemiology, 159, 1002–1012.

    Article  PubMed  Google Scholar 

  • Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol, 14, S101–S117.

    Google Scholar 

  • Dermen, K. H., and Cooper, M. L. (2000). Inhibition conflict and alcohol expectancy as moderators of alcohol's relationship to condom use. Experimental and Clinical Psychopharmacology, 8, 198–206.

    Article  PubMed  CAS  Google Scholar 

  • Dermen, K. H., Cooper, M. L., and Agocha, V. B. (1998). Sex-related alcohol expectancies as moderators of the relationship between alcohol use and risky sex in adolescents. Journal of Studies on Alcohol, 59, 71–77.

    PubMed  CAS  Google Scholar 

  • Doll, L. S., O’Malley, P. M., Pershing, A. L., Darrow, W. W., Hessol, N. A., and Lifson, A. R. (1990). High-risk sexual behavior and knowledge of HIV antibody status in the San Francisco City Clinic Cohort. Health Psychology, 9, 253–265.

    Article  PubMed  CAS  Google Scholar 

  • Fox, K. K., del Rio, C., Holmes, K. K., Hook, E. W., Judson, F. N., Knapp, J. S., et al. (2001). Gonorrhea in the HIV era: A reversal in trends among men who have sex with men. American Journal of Public Health, 91, 959–964.

    PubMed  CAS  Google Scholar 

  • Fromme, K., D’Amico, E., and Katz, E. C. (1999). Intoxicated sexual risk taking: An expectancy or cognitive impairment explanation? Journal of Studies on Alcohol, 60, 54–63.

    PubMed  CAS  Google Scholar 

  • George, W. H., Stoner, S. A., Norris, J., Lopez, P. A., and Lehman, G. L. (2000). Alcohol expectancies and sexuality: A self-fulfilling prophecy analysis of dyadic perceptions and behavior. Journal of Studies on Alcohol, 61, 168–176.

    PubMed  CAS  Google Scholar 

  • Gillmore, M. R., Morrison, D. M., Leigh, B. C., Hoppe, M. J., Gaylord, J., and Rainey, D. T. (2002). Does “high=high risk”? An event-based analysis of the relationship between substance use and unprotected anal sex among gay and bisexual men. AIDS and Behavior, 6, 361–370.

    Article  Google Scholar 

  • Halkitis, P. N., and Parsons, J. T. (2000). Oral sex and HIV risk reduction: Perceived risk, behaviors, and strategies among young HIV-negative gay men. Journal of Psychology and Human Sexuality, 11, 1–24.

    Article  Google Scholar 

  • Halkitis, P. N., and Parsons, J. T. (2002). Recreational drug use and HIV risk sexual behavior among men frequenting urban gay venues. Journal of Gay and Lesbian Social Services, 14, 19–39.

    Article  Google Scholar 

  • Jaffe, H. (2003). HIV/AIDS in America today. Paper presented at the National HIV Prevention Conference: Atlanta, GA.

  • Justus, A. N., Finn, P. R., and Steinmetz, J. E. (2000). The influence of traits of disinhibition on the association between alcohol use and risky sexual behavior. Alcoholism: Clinical and Experimental Research, 24, 1028–1035.

    Article  CAS  Google Scholar 

  • Kellogg, T., McFarland, W., and Katz, M. (1999). Recent increase in HIV seroconversions among repeat anonymous testers in San Francisco. AIDS, 13, 2303–2304.

    Article  PubMed  CAS  Google Scholar 

  • Leigh, B. C. (1993). Alcohol consumption and sexual activity as reported with a diary technique. Journal of Abnormal Psychology, 102, 490–493.

    Article  PubMed  CAS  Google Scholar 

  • Leigh, B. C. (2002). Alcohol and condom use; A Meta-analysis of event-level studies. Sexually Transmitted Diseases, 29, 476–482.

    Article  PubMed  Google Scholar 

  • Leigh, B. C., and Stall, R. (1993). Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation and prevention. American Psychologist, 48, 1035–1045.

    Article  PubMed  CAS  Google Scholar 

  • MacDonald, T. K., MacDonald, G., Zanna, M. P., and Fong, G. T. (2000). Alcohol, sexual arousal, and intentions to use condoms in young men: Applying alcohol myopia theory to risky sexual behavior. Health Psychology, 19, 290–298.

    Article  PubMed  CAS  Google Scholar 

  • McKirnan, D. J., Vanable, P. A., Ostrow, D. G., and Hope, B. (2001). Expectancies of sexual “escape” and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse, 13, 137–154.

    Article  PubMed  CAS  Google Scholar 

  • Page-Shafer, K. A., McFarland, W., Kohn, R., Klausner, J., Katz, M. H., Wohlfeiler, D., et al. (1999). Increases in unsafe sex and rectal gonorrhea among men who have sex with men—San Francisco, California, 1994–1997. Morbidity and Mortality Weekly Report, 48, 45–48.

    PubMed  Google Scholar 

  • Parsons, J. T., and Halkitis, P. N. (2002). Sexual and drug using practices of HIV+ men who frequent commercial and public sex environments. AIDS Care, 14, 815–826.

    Article  PubMed  CAS  Google Scholar 

  • Paul, J. P., Stall, R., and Davis, F. (1993). Sexual risk for HIV transmission among gay/bisexual men in substance abuse treatment. AIDS Education and Prevention, 5, 11–24.

    PubMed  CAS  Google Scholar 

  • Paul, J. P., Stall, R. D., Crosby, G. M., Barrett, D. C., and Midanik, L. T. (1994). Correlates of sexual risk-taking among gay male substance abusers. Addiction, 89, 971–983.

    Article  PubMed  CAS  Google Scholar 

  • Penkower, L., Dew, M. A., Kingsley, L., Becker, J. T., Satz, P., Schaerf, F. W., et al. (1991). Behavioral, health and psychosocial factors and risk for HIV infection among sexually active homosexual men: The Multicenter AIDS Cohort Study. American Journal of Public Health, 81, 194–196.

    PubMed  CAS  Google Scholar 

  • Perry, M. J., Solomon, L. J., Winett, R. A., Kelly, J. A., Roffman, R. A., Desiderado, L. L., et al. (1994). High risk sexual behavior and alcohol consumption among bar-going gay men. AIDS, 8, 1321–1324.

    PubMed  CAS  Google Scholar 

  • Purcell, D. W., Parsons, J. T., Halkitis, P. N., Mizuno, Y., and Woods, W. J. (2001). Substance use and sexual transmission risk behavior of HIV-positive men who have sex with men. Journal of Substance Abuse, 13, 185–200.

    Article  PubMed  CAS  Google Scholar 

  • Seage, G. R., Mayer, K. H., Wold, C., Lenderking, W., Goldstein, R., Cai, B., Gross, M., Herren, T. and Hingson, R. (1998). The Social context of drinking, drug use, and unsafe sex in the Boston Men Study. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 17(4), 368–375.

    Google Scholar 

  • Silvestre, A. J., Lyter, D. W., Valdiserri, R. O., Huggins, R., and Rinaldo, C. R. (1989). Factors related to seroconversion among homo- and bisexual men after attending a risk-reduction educational session. AIDS, 3, 647–650.

    Article  PubMed  CAS  Google Scholar 

  • Sobell, L. C., Brown, J., Leo, G. I., and Sobell, M. B. (1996). The reliability of the Alcohol Timeline Followback when administered by telephone and by computer. Drug & Alcohol Dependence, 42(1), 49–54.

    Article  CAS  Google Scholar 

  • Sobell, L. C., and Sobell, M. B. (1992). Timeline follow-back: A technique assessing self-reported alcohol consumption. In R. Litton, and J. P. Allen (Eds.), Measuring Alcohol Consumption: Psychosocial and Biochemical Methods (pp. 41–69). Totowa, NJ: Humana Press.

    Google Scholar 

  • Stall, R., McKusick, L., Wiley, J., Coates, T. J., and Ostrow, D. G. (1986). Alcohol and drug use during sexual activity and compliance with safe sex guidelines for AIDS: The AIDS behavioral research project. Health Education Quarterly, 13, 359–371.

    PubMed  CAS  Google Scholar 

  • Stall, R., Paul, J. P., Greenwood, G., Pollack, L. M., Bein, E., Crosby, G. M., et al. (2001). Alcohol use, drug use and alcohol-related problems among men who have sex with men: The urban men's health study. Addiction, 96, 1589–1601.

    Article  PubMed  CAS  Google Scholar 

  • Vanable, P. A., McKirnan, D. J., Buchbinder, S. P., Bartholow, B. N., Douglas, J. M., Judson, F. N., et al. (2004). Alcohol use and high-risk sexual behavior among men who have sex with men: The effects of consumption level and partner type. Health Psychology, 23, 525–532.

    Article  PubMed  Google Scholar 

  • Vittinghoff, E., Douglas, J., Judson, F., McKirnan, D., MacQueen, K., and Buchbinder, S. P. (1999). Per-contact risk of human immunodeficiency virus transmission between male sexual partners. American Journal of Epidemiology, 150, 306–311.

    PubMed  CAS  Google Scholar 

  • Watters, J. K., and Biernacki, P. (1989). Targeted sampling: Options and considerations for the study of hidden populations. Social Problems, 36, 416–430.

    Article  Google Scholar 

  • Weinhardt, L. S. (2002). Effects of a detailed sexual behavior interview on perceived risk of HIV infection: Preliminary experimental analysis in a high risk sample. Journal of Behavioral Medicine, 25, 195–203.

    Article  PubMed  Google Scholar 

  • Weinhardt, L. S., and Carey, M. P. (2000). Does alcohol lead to sexual risk behavior? Findings from event-level research. Annual Review of Sex Research 11, 125–157.

    PubMed  CAS  Google Scholar 

  • Weinhardt, L. S., Carey, M. P., Maisto, S. A., Carey, K. B., Cohen, M. M., and Wickramasinghe, S. M. (1998). Reliability of the timeline follow-back sexual behavior interview. Annals of Behavioral Medicine, 20, 25–30.

    Article  PubMed  CAS  Google Scholar 

  • Weinhardt, L. S., Carey, M. P., Carey, K. B., Maisto, S. A., and Gordon, C. M. (2001). The relation of alcohol use to HIV-risk sexual behavior among adults with a severe and persistent mental illness. Journal of Consulting and Clinical Psychology, 69, 77–84.

    Article  PubMed  CAS  Google Scholar 

  • Wolitski, R. J., Valdiserri, R. O., Denning, P. H., and Levine, W. C. (2001). Are we headed for a resurgence of the HIV epidemic among men who have sex with men? American Journal of Public Health, 91, 883–888.

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization. (1990). Composite International Diagnostic Interview. Geneva, Switzerland.

    Google Scholar 

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ACKNOWLEDGMENT

This work was supported by Grant AA 011745 from the National Institute on Alcohol Abuse and Alcoholism.

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Authors and Affiliations

  1. Mount Sinai School of Medicine, New York, USA

    Thomas W. Irwin & Jon Morgenstern

  2. National Center on Addiction and Substance Abuse at Columbia University, New York, USA

    Jon Morgenstern

  3. Hunter College and the Graduate Center of the City University of New York, New York, USA

    Jeffrey T. Parsons

  4. Columbia University, New York, USA

    Milton Wainberg

  5. Rutgers—The State University of New Jersey, Piscataway, New Jersey, USA

    Erich Labouvie

  6. Assistant Professor of Psychology in Psychiatry, Cornell University, Weill Medical College, Program Director, Substance Abuse Treatment Services, New York—Presbyterian Hospital, Payne Whitney Westchester, 21 Bloomingdale Road, Box 72, White Plains, NY, 10605, USA

    Thomas W. Irwin

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  1. Thomas W. Irwin
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Correspondence to Thomas W. Irwin.

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Irwin, T.W., Morgenstern, J., Parsons, J.T. et al. Alcohol and Sexual HIV Risk Behavior Among Problem Drinking Men Who Have Sex With Men: An Event Level Analysis of Timeline Followback Data. AIDS Behav 10, 299–307 (2006). https://doi.org/10.1007/s10461-005-9045-7

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