We analyzed data from 6,341 injection drug users (IDUs) entering detoxification or methadone maintenance treatment in New York City between 1990 and to test the hypothesis that alcohol use and intoxication is associated with increased HIV sexual risk behaviors. Two types of associations were assessed: 1) a global association (i.e., the relationship between HIV sexual risk behaviors during the six months prior to the interview and at-risk drinking in that period, defined as more than 14 drinks per week for males or 7 drinks per week for females), and 2) an event-specific association (i.e., the relationship between HIV sexual risk behaviors during the most recent sex episode and alcohol intoxication during that episode). Sexual risk behaviors included multiple sex partners and engaging in unprotected sex. After adjusting for the effects of other variables, at-riskdrinkers were more likely to report multiple sex partners and engaging in unprotected sex with casual sex partners (both global associations). IDUs who reported both they and their casual partners were intoxicated during the most recent sex episode were more likely to engage in unprotected sex (an event-specific association). We also observed two significant interactions. Among IDUs who did not inject cocaine, moderate-drinkers were more likely to report multiple partners. Among self-reported HIV seropositive IDUs, when both primary partners were intoxicated during the most recent sex episode they were more likely to engage in unprotected sex. These observations indicate both global and event-specific associations of alcohol and HIV sexual-risk behaviors.
KeywordsAlcohol; HIV; sexual risk behaviors
1.IntroductionDrug users are at a greater risk of HIV infection than the general population (Centers for Disease Control and Prevention, CDC, 2004; CDC, 2003;Deren et al., 2004;Holmberg, 1996). The increased risk due to sharing contaminated needles and other injection equipment among injection drug users (IDUs) seems more obvious and has been well documented (CDC, 1982;Fauci, 1986). Moreover, after accounting for injection risk, sexual risk behaviors have been found to be related to HIV infection (Strathdee et al., 2001), and IDUs with sexual risk behaviors have a higher likelihood of HIV infection (Kral et al., 2001 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Alcohol consumption has also been associated with increased sexual risk (Bryant, 2006;Parker et al. 1994;Stall et al., 1986), as well as injection risk behaviors (Saxon and Calsyn, 1992).
NIH Public AccessResults from the General Social Survey indicate ...