Assessing sexual motives for drinking alcohol among HIV-positive men who have sex with men.

Abstract

Individuals who drink alcohol for the explicit motive of facilitating or enhancing sex may be more likely to engage in risky sexual behavior, including having sex under the influence of alcohol. However, efforts to assess sexual motives for drinking have been very limited to date. We examined the psychometric properties of a 5-item measure of sexual motives for drinking (SMD) in a sample of HIV-positive heavy drinking men who have sex with men. Findings provided excellent support for the scale's internal consistency and concurrent validity with a well-established measure of sexual alcohol expectancies (SAEs). Good discriminant validity was also established, as SMDs were correlated with other drinking motives but uniquely predicted the proportion of sex acts occurring under the influence of alcohol and other drugs, over-and-above other drinking motives and SAEs. SMDs were not significantly associated with unprotected anal intercourse. Adjusting for alcohol problem severity, higher SMDs were associated with lower willingness to consider changing drinking. Results suggest this measure of SMDs exhibits sound psychometric properties and may be useful in studies examining the association between alcohol use and sexual behavior.

The role of discrimination in alcohol-related problems in samples of heavy drinking HIV-negative and positive men who have sex with men (MSM)

“…Sexual motives for drinking were assessed using a 5-item scale (Kahler et al, 2015). Items are rated on the same scale as other motives; 0 ( almost never ) to 5 ( almost always/always ).…”

“…That is, those who report drinking in order to have more fun often report drinking more heavily, which in turn increases their likelihood of experiencing alcohol-related problems. Although social facilitation motives are another common reason for drinking, findings rarely suggest an association with problems and, overall, have been mixed about their association with use (Cooper, 1994; Kahler et al, 2015; Magid et al, 2007). …”

“…A measure of sexual motives for drinking has recently been developed, and drinking specifically to enable or enhance sex could play an important role in the relations between types of discrimination and alcohol use/problems (Kahler et al, 2015). Experiencing ostracism or ridicule because of one’s sexual orientation may be associated with feeling the need to drink in order to approach potential sexual partners which, in turn, could lead to heavier use.…”

“…However, HIV-positive MSM experience multiple forms of discrimination that are relevant to sexuality (i.e., from both their sexual orientation and HIV-status), so it is possible that sexual motives for drinking play a more prominent role in alcohol use for HIV-positive MSM. In a psychometric study involving MSM living with HIV, Kahler and colleagues (2015) found that endorsing sexual motives for drinking was not directly associated with experiencing alcohol-related problems. However, this study did not explore associations between sexual motives for drinking and alcohol use, or whether these motives could be indirectly associated with problems through heavier drinking.…”

The role of sexual expectancies of substance use as a mediator between adult attachment and drug use among gay and bisexual men

“…Expectancies related to condom use may function differently for HIV-positive men given the potential for sero-sorting and other alternative strategies for managing HIV related risk (Maisto et al, 2008). Furthermore, HIV-related stigma may alter expectancies related to potential intimacy and emotional closeness with a possible relationship partner (Kahler et al, 2015), though some research indicates similar expectancy scale function in HIV-positive individuals (Maisto et al, 2008). The analyses were limited to men who were not in relationships, as the specific measure of interpersonal expectancies has several items which may function differently for men in primary relationships compared to men who are single.…”