Daily Associations Between Alcohol Use and Unprotected Anal Sex Among Heavy Drinking HIV-Positive Men Who Have Sex with Men

Kahler, Christopher W.; Wray, Tyler B.; Pantalone, David W.; Kruis, Ryan; Mastroleo, Nadine R.; Monti, Peter M.; Mayer, Kenneth H.

doi:10.1007/s10461-014-0896-7

Cited by 69 publications

(61 citation statements)

References 40 publications

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“…Compared to Light users variables associated with Alcohol/marijuana class were lack of health insurance, younger age and greater odds of anal sex under the influence. The finding that both Alcohol/marijuana and Poly-user classes were significantly more likely to engage in sex under the influence is consistent with literature on the association between heavy and binge alcohol use and unprotected sex (27,28). The reduced rate of health insurance among this group may provide insight into the low rates of substance abuse treatment access and utilization, previously observed in this population.…”

Section: Discussionsupporting

confidence: 89%

Associations Between Drug and Alcohol Use Patterns and Sexual Risk in a Sample of African American Men Who Have Sex with Men

et al. 2015

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Men who have sex with men (MSM) are the largest risk group in the US HIV epidemic and African American MSM (AA MSM) are disproportionately affected. Substance-abusing sexual minorities warrant attention as they are at elevated risk for HIV, yet are not a homogeneous risk group. The purpose of this study was to use latent class analysis to identify patterns of drug and alcohol use in a sample of 359 AA MSM and examine associations with sexual risk. Three classes were identified: Individuals who used multiple substances (Poly-users) (18%), Alcohol/marijuana users (33%) and individuals who had low probability of reporting drug or problematic alcohol use (50%). Results from multivariate analysis indicate that Poly-users were older and more likely to report sex exchange and recent sexually transmitted infection compared to the other classes. Alcohol and Poly-users were more likely to report sex under the influence. Identifying and defining substance use patterns can improve specification of risk groups and allocation of prevention resources.

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Section: Discussionsupporting

confidence: 89%

Associations Between Drug and Alcohol Use Patterns and Sexual Risk in a Sample of African American Men Who Have Sex with Men

et al. 2015

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“…Overall, these findings are consistent with other data regarding the role of event-level substance use (Chiasson et al, 2007; Colfax et al, 2004; Drumright et al, 2006a; Lambert et al, 2011), including a recent study of HIV-positive GBMSM that found daily alcohol and drug use were both associated with an increased odds of anal intercourse and CAS while adjusting for individual frequency of use (Kahler et al, 2015). However, unlike the research by Kahler et al and other studies, ours is one of the first to identify a reciprocal association between higher frequency use and both sexual engagement and CAS while accounting for event-level use, which was particularly true for marijuana, though also partially true for club drugs and heavy drinking for sexual engagement as well as at least one of the models of CAS for each.…”

Section: Discussionsupporting

confidence: 89%

Aggregate and event-level associations between substance use and sexual behavior among gay and bisexual men: Comparing retrospective and prospective data

Rendina

Moody

Ventuneac

et al. 2015

Drug and Alcohol Dependence

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Background Despite limited research, some evidence suggests that examining substance use at multiple levels may be of greater utility in predicting sexual behavior than utilizing one level of measurement, particularly when investigating different substances simultaneously. We aimed to examine aggregated and event-level associations between three forms of substance use—alcohol, marijuana, and club drugs—and two sexual behavior outcomes—sexual engagement and condomless anal sex (CAS). Method Analyses focused on both 6-week timeline follow-back (TLFB; retrospective) and 30-day daily diary (prospective) data among a demographically diverse sample of 371 highly sexually active HIV-positive and HIV-negative gay and bisexual men. Results Models from both TLFB and diary showed that event-level use of alcohol, marijuana, and club drugs was associated with increased sexual engagement, while higher aggregated frequency marijuana and any frequency club drug use were associated with decreased sexual engagement. Event-level use of club drugs was consistently associated with increased odds of CAS across both TLFB and diary models while higher frequency marijuana use was most consistently associated with a lower odds of CAS. Conclusions Findings indicated that results are largely consistent between retrospective and prospective data, but that retrospective results for substance use and sexual engagement were generally greater in magnitude. These results suggest that substance use primarily acts to increase sexual risk at the event-level and less so through individual-level frequency of use; moreover, it primarily does so by increasing the likelihood of sex on a given day with fewer significant associations with the odds of CAS on sex days.

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“…Briefly, male heavy drinkers living with HIV were recruited from an urban health center with extensive experience providing HIV clinical care (for details see Kahler et al, 2014). Participants were randomized either to treatment-as-usual or to a brief motivational intervention to reduce alcohol use plus treatment-as-usual.…”

Section: Methodsmentioning

confidence: 99%

Alcohol use predicts elevation in inflammatory marker soluble CD14 in men living with HIV

et al. 2016

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Independently, HIV infection and heavy alcohol use increase microbial translocation of gut products into systemic circulation. Microbial translocation and consequent immune response have been linked to chronic inflammation and a host of negative health outcomes in individuals living with HIV. However, previous research has not systematically investigated the immune correlates of heavy drinking specifically within the HIV-positive population. This pilot study investigated microbial translocation and immune activation as a function of alcohol use in 21 HIV-positive men who met NIAAA criteria for heavy drinking. Participants averaged 46.7 ± 8.5 (mean ± standard deviation) years of age, 12.2 ± 9.2 years since HIV diagnosis, 337 ± 158 CD4 nadir, and 643 ± 245 current CD4 count. All participants were virologically suppressed on antiretroviral therapy. Data on alcohol use and immune function were collected at baseline and three-month follow-up. Plasma concentrations of markers of microbial translocation and immune activation [lipopolysaccharide (LPS), soluble CD14 (sCD14), endotoxin core antibody immunoglobulin M (EndoCAb)] were measured using enzyme-linked immunosorbent assays. Generalized estimating equation models tested alcohol use variables as predictors of LPS, sCD14, and EndoCAb levels. Greater quantity and frequency of drinking significantly predicted higher sCD14 levels (p’s <.01). Conversely, longer duration of abstinence from alcohol significantly predicted lower sCD14 levels (p <.001). These results remained significant after controlling for age, HIV duration, smoking status, current CD4 count, CD4 nadir, and antiretroviral drug type. In addition, participants with ≥50% relative reduction in drinks per week showed a significant decrease (p <.05) in sCD14 from baseline to three-month follow-up. This pilot study provides preliminary evidence that heavy drinking may increase a key inflammatory marker in HIV-infected individuals with suppressed infection.

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Daily Associations Between Alcohol Use and Unprotected Anal Sex Among Heavy Drinking HIV-Positive Men Who Have Sex with Men

Cited by 69 publications

References 40 publications

Associations Between Drug and Alcohol Use Patterns and Sexual Risk in a Sample of African American Men Who Have Sex with Men

Associations Between Drug and Alcohol Use Patterns and Sexual Risk in a Sample of African American Men Who Have Sex with Men

Aggregate and event-level associations between substance use and sexual behavior among gay and bisexual men: Comparing retrospective and prospective data

Alcohol use predicts elevation in inflammatory marker soluble CD14 in men living with HIV

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