The Association Between Alcohol Use and Sexual Risk Behaviors Among African American Women Across Three Developmental Periods: A Review

Abstract

Background: African American women experience increased rates of sexually transmitted diseases and HIV. The use of alcohol may increase sexual risk behaviors among this population. Purpose: This paper provides a review and critique of the literature examining the association between alcohol use and sexual risk behaviors among African American females including a: (a) synthesis of research findings from adolescent, college-aged/early adulthood, and adult samples; (b) methodological critique of the literature; and (c) guidance for future research. Methods: We reviewed 32 studies examining the association between alcohol use and sexual risk behaviors among African American females across developmental periods. Results: Similar to previous association studies, results suggest that increased use of alcohol is associated with increased sexual risk practices among African American females. Further, even non-abuse levels of drinking among African American females, at all ages, were related to increased sexual risk-taking. Conclusions: Future studies should seek to recruit samples that more fully reflect the diversity of African American women’s experiences across the lifespan. Given the association between alcohol use and/or abuse and the prevalence of STI/HIV-associated risk behaviors and adverse biological outcomes (i.e., STIs, including HIV) among African American females across the lifespan, there is a clear need to develop and evaluate prevention research efforts tailored for this subgroup.

Sex-Related Alcohol Expectancies Among African American Women Attending an Urban STI Clinic

“…The SRAEs of African American women attending an STI clinic may result in high risk sex and also in unwanted/forced/coerced sex, and suggests the importance of developing integrated alcohol -sexual risk reduction interventions for high risk women (Sales et al, 2012; Stappenbeck et al, 2013). First, we recommend that such interventions increase self-awareness and self-monitoring by helping women identify their SRAEs.…”

“…Alcohol use, particularly binge drinking ≥4 drinks/occasion for women (Wechsler, Dowdall, Davenport, & Rimm, 1995) is correlated with HIV/STI risk behaviors which include: unprotected vaginal and anal sex, multiple sex partners, coerced or forced sex, and sex with high- risk partners (Cooper, 2002; Hutton et al, 2008; Jenness, Beier, Neaigus, Murrrill, Wendel, & Hagan, 2011; Rehm, Shield, Joharchi, & Shuper, 2012; Scott-Sheldon, Senn, Carey, Urban, & Carey, 2013; Seth et al, 2011; Stockman, Campbell, & Celentano, 2010). Among African American women, even non-abuse levels of consumption are associated with HIV/STI risk behaviors and STIs (Sales, Brown, Vissman, & DiClemente, 2012; Seth et al, 2011). While African American women have lower prevalence rates of alcohol use and binge drinking than white or Hispanic women, they experience more adverse medical and social outcomes from their alcohol use (Boyd, Mackey, & Phillips, 2006; Caetano, Schafer, & Cunradi, 2001; Mulia, Ye, Greenfield, Zemore, 2009; Sales et al, 2012; Sempos, Rehm, Wu, Crespo, & Trevisan, 2003).…”

“…Among African American women, even non-abuse levels of consumption are associated with HIV/STI risk behaviors and STIs (Sales, Brown, Vissman, & DiClemente, 2012; Seth et al, 2011). While African American women have lower prevalence rates of alcohol use and binge drinking than white or Hispanic women, they experience more adverse medical and social outcomes from their alcohol use (Boyd, Mackey, & Phillips, 2006; Caetano, Schafer, & Cunradi, 2001; Mulia, Ye, Greenfield, Zemore, 2009; Sales et al, 2012; Sempos, Rehm, Wu, Crespo, & Trevisan, 2003). …”

Prevalence and covariates of human immunodeficiency virus (HIV) risk behaviours among circumcised and uncircumcised men in Botswana: A national cross sectional study

“…Some studies have shown that alcohol consumption is the key driver of HIV/AIDS in Africa, especially through risk behaviours such multiple sex partnerships and inconsistent condom use (Leclerc-Madlala, 2009;Morojele, 2013;Braithwaite et al, 2014). Moreover, recent systematic reviews and meta-analyses have shown that alcohol use was found to be associated with HIV risk behaviours especially having multiple sex partners (Scott et al, 2013;Sales et al, 2012).…”

Demographic Predictors of Event-Level Associations between Alcohol Consumption and Sexual Behavior

“…41,42 Samples consisting solely of African American participants indicate associations between alcohol and sexual risk intentions or behaviors. 2,43,44 A smaller body of research has examined race and ethnicity as moderators of the links between alcohol use and sexual behavior, often finding stronger associations between alcohol consumption and sexual behavior among whites. [45][46][47][48] While alcohol consumption increases the likelihood of sexual activity across relationship types, this effect seems to be strongest for sex with casual partners, 10,16,46,[49][50][51][52][53][54] likely owing to the centrality of alcohol consumption in scripts that guide casual sex encounters.…”