The Effects of Alcohol and Sexual Arousal on Determinants of Sexual Risk in Men Who Have Sex with Men

Abstract

Primary prevention efforts aimed at sexual risk behaviors are critical. This experiment was designed to investigate the effects of alcohol intoxication and sexual arousal, as well as person variables of alcohol sex expectancies and attitudes toward condom use, on hypothesized determinants of sexual risk behaviors among men who have sex with men (MSM). The participants were 117 MSM aged 21–50 years who were randomly assigned to one of six separate experimental conditions created by the combination of beverage administration (water control, placebo or alcohol designed to raise blood alcohol level to .07%) and sexual arousal (low or high, manipulated by participants’ viewing non-erotic or mildly erotic film clips). Participants attended two experimental sessions. The first session included completing questionnaires about beliefs about alcohol’s effects on sex and attitudes toward condoms’ effect on sexual pleasure. The second session involved the beverage condition and arousal manipulations. Following these, participants viewed and responded to two interactive videos depicting high sexual risk scenarios. Participants also completed the CARE, a measure of risk perceptions. The dependent variables were behavioral skills, intentions to have unsafe sex, and “risk exposure,” derived from responses to the videos. The results of both planned and exploratory analyses showed general support for the hypothesized enhancement of alcohol’s effects on sexual risk by both sexual arousal and expectancies. Also as predicted, condom attitudes showed direct relationships to risk exposure and intentions. Implications of the findings for models of alcohol’s effects on sexual risk and for the development of HIV prevention interventions were discussed.

Pervasive Heavy Alcohol Use and Correlates of Increasing Levels of Binge Drinking among Men Who Have Sex with Men, San Francisco, 2011

“…2,3 The acute effects of alcohol consumption (e.g., altered cognition, impaired judgment, and increased sexual desire and confidence) may contribute to risk-taking behaviors. [4][5][6][7] A myriad of psychosocial factors (e.g., cognitive escape, impulsivity, expectancies) are believed to mediate the association between alcohol and sexual risk behaviors. 5,[8][9][10][11][12][13] Furthermore, bar and club venues frequented by MSM provide conducive environments for both meeting sexual partners and binge drinking.…”

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

“…A number of studies using global measures have generally linked various alcohol-related variables to risky sexual outcomes in MSM (20–22), with some exceptions (23–26). Although preliminary, one published experimental study examining the alcohol-risky sex link among MSM supported an association between alcohol intoxication and intentions to engage in unprotected anal intercourse (UAI) (27). Finally, in contrast to research in heterosexual populations, a recent review of event-level studies concluded that, across several studies of MSM specifically, binge alcohol use was consistently related to sexual risk outcomes such as UAI (28).…”

Co-occurring Health Risks Among Middle Aged Hispanic Men Who Have Sex With Men (HMSM) in South Florida

“…Participants who were older were less likely to report substance abuse in the past three months (AOR = 0.93, 95% CI = 0.89, 0.97) and participants reporting increased depressive symptoms were more likely to report substance abuse (AOR = 1.05, 95% CI = 1.01, 1.09). The findings from this study supports previous research findings linking depressive symptoms with substance use/abuse in Hispanic men (Gonzalez-Guarda, Florom-Smith, & Thomas, 2011;Gonzalez-Guarda et al, 2010;Maisto, Palfai, Vanable, Heath, & Woolf-King, 2012). Additionally, this contradicts this study's proposed hypothesis that increased age in middle age HMSM may increase risk for depression; however, this study was not exclusively middle age HMSM.…”

“…In a study by Maisto et al (2012) Post-hoc analyses reported that the high conflict/high expectancy participant group engaged in a significantly higher percentage of their sexual acts under the influence than the high conflict/low expectancy group (P < 0.01), and the low conflict/low expectancy group (P = 0.048), signifying participants high in conflict appear more sensitive to the effect of expectancies, compared to their low conflict counterparts (Well et al, 2011).…”

“…Research has shown that substance use/abuse is associated with sexual risk (De Santis et al, 2009;Maisto et al, 2012). Because there is an abundance of literature on substance use/abuse behaviors for gay men and HMSM, it would be impossible to include all of the studies.…”