Research Summary; Unsafe sex by people infected with HIV poses a grave public health risk. To examine whether alcohol use increases the likelihood of unsafe sex in people with HIV, investigators interviewed 262 patients from 2 HIV clinics. Alcohol consumption measures assessed use in the past 6 months and included drinking days, drinks per drinking day, binge drinking,* and hazardous drinking.**
In the past 6 months, 63 percent of patients had been sexually active,
38 percent had unprotected sex (i.e., no condom), and
21 percent had multiple sex partners.
All alcohol consumption measures were significantly associated with the likelihood of having any sex (odds ratios ranging from 1.5 to 2.9) and of having unprotected sex (odds ratios ranging from 1.4 to 2.7).
One-third of hazardous drinkers — compared with 9 percent of nonhazardous drinkers — were having both unprotected sex and sex with multiple partners.
Heroin and cocaine use did not significantly affect the likelihood of having any or unprotected sex.
Comments by Jeffrey Samet, MD, MA, MPH:
This study demonstrates a clear association between alcohol use and unsafe sex in patients infected with HIV. As the authors note, determining the basis of this association (e.g., risk-taking personality, lowered sexual inhibitions due to alcohol) requires studies that demonstrate the relationship between the two behaviors. Nevertheless, these findings support the case for assessing alcohol use among all patients with HIV.
* 5 or more drinks per day for men, 3 or more drinks per day for women ** at least 1 binge episode, or greater than 14 drinks per week for men and greater than 7 drinks per week for women
Reference: Stein M, Herman DS, Trisvan E, et al. Alcohol use and sexual risk behavior among human immunodeficiency virus-positive persons. Alcohol Clin Exp Res. 2005; 29(5): 837-843.
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Counseling Clients with HIV Disease: Assessment, Intervention, and Preventionby Mary Ann Hoffman
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