Alcohol use predicts sexual risk behavior with HIV-negative or partners of unknown status among young HIV-positive men who have sex with men

Abstract

Although the relationship between substance use and heightened sexual risk behaviors have been documented in samples of young men who have sex with men (YMSM) and HIV-positive adult men who have sex with men (MSM), there is a dearth of research on the role of substance use in the sexual risk behaviors of HIV-positive YMSM. We examined associations between alcohol and other drug use with sexual risk behaviors among a sample of HIV-positive YMSM (N=200). There were no significant predictors of either receptive or insertive unprotected anal intercourse (UAI) with HIV-positive partners among the substance use variables. Failure to use a condom after drinking alcohol (β=2.00, p<0.01) was significantly associated with insertive UAI with HIV-negative partners or partners of unknown status. Failure to use a condom after drinking alcohol (β=1.36, p<0.05) and age (β=0.35, p<0.05) were significantly associated with receptive UAI with HIV-negative partners or partners of unknown status. Findings from this article underscore the role of alcohol in facilitating UAI among HIV-positive YMSM and their HIV-negative and status-unknown partners.

Keywords:

• MSM
• HIV-positive
• youth
• alcohol
• sexual risk behavior
• secondary prevention

Acknowledgements

The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) is funded by grant Nos. 5 U01 HD 40533 and 5 U01 HD 40474 from the National Institutes of Health through the National Institute of Child Health and Human Development (Bill Kapogiannis, MD) with supplemental funding from the National Institutes of Drug Abuse (Nicolette Borek, Ph.D.) and Mental Health (Susannah Allison, Ph.D.). Additional funding from the National Institute of Mental Health under grant K01MH089838 aided in the development of this article. We would like to thank the principal investigators and site coordinators at the clinical sites within the ATN who recruited the participants for this study. ATN070 was scientifically reviewed by the ATN's Behavioral Leadership Group. We would also like to thank individuals from the ATN Data and Operations Center (Westat) including Julie Davidson, MSN and Jacqueline Loeb, MBA; and individuals from the ATN Coordinating Center at the University of Alabama at Birmingham including Craig Wilson, MD; Cindy Partlow, M.Ed.; and Marcia Berck, BA. Additionally, we would like to acknowledge the thoughtful input given by participants of our national and local Youth Community Advisory Boards. Finally, our deep gratitude goes to the participants in this study whose thoughtful input made this study possible.

The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of NIDA or any of the sponsoring organizations, agencies, or the US government.