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Research Summary

More Evidence Heavy Episodic Drinking Heightens HIV/STI Risk

Heterosexual African American males are disproportionately affected by HIV, and their heightened risk is not well explained. To determine whether heavy episodic alcohol use is associated with risky sexual behaviors and HIV/STI* diagnosis, researchers conducted a cross-sectional study of 617 black men age 18–65 whose sex partners were exclusively women and who reported having sex with 2 or more partners in the past year. Participants were recruited from primary and urgent care clinics in Boston. Thirty-four percent of participants reported heavy episodic drinking in the past 30 days, and 45% reported past 30-day illicit drug use. Associations between heavy episodic drinking, risky sex practices, and HIV/STI diagnoses were tested in multivariable logistic regression models controlling for age, illicit drug use, homelessness, employment, incarceration history, and current main partner.

  • Participants with heavy episodic drinking were more likely to have unprotected vaginal or anal sex with women other than their main partner (adjusted odds ratio [AOR], 1.7 and 2.3, respectively) and to be involved in sex trade (AOR, 2.1).
  • Participants with heavy episodic drinking were more likely to have had a recent (past 6-month) HIV or STI diagnosis (AOR, 1.9).
  • Heavy episodic drinking was not associated with unprotected sex with main partners.
*Human immunodeficiency virus/sexually transmitted infections.


Heavy episodic drinking and its impact on unprotected sex with non-main partners is potentially a key behavior amenable to intervention by clinicians. Offering specific counseling to reduce drinking and increase use of protection with non-main partners in patients with heavy episodic alcohol use may reduce HIV/STI risk.

Hillary Kunins, MD, MPH, MS


Raj A, Reed E, Santana MC, et al. The associations of binge alcohol use with HIV/STI risk and diagnosis among heterosexual African American men. Drug Alcohol Depend.2009;101(1–2):101–106.