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Research Summary

Alcohol Use and Unsafe Sex by People With HIV

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% of patients had been sexually active, 38% had unprotected sex (i.e., no condom), and 21% 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% 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.


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 longitudinal studies that demonstrate the temporal relationship between the two behaviors. Nevertheless, these findings support the case for assessing alcohol use among all patients with HIV.

Jeffrey H. Samet, MD, MA, MPH
*>=5 drinks per day for men, >=3 drinks per day for women
**>=1 binge episode, or >14 drinks per week for men and >7 drinks per week for women


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.