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.

Comments:

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

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.