Alcohol Use and Sexual Risk Behavior Among Human

Background: This study was undertaken to determine if alcohol use is associated with sexual risk taking among human immunodeficiency virus (HIV)–infected persons. Methods: Cross-sectional interviews of 262 HIV-infected patients in the Brown University AIDS Pro-gram were performed. Factors associated with any sexual activity, unsafe sexual activity, and a 4-fold typology of sexual risk were examined. Alcohol measures included drinking days, drinks per drinking day, binge drinking, and hazardous alcohol use. Results: The sample was 58%male and 40 % white; 67 % of patients were self-identified as heterosexual, and 48 % drank alcohol. Nearly two thirds of patients reported sexual activity in the past 6 months, with 38% reporting unprotected sex during that period. All measures of alcohol use were significantly associated with any sexual activity and with unsafe sexual behavior. As an example, controlling for age, HIV transmission risk, marital status, and HIV clinical indicators, hazardous drinkers were 5.64 times more likely to report unprotected sex and have multiple partners (p 0.01) than were those not drinking at hazardous levels. Conclusions: A high proportion of HIV-infected persons were sexually active and having unsafe sex. Alcohol, at all levels of use, was associated with increased sexual risk taking. Key Words: Alcohol, HIV Sexual Risk. ALCOHOLUSEMAY influence high-risk sexual behav-ior in a variety of populations (Graves and Leigh, 1995; Woods et al., 1996; Strunin, 1999). Alcohol use is commonly associated with unprotected sexual relations among populations at particular risk for human immuno-deficiency virus (HIV), contributing to risky sexual behav-ior among men who have sex with men (Penkower et al., 1991), drug users (Stein et al., 2000; Stein et al., 2001), young adults (Seage et al., 1998), and men seeking mental health and prevention services (Kalichman et al., 1997). Among people living with HIV infection, unsafe sexual behavior remains prevalent as documented by both self-report and laboratory tests for sexually transmitted infec