Expectancies of sexual "escape" and sexual risk among drug and alcohol-involved gay and bisexual men.
OBJECTIVE
We tested the hypotheses that sexual risk would relate to gay/bisexual men's patterns of combining alcohol or drugs with sex, their motivation to use drugs to cognitively "escape" awareness of HIV risk, and their use of bars as social and sexual settings.


METHODS
We conducted extensive interviews among African-American (n = 139) and White (n = 112) gay and bisexual men who were attending a behavioral intervention for safer sex results. Those who frequently combined drugs with sex reported higher rates of sexual risk and Hepatitis B infection than did men who infrequently combined substances with sex, or who combined only alcohol with sex. Sexual risk was pronounced among more frequent drug users who also reported strong expectancies that alcohol or drugs facilitate sex and cognitively escape from awareness of HIV risk. Frequenting bars per se was not an important factor in sexual risk.


CONCLUSIONS
Men who use alcohol or drugs to enhance sexuality and escape self-awareness of HIV risk have a significantly diminished capacity to avoid sexual risk.
McKirnan
D J
DJ
Department of Psychology, University of Illinois at Chicago, m/c 285, 1007 West Harrison Street, Chicago, IL 60607-7137, USA. davidmck@uic.edu
Vanable
P A
PA
Ostrow
D G
DG
Hope
B
B
D000328:Adult; D001741:Black or African American; D001727:Bisexuality / Q000523:psychology*; D003042:Cocaine / Q000009:adverse effects*; D003717:Denial, Psychological; D015658:HIV Infections / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D009609:Nitrous Oxide / Q000009:adverse effects*; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires
D003042:Cocaine; D009609:Nitrous Oxide