title: Intoxication before intercourse and risky sexual behavior in male veterans with and without human immunodeficiency virus infection.
abstract: BACKGROUND
  Male veterans represent a large population at risk for acquiring or transmitting human immunodeficiency virus (HIV) infection. We sought to determine the prevalence of risky sexual behavior among veterans with and without HIV infection and to assess the relationship of intoxication before intercourse and other measures of drug and alcohol use to risky sexual behavior in this population.
  
  
  METHODS
  We analyzed baseline data on 1009 HIV-positive (mean age 49 years) and 710 HIV-negative male veterans (mean age 55 years) who were participating in the Veterans Aging Cohort 5-Site Study (VACS 5). Participants completed a written questionnaire that included measures of alcohol and drug use and risky sexual behavior.
  
  
  RESULTS
  Compared with HIV-negative veterans, HIV-positive veterans were more likely to report 5 or more sexual partners in the past year (14% vs. 4%, P < 0.01), less likely to report not using a condom at last intercourse (25% vs. 75%, P < 0.01), and similarly likely to report having 2 or more partners and inconsistent condom use (10% vs. 10%). Among sexually active HIV-positive veterans, intoxication before intercourse was significantly associated with having 5 or more sexual partners in the past year (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.1-2.8), inconsistent condom use (OR 1.8, 95% CI 1.2-2.7), and the combined measure of 2 or more partners and inconsistent condom use (OR 1.8, 95% CI 1.1-3.0). Intoxication before intercourse was not significantly associated with these behaviors in HIV-negative veterans, although similar trends were noted.
  
  
  CONCLUSIONS
  Risky sexual behavior was common among male veterans attending outpatient clinics and is more common among HIV-positive veterans who use alcohol and drugs in sexual situations. Asking HIV-positive men a single question about intoxication before intercourse could help to identify men at increased risk of engaging in risky sexual behavior, and specific advice to avoid intoxication in sexual situations could help to reduce risky sexual behavior.
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. cookrl@upmc.edu
authors.forename: Robert L
authors.initials: RL
authors.lastname: Cook
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: McGinnis
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kraemer
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Gordon
authors.forename: Joseph
authors.initials: J
authors.lastname: Conigliaro
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Maisto
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
authors.forename: Stephen
authors.initials: S
authors.lastname: Crystal
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.forename: Kendall J
authors.initials: KJ
authors.lastname: Bryant
authors.forename: R Scott
authors.initials: RS
authors.lastname: Braithwaite
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
mesh_terms: D015331:Cohort Studies; D003075:Coitus; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014728:Veterans