Alcohol consumption, drug use, and condom use among STD clinic patients.
OBJECTIVE
Research on the association between substance use and sexual risk behavior has yielded a complex pattern of findings. Such inconsistent findings may reflect method variance, including factors such as gender of the participant, nature of the sexual event, partner characteristics, and type of substance used. The purpose of this study was to investigate the association between substance use and unprotected sex independently for alcohol, drugs, or combined substance use and to examine partner characteristics as a moderator of this association.


METHODS
Participants (N = 1,419; 48% women) were recruited from a publicly funded sexually transmitted disease clinic and were asked to complete an audio computer-assisted self-interview regarding their most recent sexual experience, including nature of the event, substance use, and partner characteristics.


RESULTS
Analyses showed that alcohol use was related to condom use when gender and partner type were considered; thus, for women, but not for men, partner type interacted with alcohol consumption such that condom use was less likely when alcohol consumption preceded sex with nonprimary partners (drinking was unrelated to condom use with primary partners). Subsequent analyses examining partner substance use showed that women, but not men, who reported both they and their nonprimary partners were drinking during sex were less likely to use a condom.


CONCLUSIONS
At the event level, alcohol consumption among sexually transmitted disease clinic patients is associated with condom use, but this association differs by gender and partner characteristics. Findings suggest the need to strengthen substance-use components in sexual risk reduction interventions for women and their partners.
Scott-Sheldon
Lori A J
LA
Center for Health and Behavior, Syracuse University, New York 13244-2340, USA. lajss@syr.edu
Carey
Michael P
MP
Vanable
Peter A
PA
Senn
Theresa E
TE
Coury-Doniger
Patricia
P
Urban
Marguerite A
MA
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D017280:Condoms; D003268:Contraception Behavior / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*