title: Daily associations between alcohol use and unprotected anal sex among heavy drinking HIV-positive men who have sex with men.
abstract: Men who have sex with men (MSM) account for the largest proportion of new HIV infections in the United States. Alcohol may facilitate HIV transmission by increasing unprotected anal sex, but few studies have focused on transmission behaviors in HIV-positive MSM. This study explored daily associations between alcohol use and sexual behavior among heavy drinking HIV-positive MSM using a 30-day Timeline Followback interview. Results of generalized estimating equations indicated that greater alcohol consumption on a given day was associated with a linear increase in the odds of having unprotected anal sex with partners of any HIV status. However, the odds of reporting unprotected anal sex with HIV-negative or HIV-status unknown partners increased in a curvilinear fashion, occurring primarily at very heavy levels of use (12+ drinks). Results suggest that very heavy drinking increases the risk of engaging in sexual behavior that has the potential for transmitting HIV to other men.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA, Christopher_Kahler@brown.edu.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kahler
authors.forename: Tyler B
authors.initials: TB
authors.lastname: Wray
authors.forename: David W
authors.initials: DW
authors.lastname: Pantalone
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Kruis
authors.forename: Nadine R
authors.initials: NR
authors.lastname: Mastroleo
authors.forename: Peter M
authors.initials: PM
authors.lastname: Monti
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology*; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology / Q000635:transmission*; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*