title: Alcohol Use Predicts Sexual Decision-Making: A Systematic Review and Meta-Analysis of the Experimental Literature.
abstract: Alcohol is associated with HIV and other sexually transmitted infections through increased sexual risk-taking behavior. Establishing a causal link between alcohol and sexual behavior has been challenging due to methodological limitations (e.g., reliance on cross-sectional designs). Experimental methods can be used to establish causality. The purpose of this meta-analysis was to evaluate the effects of alcohol consumption on unprotected sex intentions. We searched electronic bibliographic databases for records with relevant keywords; 26 manuscripts (k = 30 studies) met inclusion criteria. Results indicate that alcohol consumption is associated with greater intentions to engage in unprotected sex (d +s = 0.24, 0.35). The effect of alcohol on unprotected sex intentions was greater when sexual arousal was heightened. Alcohol consumption is causally linked to theoretical antecedents of sexual risk behavior, consistent with the alcohol myopia model. Addressing alcohol consumption as a determinant of unprotected sex intentions may lead to more effective HIV interventions.
authors.affiliation: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA. lori_scott-sheldon@brown.edu.|Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA. lori_scott-sheldon@brown.edu.|Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA. lori_scott-sheldon@brown.edu.
authors.forename: Lori A J
authors.initials: LA
authors.lastname: Scott-Sheldon
authors.affiliation: Center for Alcohol and Addiction Studies, Brown School of Public Health, Providence, RI, USA.
authors.forename: Kate B
authors.initials: KB
authors.lastname: Carey
authors.affiliation: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA.|Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.|Bradley/Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA.
authors.forename: Karlene
authors.initials: K
authors.lastname: Cunningham
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA.
authors.forename: Blair T
authors.initials: BT
authors.lastname: Johnson
authors.affiliation: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA.|Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.|Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Carey
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000523:psychology; D003657:Decision Making; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D033182:Intention; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D047568:Unsafe Sex / Q000523:psychology*; D055815:Young Adult
keywords: Alcohol; Experimental methods; Meta-analysis; Sexual behavior; Unprotected sex