AIDS and Behavior

, Volume 14, Supplement 1, pp 113–125 | Cite as

The Use of Qualitative Comparative Analysis for Critical Event Research in Alcohol and HIV in Mumbai, India

  • Jean J. Schensul
  • Devyani Chandran
  • S. K. Singh
  • Marlene Berg
  • Sharad Singh
  • Kamla Gupta
Original Paper


In this paper we use Qualitative Comparative Analysis (QCA) in critical event analysis to identify under what conditions alcohol is necessary in contributing to unprotected sex. The paper is based on a set of in-depth interviews with 84 men aged 18 = 29 from three typical low income communities in Mumbai who reported using alcohol and having sex with at least one nonspousal partner once or more in the 30 days prior to the interview. The interviews included narratives of critical events defined as recent (past 30–60 day) events involving sexual behavior with or without alcohol. The paper identifies themes related to alcohol, sexuality and condom use, uses QCA to identify and explain configurations leading to protected and unprotected sex, and explains the differences. The analysis shows that alcohol alone is not sufficient to explain any cases involving unprotected sex but alcohol in combination with partner type and contextual factors does explain unprotected sex for subsets of married and unmarried men.


Alcohol HIV Scripts Critical event QCA Prevention 


  1. 1.
    Bennett LA, et al. Alcoholic beverage consumption in India, Mexico and Nigeria—a cross-cultural comparison. Alcohol Health Res World. 1998;22(4):243–52.PubMedGoogle Scholar
  2. 2.
    Demers A, Room R, Bourgault C. Surveys of drinking patterns and problems in seven developing countries. Geneva: World Health Organization; 2000.Google Scholar
  3. 3.
    Tripathi BM. Alcohol use and sexual risk behaviors across cultures: a literature review from eight countries: WHO study on determinants of sexual risk behaviors amongst alcohol users in diverse cultural settings. Geneva: WHO; 2002.Google Scholar
  4. 4.
    Akinade EA. Taking behavior and substance abuse Vis-a-Vis HIV transmission in African Societies. J Instr Psychol. 2001;28(1):3–8.Google Scholar
  5. 5.
    Fritz KE, et al. The association between alcohol use, sexual risk behavior, and HIV infection among men attending beerhalls in Harare, Zimbabwe. AIDS Behav. 2002;6(3):221–8.CrossRefGoogle Scholar
  6. 6.
    Mataure P, McFarland W. Alcohol use and high-risk sexual behavior among adolescents and young adults in Harare, Zimbabwe. AIDS Behav. 2002;6(3):211–9.CrossRefGoogle Scholar
  7. 7.
    Anderson MM, Forssman AL, Milsom I. Age of sexual debut related to life-style and reproductive health factors in a group of Swedish teenage girls. Acta Obstet Gynecol Scand. 1996;75(5):484–9.CrossRefGoogle Scholar
  8. 8.
    Mott FL, et al. The determinants of first sex by age 14 in a high-risk adolescent population. Family Plan Perspect 1996;28:113–18.Google Scholar
  9. 9.
    NJea Murray. Gender differences in factors influencing first intercourse among urban students in Chile. Int Family Plan Perspect. 1998;24(3):139.CrossRefGoogle Scholar
  10. 10.
    Ray R. South Asia: Drug Demand Reduction Report. New Delhi: UNDCP Regional Office for South Asia;1998.Google Scholar
  11. 11.
    Dunn MD, Bartee RT, Perko MA. Self-reported alcohol use and sexual behaviors of adolescents. Psychological Reports92. 2003;1:339–48.Google Scholar
  12. 12.
    Malow RM, et al. Substance-abusing adolescents at varying levels of HIV risk: psychosocial characteristics, drug use, and sexual behavior. J Subst Abuse. 2001;13(1–2):103–17.Google Scholar
  13. 13.
    Dermen KH, Cooper ML. Inhibition conflict and alcohol expectancy as moderators of alcohol’s relationship to condom use. Exp Clin Psychopharmacol. 2000;8(2):198–206.CrossRefPubMedGoogle Scholar
  14. 14.
    MacDonald TK. Alcohol, sexual arousal, and intentions to use condoms in young men: applying alcohol myopia theory to risky sexual behavior. Health Psychol. 2000;19(3):290–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Morrison TC, et al. Frequency of alcohol use and its association with STD/HIV-related risk practices, attitudes and knowledge among an African-American community-recruited sample. Int J STD AIDS. 1998;9(10):608–12.CrossRefPubMedGoogle Scholar
  16. 16.
    Stall R, et al. Alcohol and drug-use during sexual-activity and compliance with safe sex guidelines for aids—the aids behavioral-research project. Health Educ Q. 1986;13(4):359–71.PubMedGoogle Scholar
  17. 17.
    Morris RE, Anderson MM, Knox GW. Incarcerated adolescents’ experiences as perpetrators of sexual assault. Arch Pediatr. 2002;156(8):831–5.Google Scholar
  18. 18.
    Kalichman SC, Heckman T, Kelly JA. Sensation seeking as an explanation for the association between substance use and HIV-related risky sexual behavior. Arch Sex Behav. 1996;25(2):141–54.CrossRefPubMedGoogle Scholar
  19. 19.
    Kalichman SC, Kelly JA, Rompa D. Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services. Health Psychol. 1997;16(4):369–73.CrossRefPubMedGoogle Scholar
  20. 20.
    Calzavara LM, Coates RA, Raboud JM, et al. Ongoing high-risk sexual behaviors in relation recreational drug use in sexual encounters. Analysis of 5 years of data from the Toronto Sexual Contact Study. Ann Epidemiol. 1993;3(3):272–80.PubMedGoogle Scholar
  21. 21.
    Godin G, Savard J, Kok G, Fortin C, Boyer R. HIV seropositive gay men: understanding adoption of safe sexual practices. AIDS Educ Prev. 1996;8(6):529–45.PubMedGoogle Scholar
  22. 22.
    Gold RS, Skinner MJ. Situational factors and thought processes associated with unprotected intercourse in young gay men. AIDS. 1992;6(9):1021–30.CrossRefPubMedGoogle Scholar
  23. 23.
    Leigh BC. The relationship of substance use during sex to high-risk sexual-behavior. J Sex Res. 1990;27(2):199–213.CrossRefGoogle Scholar
  24. 24.
    Leigh BC, Stall R. Substance use and risky sexual-behavior for exposure to HIV—issues in methodology, interpretation, and prevention. Am Psychol. 1993;48(10):1035–45.CrossRefPubMedGoogle Scholar
  25. 25.
    Gilmore S, DeLamater J, Wagstaff D. Sexual decision making by inner city black adolescent males: a focus group study. J Sex Res. 1996;33(4):363–71.CrossRefGoogle Scholar
  26. 26.
    Maxwell JA. Using qualitative methods for causal explanation. Field Methods. 2004;16(3):243–64.CrossRefGoogle Scholar
  27. 27.
    Miethe TD, Drass KA. Exploring the social context of instrumental and expressive homicides: an application of qualitative comparative analysis. J Quant Criminol. 1999;15(1):1–21.CrossRefGoogle Scholar
  28. 28.
    Schweitzer T. Actor and event orderings across time: latice representation and Boolean analysis of the political disputes in Chen Village, China. Social Netw. 1996;18:247–66.CrossRefGoogle Scholar
  29. 29.
    Fuzzy-Set/Qualitative Comparative Analysis [computer program]. Version 2.0. Tucson, AZ: Department of Sociology, University of Arizona; 2006.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jean J. Schensul
    • 1
  • Devyani Chandran
    • 2
  • S. K. Singh
    • 3
  • Marlene Berg
    • 1
  • Sharad Singh
    • 3
  • Kamla Gupta
    • 3
  1. 1.Institute For Community ResearchHartfordUSA
  2. 2.School of Social Work, St. Olaf CollegeNorthfieldUSA
  3. 3.International Institute For Population SciencesMumbaiIndia

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