AIDS and Behavior

, Volume 19, Issue 3, pp 422–430 | Cite as

Daily Associations Between Alcohol Use and Unprotected Anal Sex Among Heavy Drinking HIV-Positive Men Who Have Sex with Men

  • Christopher W. KahlerEmail author
  • Tyler B. Wray
  • David W. Pantalone
  • Ryan D. Kruis
  • Nadine R. Mastroleo
  • Peter M. Monti
  • Kenneth H. Mayer
Original Paper


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.


Sexual risk behavior Men who have sex with men Alcohol HIV-positive 


Los hombres que tienen relaciones sexuales con hombres (HSH) representan la mayor proporción de nuevos casos de VIH en los Estados Unidos. El uso de alcohol puede facilitar la transmisión del VIH mediante el aumento de relaciones sexuales anales sin protección, pero pocos estudios se han enfocado en estos comportamientos entre HSH VIH-positivo. Este estudio exploró asociaciones diarias entre el consumo de alcohol y la conducta sexual entre HSH VIH-positivo utilizando la entrevista Timeline Followback de 30 días. Los resultados de las Ecuaciones de Estimación Generalizadas (GEE) indicaron que el mayor consumo de alcohol en un día determinado es asociado con un aumento lineal en las probabilidades de tener sexo anal sin protección sin importar si la pareja es portadora de VIH o no. Sin embargo, las probabilidades de informar sobre el sexo anal sin protección con parejas VIH-negativas o VIH estatus desconocido aumentó de forma curvilínea, ocurriendo principalmente durante situaciones de muy alto uso de alcohol (12 tragos o más). Los resultados sugieren que altos consumos de alcohol aumentan el riesgo de involucrarse en conductas sexuales que tiene el potencial de transmitir el VIH a otros hombres.

Palabras claves

Conductas sexuales de riesgo Hombres que tienen relaciones sexuales con hombres Alcohol VIH-positivo 



The study was supported by Grants P01AA019072 and T32AA007459 from the National Institute on Alcohol Abuse and Alcoholism.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Christopher W. Kahler
    • 1
    Email author
  • Tyler B. Wray
    • 1
  • David W. Pantalone
    • 2
    • 3
  • Ryan D. Kruis
    • 2
  • Nadine R. Mastroleo
    • 1
  • Peter M. Monti
    • 1
  • Kenneth H. Mayer
    • 2
    • 4
  1. 1.Center for Alcohol and Addiction StudiesBrown University School of Public HealthProvidenceUSA
  2. 2.The Fenway InstituteFenway HealthBostonUSA
  3. 3.University of Massachusetts BostonBostonUSA
  4. 4.Beth Israel Deaconess Medical Center/Harvard Medical SchoolBostonUSA

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